Conclusions & Recommendations

TEC acknowledges the need for robust surveillance to ensure the investments made to date are not lost; however, the required surveillance is not at present clear and there is a need to clarify this.

There are several steps that need to be taken to clarify the bigger picture, and ITI has a role to play itself and in collaboration with other partners.

Surveillance should be a theme in upcoming ITI-supported regional meetings and in discussions with Ministry of Health colleagues.

While ITI closely manages final shipments based on inventory reports to minimize drug remaining in country, there is likely to still be some donated Zithromax® in-country after MDA stops. Countries should be reminded of the ICTC Transition manual

TEC recommends that ITI trial: extending the MOU with the country beyond the end of shipments; conducting a ‘close out’ supply chain assessment in transitioning countries

TEC recommends to ITI Management: Reconsider the layout of the agenda to increase clarity around timing of topics to be addressed.

TEC recommends to ITI Management: On Applications:
-Instead of using the term “Elimination achieved”, use the term “TF threshold achieved” for districts where surveillance surveys are TF1-9 < 5%
-Change “Cumulative distributions” column to “Total number of MDAs from 20XX to present” and include a total count of all MDAs
-Highlight TT values ≥0.2 threshold

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®.