The GSA Blog

Yemen: an impressive journey against schisto

Yemen continues its impressive journey against schistosomiasis and other neglected tropical diseases

Amman in Jordan recently hosted the 7th review meeting of the Yemen Schistosomiasis Control Project (28th – 30th April). That it was not possible for the meeting to be held in Sana’a tells its own story about the challenges of operating in Yemen currently.

This six year programme (2010-2016) aims to control schistosomiasis and STH-related morbidity. It is implemented by Yemen’s National Schistosomiasis Control Programme (NSCP, part of the Ministry of Public Health and Population), in partnership with the World Health Organization, the World Bank, The END Fund, and the Schistosomiasis Control Initiative. The programme has also benefitted enormously from donated albendazole from GlaxoSmithKline.

These partners came together in Jordan to review the progress made in the past year and to discuss plans for the future control and elimination of neglected tropical diseases (NTDs) in the country. Additional expert input was provided by representative of the Global Schistosomiasis Alliance and the Filariasis Programmes Support Unit of the Liverpool School of Tropical Medicine.

Since its inception in 2010, the programme has implemented ten treatment campaigns, involving the distribution of 26 million treatments against both schistosomiasis and STH (using 62.8m tablets of praziquantel and albendazole respectively). Treatment coverage of school-aged children (both enrolled and non-enrolled) has averaged 77.0% of those targeted. 

The programme has achieved its primary aim of the control of morbidity of schistosomiasis and is looking to achieve elimination as a public health problem. According to an independent impact evaluation exercise conducted by the University of Sana’a, infection levels from the most recent surveys indicated falls to 8% overall prevalence and 2% prevalence of heavy infection.

Even against the current extremely challenging operating environment the programme managed to implement a campaign treating 400,000 people this year.

In addition, an onchocerciasis pilot programme treated over 150,000 people in endemic wadis (valleys) in the west of the country. This will hopefully help kick-start the country’s onchocerciasis elimination programme in the years to come.

This review meeting marked the end of this current stage of the programme and it provided an opportunity to review how far the programme had come. But, more importantly to look ahead to what the next stage of NTD control and elimination will be.

There is still much work to do. Whatever the future design it will likely involve greater integration between NTDs, and a consortium of funders and partners. The programme will need to remain flexible enough to deal with changing security situation.

If the programme is to look towards elimination of schistosomiasis then it will be necessary to explore the possibility of the donation of praziquantel, which would help to leverage additional funders who would see more bang for their buck. Yemen currently falls outside the Merck / WHO donation as it is restricted to Africa.

Whatever the future holds it will certainly build on the successful platform already laid. The list of NTD achievements is impressive – lymphatic filariasis is now in post-MDA surveillance, meaning the country is on its way to being disease free, schistosomiasis and STH are controlled and are potentially moving to being eliminated, the onchocerciasis elimination plan has commenced, trachoma mapping is completed and plans are being developed to implement the full SAFE strategy in at least two governorates

All partners hope the peace talks succeed to enable the country to realize its NTD control and elimination plans.

The group wishes to pay their respects to the memory of Dr. Abdullah Oshaish, the first Director of the NSCP who sadly died in May 2016 in Sana’a, Yemen. Our thoughts are with his family.