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  • ITI supports country programs to make their own determination when they are ready to restart field activities (surveys and/or MDA) in the context of the COVID-19 pandemic. ITI stands ready to provide Zithromax® when MDA is restarted.

  • The TEC reflected on their principle that the Zithromax® donation is based on demonstrated evidence of need. If it is safe to conduct field activities, scheduled impact surveys should be conducted prior to potential MDA so that the normal data-driven process is not interrupted.

  • TEC recognizes that coronavirus safety adaptations may be required to complete surveys. Such adaptations would ideally be agreed between partners and the Ministry of Health prior to implementation.

  • Following a survey, if drug is warranted ITI will ship the drug for those MDAs.

  • TEC recognizes that there may be a need for mitigation in hyper-endemic areas that warrant continued treatment. TEC would be prepared to review reasonable and evidence-based requests from national programs for additional Zithromax® that conform to local policy and regulatory standards.


This recommendation was further considered during the TEC 23 meeting and at a meeting of TEC members and invited experts on May 11th, 2021. An update will be provided at the TEC 24 meeting.


  • The TEC noted that there are still areas that are unmapped – due in part to insecurity, access issues, and lack of funding (e.g., DRC, South Sudan, Lake Chad Basin [Chad and Nigeria], Amazon Basin).

  • TEC also raised concerns over “statistically invisible” populations (e.g., migratory populations, refugees, internally displaced persons) which are not adequately represented/sampled in current survey methodologies to ensure equitable access to the Zithromax® donation and surgical services.

  • Lack of MDA partners and funding source in these areas is an added challenge.

  • The TEC raised concerns about how to encourage progress towards elimination in these areas, and how to ensure that ongoing transmission in these areas doesn’t affect surrounding areas that are under treatment. The TEC recommended that ITI include details about suspected endemic areas in country documents and presentations at future TEC meetings; discuss with countries with unmapped areas to understand the support they need; discuss with ICTC how to mobilize funding and partners and develop an approach to get the mapping done.


Work on this recommendation is ongoing. As noted above, districts identified by national programs as suspected endemic have been noted in the “Comments” column of the Zithromax®️ Application.

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