Conclusions & Recommendations

TEC notes that there is continued difficulty in making evidence-based decisions in the context of refugees and internally-displaced persons (IDPs), which indicates the need for clarification of the decision-making guidelines

The TEC considered whether a survey in a fluid population provides any actionable information; and recognizes other methodologies that allow more flexibility and context-specific data capture may be needed. The experience of other programs working in similar situations may be instructive to the trachoma community in determining the necessary indicators to allow ITI to determine the point when MDA with Zithromax® is no longer needed.

The TEC Refugee/IDP Committee will think through these issues and bring thinking to the next TEC meeting for further consideration, particularly around the issue of data gathering in these populations. The Committee is now comprised of Chad, Robin, Stephanie, and David.

Given the lack of funding support for the Central African Republic trachoma program, TEC recommends to ITI to encourage the national program to submit a funding request to ESPEN for MDA.

TEC recognizes the difficulty in interpreting the survey results in Korhogo, where baseline surveys were conducted at the same time as administrative redistricting resulting in a poor match of survey evaluation units and administrative districts. TEC approved the application for one round of MDA followed by impact surveys for the entirety of each of the new Korhogo districts (Korhogo 1, Korhogo 2, Dikodougou, Mbengue, Sinematiali). The TEC recommends to the NTD program of Côte d’Ivoire that impact surveys be conducted along the new administrative unit structures and not the previous survey evaluation units.

Continue to monitor actual ratio of POS and tablets reported to be administered by countries, and report back to TEC.

TEC welcomed the presentation on Crown Agents’ plans and encourages them to successfully implement without delays.

TEC recommends that ITI continue to invite high level representation from Crown Agents at future TEC meetings.

The TEC recognizes the challenges facing the Americas to eliminate trachoma particularly among indigenous populations in the Amazon Basin. The TEC recommends that ITI consult with PAHO to identify areas of technical and/or financial support within the ITI mandate that would support PAHO in its leadership role in trachoma elimination.

TEC recommends that ITI send a high-level delegation to Colombia (including PAHO and TEC liaison) to discuss with the Ministry of Health the MDA strategy and delivery of the donation program, to determine:
-the baseline survey sampling frame
-the basis by which communities are targeted for treatment or excluded from treatment
-plans to evaluate program impact
-how coverage is reported
-whether the populations are static or migratory, and if migration crosses departmental or country borders
-whether funding is available for treatments and surveys