On USAID’s Act to End Neglected Tropical Diseases | East program, sustainability is not just a desired by-product of our work, but a necessary goal on its own and a critical way that we work to achieve disease-specific targets in Africa, Asia, and the Americas.
We spoke to expert Richard Killian, Act | East’s Health Systems Strengthening Lead, about why this is an important moment for the sustainability of NTD programs. Mr. Killian is passionate about improving health and has spent his career working to strengthen health systems.
What is the current state of global progress against NTDs?
It has been an exciting time for me—as someone with many years of health systems strengthening experience—to join the NTD community. The global NTD landscape is shifting. The tremendous progress we’ve seen to date means sustainability is more important than ever. The NTD community must identify opportunities to apply the capacity built, maintain or expand upon accomplishments, and take a more holistic approach.
To do so, we need a paradigm shift to look at how NTD programs fit into national health systems and engage with related sectors. NTD progress has mostly been achieved through a vertical approach supported by external financial, technical, and material support. The next phase requires a continued commitment of financial and human resources—a larger proportion of which may need to be mobilized domestically.
The COVID-19 pandemic, and past shocks such as the Ebola crisis, have also reinforced the importance of resilient national health systems that can withstand and respond to urgent priorities and shifts in resources.
Speaking of strong health systems, are efforts to achieve NTD program sustainability and to strengthen health systems the same thing?
That is a good question. Health systems strengthening refers to efforts to improve one or more core health system functions to help ensure all people—especially the vulnerable and marginalized—can access quality health services. Sustainability can be thought of as a result of a strong health system. In the case of NTDs, sustainability is achieved when a country has a strong health system that can deliver high quality NTD interventions for as long as required. This requires countries to assess the current state of sustainability of their NTD programming and to identify, prioritize and address gaps.
A more sustainable NTD response must also recognize that health systems don’t operate in a vacuum. Other sectors—including finance, education, water and sanitation, and agriculture—share targeted groups and service delivery platforms. For example, many NTD programs work with ministries of education to distribute deworming drugs at regular intervals to children at school. When thinking about resources for NTD programming, we therefore need to identify and leverage contributions of other sectors and partners for greatest impact. For example, vibrant mechanisms for joint planning and coordination, whether based in health or other ministries, can enhance information sharing for multisectoral collaboration.
Learn more about RTI’s work in controlling and eliminating neglected tropical diseases.
How is Act | East advancing sustainability?