In 2016, in order to define how stakeholders can work together to
implement cross cutting approaches, the Neglected Tropical Disease NGO Network
(NNN) published The BEST framework: A comprehensive
approach towards NTDs. This framework provides NTD stakeholders with
a comprehensive conceptual approach for NTD programming and details the diverse
cross-sectoral efforts needed to reach control, elimination and eradication
targets.
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| Prof KH Martin Kollmann |
This paradigm shift requires engaging with and working
holistically with a broad range of development stakeholders. It includes
actively involving people affected by NTDs at all stages of programs, from
conception and planning to implementation, monitoring and evaluation, and
embedding cross-sectoral approaches and systems thinking into NTD work. To
support this transition a range of NNN cross cutting groups, such as the WASH Working Group and the DMDI Working Group, have been established, bringing
together a diverse range of stakeholders to share experiences, develop tools
and identify preferred practices for comprehensive programming.
Through the DMDI Working Group, strategies are in development to
improve and mainstream the inclusion of people affected by NTDs and other
marginalized groups in all work. These complement and support other
stakeholders’ efforts to design
participatory and inclusive programs in accordance with the BEST framework.
A key priority of the WASH Working Group is the promotion of
"inclusive WASH", an approach to increase universal access and the
active and meaningful participation of affected people. Inclusive WASH recognizes
that marginalized and vulnerable people bring a unique insight to NTD programs
and should be consulted at all stages of NTD programs to make them accessible
and inclusive. People who have experienced disease, disability, stigma and
social exclusion take the programs closer to the communities they are designed
to benefit. This helps to ensure that infrastructure, such as hand and face
washing stations and latrines are accessible and appropriate to people with
disabilities.
Furthermore, because WASH activities to prevent diseases like
trachoma, schistosomiasis and soil transmitted helminths are often conducted in
schools, careful planning is required to ensure children with disabilities, who
are often excluded from schools, can access interventions and participate in
these programs.
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| Leah Wohlgemuth |
Sharing lessons between these groups has led to a stronger
understanding of the importance of social inclusion and more systematic
engagement of disabled persons and women in WASH and NTD programs.
Organizations seeking to use the BEST framework can learn from these
experiences and engage in these platforms to increase program
effectiveness.
Similarly, through task groups on “Indicators, Mapping and
mHealth”, “Interventions”, “Mental Wellbeing and Stigma”, “Participation,
Inclusion and Human Rights” and an upcoming group on “Livelihoods”, the DMDI
Working Group is working on strategies and resources, such as guidelines on
mental health and NTDs in collaboration with WHO. A dynamic cross-cutting NTDs,
Morbidity and Disability (NMD) toolkit, which addresses the urgent need
for quality data on disease complications and other aspects of disability among
NTD affected persons, is available online.
The success of such cross cutting groups is evident as more
stakeholders working on NTDs look to engage partners working across sectors and
adopt cross cutting approaches. Over the last year, three new NNN cross cutting
groups have formed, on Skin Related NTDs, Integrated Vector Control and
Conflict and Humanitarian Emergency. Further information on these cross cutting
issues is also being shared on infoNTD,
an online portal dedicated to making cross cutting NTD resources easily
available.
The importance of cross-sectoral collaboration and cross cutting
approaches are also being increasingly recognized by donors who have started to
specifically include details about behaviour, environment and social inclusion
along with preventive chemotherapy and morbidity management in their funding
requirements. For partners who are developing comprehensive and inclusive
programs, this provides the opportunity to mobilize additional resources, build
the evidence and enhance advocacy as the value of such holistic NTD work to
broader development issues is more and more recognised.
Comprehensive and inclusive NTD programs move beyond achieving
direct progress on Sustainable Development Goal 3.3, calling for an end to
NTDs. Through cross-sectoral collaborations, comprehensive approaches to NTD
programs will play a vital role in the achievement of other SDGs relating to
poverty (SDG 1), quality education (SDG 4), gender equality (SDG 5) and clean
water and sanitation (SDG 6). The BEST framework provides an important
opportunity for the NTD community to leverage broader development benefits and
contribute to the strengthening of health systems. This enhanced
systematic engagement of affected people, cross-sectoral partners and the NNN
working groups, will help to expand and forge new partnerships, develop and
refine strategies to ensure that programs remain effective and efficient in
reaching the world's most marginalized people.
About the authors:
Leah Wohlgemuth is Chair of the WASH Working Group and Regional
Technical Advisor at Sightsavers
Professor KH Martin Kollmann is Chair of the DMDI Working Group
and Senior Advisor NTDs at CBM
