First Meeting Of The Who Strategic And Technical Advisory Group Working Group On Access To Safe Efficacious And Quality Assured Health Products For Neglected Tropical Diseases

The STAG Working Group on access to safe, efficacious and quality-assured health products for neglected tropical diseases was established in 2021 to facilitate alignment of stakeholders on strategies and best practices for improving access to medicines and other health products for NTDs. The Working Group held its second technical meeting virtually on 19 September 2023. The main outcomes of the meeting were to expand the scope of drug efficacy monitoring to include other neglected tropical diseases and to seek synergy in addressing common issues and challenges across diseases for procurement and supply chain management. In addition to the Working Group’s members, observers, invited guests and the WHO secretariat attended the meeting. This publication contains the report of the meeting and its recommendations to STAG, which will be helpful as a reference and of use to the wider NTD community.

"The presence, or absence, of neglected tropical diseases (NTDs) can be seen as a proxy for poverty and for the success of interventions aimed at reducing poverty. Today, coverage of the public-health interventions recommended by the World Health Organization (WHO) against NTDs may be interpreted as a proxy for universal health coverage and shared prosperity - in short, a proxy for coverage against neglect. As the world's focus shifts from development to sustainable development, from poverty eradication to shared prosperity, and from disease-specific goals to universal health coverage, control of NTDs will assume an important role towards the target of achieving universal health coverage, including individual financial risk protection. Success in overcoming NTDs is a "litmus test" for universal health coverage against NTDs in endemic countries. The first WHO report on NTDs (2010) set the scene by presenting the evidence for how these interventions had produced results. The second report (2013) assessed the progress made in deploying them and detailed the obstacles to their implementation. This third report analyses for the first time the investments needed to achieve the scale up of implementation required to achieve the targets of the WHO Roadmap on NTDs and universal coverage against NTDs. INVESTING TO OVERCOME THE GLOBAL IMPACT OF NEGLECTED TROPICAL DISEASES presents an investment strategy for NTDs and analyses the specific investment case for prevention, control, elimination and eradication of 12 of the 17 NTDs. Such an analysis is justified following the adoption by the Sixty-sixth World Health Assembly in 2013 of resolution WHA6612 on neglected tropical diseases, which called for sufficient and predictable funding to achieve the Roadmap's targets and sustain control efforts. The report cautions, however, that it is wise investment and not investment alone that will yield success. The report registers progress and challenges and signals those that lie ahead. Climate change is expected to increase the spread of several vector-borne NTDs, notably dengue, transmission of which is directly influenced by temperature, rainfall, relative humidity and climate variability primarily through their effects on the vector. Investments in vector-borne diseases will avoid the potentially catastrophic expenditures associated with their control. The presence of NTDs will thereby signal an early warning system for climate-sensitive diseases. The ultimate goal is to deliver enhanced and equitable interventions to the most marginalized populations in the context of a changing public-health and investment landscape to ensure that all peoples affected by NTDs have an opportunity to lead healthier and wealthier lives."--Publisher's description.

The sixteenth (hybrid) meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases (STAG-NTD) was held on 27–28 September 2022. Presentations were given on (i) progress since the last meeting from the Director, WHO regions and partners, (ii) the impact of the coronavirus disease (COVID-19) pandemic on NTD programmes and (iii) global support to NTD programmes. A number of recommendations were made in relation to lessons learnt from COVID-19, on advocacy and financing, for specific NTDs and on diagnostics. Four departing members were appreciated for their contribution to the STAG-NTD. The next (seventeenth) meeting of the STAG-NTD will be held in 2023.

The fifth meeting of the WHO Diagnostic Technical Advisory Group for Neglected Tropical Diseases (DTAG) was held in November 2022. The DTAG was established in 2019 to address gaps in NTD diagnostics through a harmonized approach for identifying and prioritizing diagnostic needs, and to inform WHO strategies and guidance on NTD diagnostics. The meeting addressed the end-to-end process of diagnostic development, including regulatory pathways, as we all as advocacy and resource mobilization, and engagement of diagnostics manufacturers and developers. The DTAG and its disease-specific and cross-cutting subgroups have supported and facilitated the development of several target product profiles for selected NTDs to address the critical diagnostic gaps.

The Diagnostic Technical Advisory Group (DTAG) for the WHO Global NTD Programme was formed to foster a unified approach for identifying and prioritizing diagnostic needs, and to inform WHO strategies and guidance on NTD diagnostics. The first meeting of the DTAG was held at the Inter Parliamentary Union in Geneva, Switzerland, in October 2019. The second took place virtually in October 2020, the third in June 2021, the fourth in October 2021 and the fifth in November 2022. Several disease-specific and cross-cutting DTAG subgroups have been formed, resulting in the development of target product profiles (TPPs) for new diagnostics, some of which have been published, and some of which are in production. WHO/NTD convened the sixth DTAG meeting on 14 and 15 February 2024, with the following objectives across the end-to-end process of diagnostic development: -consider updates from disease-specific subgroups and TPP production; -discuss progress made by the cross-cutting and resource mobilization subgroups; -discuss the Expert Review Panel for Diagnostics (ERPD) NTD pilot project and lessons learnt; -discuss engagement of manufacturers and developers; -discuss laboratory capacity strengthening and standardization of molecular methods; -deliberate on the priority/focus areas of engagement for the DTAG for the next 2 years.

"Neglected tropical diseases (NTDs) blight the lives of a billion people worldwide and threaten the health of millions more. These ancient companions of poverty weaken impoverished populations, frustrate the achievement of health in the Millennium Development Goals and impede global health and economies has convinced governments, donors, the pharmaceutical industry and other agencies, including nongovernmental organizations (NGOs), to invest in preventing and controlling this diverse group of diseases. Global efforts to control "hidden" diseases, such as dracunculiasis (guinea-worm disease), leprosy, gains including the imminent eradication of dracunculiasis. Since 1989 (when most endemic countries began reporting monthly from each endemic village), the number of new dracunculiasis cases has fallen from 892 055 in 12 endemic countries to 3190 in 4 countries in 2009, a decrease of more than 99%. The World Health Organization (WHO) recommends five public-health strategies for the prevention and control of NTDs: preventive chemotherapy; intensified case-management; vector control; the provision of safe water, sanitation and hygiene; and veterinary public health (that is, applying veterinary sciences to ensure the health and well-being of humans). Although one approach and delivered locally." - p. vii