Despite great progress in elimination and control of neglected tropical diseases, new tools and strategies are needed to overcome emerging challenges and guide both programmatic decision-making and post-intervention disease surveillance. To this end, U.S. Agency for International Development (USAID) is committed to supporting the following five operations research goals:
HEALTH RESEARCH GOALS
- Support innovative approaches in disease mapping
- Develop new laboratory diagnostics and tools
- Support best practices for monitoring and documenting progress toward elimination
- Develop tools to manage morbidity
- Deliver a macrofilaricide for onchocerciasis and lymphatic filariasis
To achieve expansion of MDA to populations in need, USAID’s country-level support has focused on addressing key programmatic questions and employing appropriate responses: Mapping, Monitoring Progress, and Evaluation.
In 2014, USAID joined the The Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD). Through a Global Development Alliance with the Bill & Melinda Gates Foundation, COR-NTD enables a broader reach with input from country programs for global coordination across the research spectrum, and aims to remove barriers and accelerate progress toward the WHO 2020 NTD goals.
Through this rapid-response granting mechanism, USAID has facilitated partnerships between implementers of the USAID mass drug administration (MDA) programs with U.S. and foreign academic research institutions, and National NTD Programs. Currently, the COR-NTD project supports operational research in the following areas: innovative approaches in NTD mapping; improved program monitoring and evaluation (M&E); best practices for documenting elimination; and tools to manage morbidity.
The USAID NTD Program is developing a macrofilaricidal drug (to kill adult worms before they can cause morbidity) for use in individual case management and eventually, as an alternative preventive treatment in filariasis and onchocerciasis MDA programs. A macrofilaricidal drug could reduce the number of MDA cycles needed for these diseases, thereby easing program implementation and enhancing chances of disease elimination. Additionally, certain “hot spots” or disease foci in very remote areas with very high disease burden and inadequate programmatic support could benefit from such a drug. Ongoing investments aim to measure efficacy using novel technologies and down-selecting from new drug targets and repurposed existing drugs.
The USAID NTD Program is investing in the advancement of new newly developed laboratory tools and their performance evaluation in national NTD programs for lymphatic filariasis (LF), trachoma, onchocerciasis, and schistosomiasis. Validation of these newly developed assays will ensure that programs have sensitive and specific diagnostic tools and survey methodologies for using their deployment to make decisions about stopping MDA and conducting post-MDA surveillance. These new tools aim to bring laboratory confirmed diagnostics, which once were confirmed to central laboratories, to the point-of-care itself, which can provide data for decision-making in real-time, and save in field operation costs.