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Ascend programme

Neglected tropical diseases (NTDs) adversely affect the lives of more than 1.5 billion people in the most marginalised communities. Given the scale of need and the devastating health, social and economic impacts, the control and elimination of NTDs is crucial.

There has been much progress since 2010 – around 500 million fewer people are at risk and 40 countries have eliminated at least one NTD.

The Accelerating the Sustainable Control and Elimination of Neglected Tropical Disease (Ascend) programme was a  three-year programme funded by UK Aid that ran for two years, working to fight neglected tropical diseases (NTDs) in West and Central Africa. Watch a short explainer video here.

The Ascend programme was set up to make major progress towards eliminating five NTDs, in thirteen countries.

The programme focused on five diseases: lymphatic filariasis (LF); onchocerciasis; trachoma, schistosomiasis (SCH) and soil-transmitted helminths (STH), offering an opportunity to redouble efforts and increase momentum towards ending these diseases.

KEY INFORMATION

Countries: Benin, Burkina Faso, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of Congo, Ghana, Guinea, Guinea Bissau, Liberia, Niger, Nigeria, Sierra Leone

Implementing partners: Unlimit Health was part of a consortium of partners led by Sightsavers, along with Mott Macdonald and the Liverpool School of Tropical Medicine.

Funded by: UK Aid

Timescale: 2019-2021

Objectives of the programme

  • Strengthen health systems to ensure sustainable delivery of NTD control and elimination activities
  • Increase coverage of preventive treatment for NTDs in the selected countries through mass drug administration
  • Increase coverage of curative treatment and morbidity management and disability prevention services for NTDs in the selected countries
  • Increase reach and coverage of prevention messages, including the promotion of behaviours that improve hygiene and prevent disease
  • Increase knowledge and evidence to inform more effective responses to NTDs

Achievements in the first year

In its first year, the Ascend West and Central Africa programme made a huge impact and surpassed many of its targets, including the unpredicted feat of adapting funds to support ministries with their Covid-19 response at the end of the year.

Healthcare worker performs a blood test in Niger.

Highlights included:

  • 73 million people were reached with messages on the importance of treatment as well as hygiene and sanitation practices, disseminated in advance of and during MDA campaigns.
  • The programme supported the training of more than 375,000 community volunteers and teachers
  • Great progress was made on health systems strengthening in year one of the programme. 92% of Implementing Units (IUs) had drugs in time to conduct MDA, a considerable achievement given that treatments were delivered in hundreds of IUs across twelve countries.
  • MDA was conducted across more than 700 IUs in seven countries and over 94% achieved recommended epidemiologic coverage.
  • Over 127 million treatments – this represents over 86 million people receiving treatment – were distributed across seven countries in year one; which was a 108% achievement against the annual milestone. Five out of the seven countries with MDA planned in year one achieved treatment targets.
  • Of the 127 million treatments provided, 46% were provided to men and boys and 54% to women and girls. The ratio of males and females who received treatment was very close to equal across all countries.
  • The programme also successfully launched a new learning and innovation fund, providing grants to test out new ideas, generate new evidence and enhance learning.

Impact of Covid-19 on Ascend

Following guidance from the World Health Organization in response to the Covid-19 pandemic, all activities involving large gatherings were put on hold across all countries to ensure people’s safety. We followed the approaches taken by national governments closely, to assess when it was possible and safe to resume.

Adapting the programme

Beginning in March 2020, the Ascend team prioritised flexing our activities, and developed a series of Covid-19 activities to support the targeted countries response to the pandemic. The activities build on all the partners’ existing presence and trusted working relationships with ministries of health, other government and local partners in each country, and our experience in strengthening local health systems. We brought expertise in social behaviour change communications, adapting our NTD focused behaviour change communications and water and sanitation and hygiene component to provide timely, focused support to national communications to reduce the transmission of Covid-19.

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