Conclusions & Recommendations

TEC notes that for 2020, 14.5 million treatments in 86 districts were approved contingent on confirmation of funding where the presumed funding source is DFID/Ascend-Crown Agents, and where implementing partners are not yet identified. Given that Crown Agents is a new entity in the implementation of NTD programs, TEC recommends that ITI work closely with DFID-Ascend and Crown Agents to identify funding needs, support the inception phase, and identify where future assistance may be required.

TEC acknowledged the presence of the World Health Organization representatives from Headquarters, PAHO, and ESPEN/AFRO and recommend that an open invitation be extended to them (and other WHO Regional Offices, as appropriate) as Observers at future TEC meetings.

TEC recommends to ITI management to invite supply chain and management representatives from the other NTD pharmaceutical donors to future Summer TEC meetings.

TEC recommends that the ITI Supply Chain team finalize and share their SOPs and other supply chain tools with other NTD programs.

TEC congratulates the ITI Supply Chain team for their work in building supply chain capacity in donation countries. Their presentations on the supply chain strengthening plan, and actions undertaken and follow up in some countries were extremely clear and informative. They are requested to share their plans and collaborate with partners who have similar activities in their budgets.

TEC recommends a multi-pronged approach to address challenges in the Niger program:
- An independent external NTD program assessment (funded by ITI) to fully understand the factors at all levels resulting in delayed MDAs and poor coverage;
- High-level meetings and advocacy by partners, including USAID, DFID, and ITI as donors, to review the challenges and identify opportunities for improved planning, coordination, and implementation.

TEC noted with concern the challenges in the Niger trachoma program over the years that may have compromised progress towards elimination. These include low reported coverage and skipped and/or delayed MDAs. As a result, TEC is concerned about the use of donated Zithromax®, which could put future donations at risk.

TEC congratulated Niger MOH and ITI for their collaboration in improving supply chain management in-country, and for the efforts toward cross-border collaboration with Nigeria to prevent unauthorized movement of NTD drugs.

TEC recommends that ITI follow up with the Colombian MOH and PAHO to understand the program’s trachoma elimination strategy and the challenges they face in identifying program funding. While awaiting that clarity, the TEC is deferring review of Colombia’s 2020 Application for donated Zithromax®.

TEC notes the progress in collaboration between the Kenya and Uganda Ministries of Health, donors, and implementing partners to address the challenges to trachoma control posed by cross-border migration by pastoralists, and encourage them to further these efforts. TEC recommends that ITI continue to support the regional cross-border meetings that facilitate these collaborations.