Neglected tropical diseases (NTDs) are a group of infectious diseases that thrive in poor and rural settings, affecting 1.6 billion of the world’s poorest and most vulnerable people, including 850 million children.

Accelerating the Sustainable Control and Elimination of Neglected Tropical Diseases (ASCEND) is a new programme funded by the UK Department for International Development to control and eliminate NTDs in 12 countries, including Ethiopia, Kenya, Malawi, Mozambique, Sudan, South Sudan, Tanzania, Uganda, Zambia, India, Bangladesh, and Nepal.

The programme targets five NTDs: lymphatic filariasis, onchocerciasis, schistosomiasis, visceral leishmaniasis and trachoma. If left untreated, they can lead to disability, disfigurement, stigma and death.

Led by Crown Agents, the programme is being implemented by a consortium of KIT Royal Tropical Institute, Oriole Global Health, and Abt Associates.

Emphasising sustainability

ASCEND’s long-term objective is to equip governments with the tools and capabilities needed to stamp out NTDs in the long-term, beyond the life of the programme.

With an emphasis on strengthening health systems, ASCEND targets NTDs through a range of interventions that complement national health and NTD strategies. It aims to strengthen national health systems, supporting countries to provide the prevention, detection, treatment and surveillance activities necessary to maintain the reduced disease burden in the longer term, and to prevent disease resurgence.

KIT is working on monitoring, evaluation and learning, Behaviour Change Communication and Water Sanitation and Hygiene (WASH).

The five targeted NTDs

• Lymphatic filariasis: Also known as elephantiasis, this NTD is caused by infection by filarial parasites transmitted through the bite of infected female mosquitoes. Infection over long periods leads to damage of the lymphatic system, which can manifest as lymphoedema and hydrocele (scrotal swelling).
• Onchocerciasis: Also known as river blindness, this NTD is transmitted through the bite of infected blackflies, causing severe itching and eye lesions from the microfilaria. If untreated, it can lead to visual impairment and irreversible blindness.
• Schistosomiasis: Also known as bilharzia, this is an infection caused by parasitic trematode worms transmitted when larval forms, released by freshwater snails, penetrate human skin during contact with infected water. There are two forms: intestinal and urogenital schistosomiasis. Infection can result in abdominal pain, diarrhea, blood in the stool / urine and severe complications if left untreated.
• Trachoma: A chlamydial infection transmitted through personal contact via hands, clothes, flies that have been in contact with infectious discharge from the eyes/nose, facilitated through inadequate hygiene. When left untreated infection can cause irreversible corneal opacities and blindness.
• Visceral leishmaniasis: Also known as kala-azar, this infection is caused by protozoan parasites, transmitted through the bite of infected sandflies. It is the most severe form of the disease, with a high mortality rate if not treated.

Responding to COVID-19

Having worked closely with Ministries of Health and regional institutions from the 12 ASCEND countries throughout 2019, the programme is uniquely placed to support country-led responses to the COVID-19 outbreak. Our teams are currently providing a coordinated package of technical and resource assistance to mitigate the impact of the pandemic in these countries.