Tag Archives: mali

Mali on Track to Eliminate Trachoma by 2015

 

By Wangechi Thuo and Andrew Carlson 

The Community Eye Health Journal announced in November that the National Blindness Prevention Programme (PNLC) in Mali, established in 1998, is on track to eliminate trachoma as a cause of blindness by 2015.

Trachoma is a bacterial disease that is transmitted through flies that come into contact with infected people or person to person contact. In areas where people live in close proximity, the disease spreads at an alarming rate, and can quickly infect entire communities. Repeated infection causes eyelids to turn inward and scratch the cornea, leaving an infected individual one unbelievably painful step closer to blindness with every blink they take, a process called trachomatous trichiasis. In 2011 the WHO estimated that 7,260,960 people around the world had this form of trichiasis.

Just before PNLC’s inception, Mali bore a generous portion of the global burden: during a national survey conducted in February 1996-May 1997, an estimated 85,700 people needed trichiasis surgery.

Since then, thanks to a strong commitment by the government of Mali, the PNLC has consolidated support from various partners, including The Carter Center, Helen Keller International (HKI), the United Stated Agency for International Development (USAID) managed by RTI international, The END Fund, and the International Trachoma Initiative (ITI). The PNLC has set a high standard in trachoma elimination that similar national initiatives throughout sub-Saharan Africa strive to emulate.

Three important benchmarks help explain how Mali has achieved this success:

  • Distribution of antibiotics: Through district-level mass drug administration, the PNLC has reduced active disease well below the recommended threshold in 84% of the districts in which the disease is present
  • Surgical Efficiency: Since 2009, the PNLC almost halved the surgical backlog throughout the country; in 2011 alone, 8,510 trichiasis surgeries were conducted by only a handful of surgeons
  • Preventive sanitation: Since 2009, 53,090 latrines have been constructed allowing safer disposal of waste

To foster community awareness, the PNLC has developed a primary school curriculum on trachoma, trained community leaders in trachoma prevention and ensured the dissemination of health messages through radio broadcasts with help from HKI.

PNLC’s successes are even more laudable as they were achieved in spite of the military coup d’état in March 2012, which elicited a considerable decrease in financial support to the Malian government.

With support from partners, Mali is less than one year away from achieving the goal of trachoma elimination and is positioned to celebrate this achievement, five years ahead of the global elimination date. Mali’s success story and lessons learned can provide can also be example for more countries throughout the world.

Ownership of Treatment Efforts for NTDs in Mali

Community drug distributors in Cinzana, Mali prepare for mass drug distribution. Photo ©HKI.

As it takes a village to raise a child, it takes a community to control and eliminate NTDs. In Mali’s Segou Region resides Cinzana, a town made of 39 villages with 15,000 inhabitants with a high number of NTD cases. Diseases suffered by the area include trachoma, schistosomiasis, soil-transmitted helminthiasis, and lymphatic filariasis. Fortunately, Mali is one of 12 countries supported by an initiative funded by USAID called the NTD Control Program. Beginning in 2007, the Program partnered with the country’s Ministry of Health to distribute drugs and treatment to control NTDs. In Cinzana, distribution is conducted by a community group comprised of volunteers. Effective delivery of drugs to each infected individual can pose as a lofty endeavor. Limited resources and poor road infrastructures act as barriers to getting drugs to individuals in the outskirts of Cinzana, and becomes an even greater obstacle during the rainy seasons.

Despite these challenges, the NTD Control Program has been highly successful. By the end of 2009, the entire area of Cinzana received treatment. Much of this success is attributed to the community’s willingness to participate and be a part of the Program’s activities. Volunteers quickly recognized that effective distribution could only be reached if there was a large number of community drug distributors (CDDs). Thus, one of Cinzana’s economic interest groups, the Association of Community Health (ASACO), garnered the support of 200 much needed CDDs. In addition to the increase of CDDs, ASACO along with Mali’s government also provided more resources conducive to effective disease control such as notebooks, pens, and dosing poles, which are wooden tools used to identify the correct drug dosage for each individual.

Through community involvement and participation, Cinzana was able to reach 100% geographic coverage rates. Cinzana pledges to continue its diligence and dedication to the work of the NTD Control Program, working toward reaching goals and controlling NTDs.

To do your part in controlling and eliminating NTDs, please visit the Global Network website to get involved.

Support for NTD control in Mali is provided by USAID through a grant to Helen Keller International. Program activities are a part of the NTD Control Program led by RTI International. For more information, please visit http://ntd.rti.org/.

Reading List 3/18/10

Today we’re reading a couple of pieces about the ongoing fight against Guinea worm, including a rather encouraging piece out of Mali, and a profile of the director of USAID.

MALI: Hoping to eradicate guinea worm in two years, IRIN Africa

Parasite lost: Exterminating Africa’s horror worms, Debora MacKenzie, New Scientist

USAID Administrator Rajiv Shah outlines priorities, role for business, Kristi Heim, Seattle Times