Conclusions & Recommendations

TEC recommends to ITI Management: TEC Liaisons should present all Applications in the future

TEC recommends to ITI Management: Include prevalence shading for border districts in surrounding countries on all future country prevalence maps. Add border country names.

TEC recommends to ITI Management: TEC recommends ITI use caution with language about “elimination achieved” or “countries coming off the program” to not send confusing messages to countries and the broader trachoma community.

TEC recommends to ITI Management: TEC requests ITI to create concise reference guidelines of key decisions and principles as reminders for future Zithromax® donation decision making.

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.

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 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 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 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 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.