By: Kashef Ijaz, MD, Vice President-Health, The Carter Center
The COVID-19 pandemic has harmed patients, families, and economies, and even societies and political systems. It has pushed health care providers to the breaking point and brought many public health interventions to a heart-rending halt.
Nevertheless, The Carter Center has persevered in our primary mission through resilience and adaptation characteristic of our founders, former President Jimmy Carter and his wife, Rosalynn. Over more than 30 years, the Center has persisted despite wars, natural disasters, and infectious disease outbreaks. Together with ministries of health and our partners, we are overcoming the COVID-19 challenge as well.
The Center has remained focused on program implementation efforts as much as possible while ensuring safety for our staff, country partners, and beneficiaries. Our flagship Guinea Worm Eradication Program has remained 90-95% operational throughout the pandemic, with robust community-based surveillance and interventions. Having reduced the disease by 99.99% since 1986, the program in 2020 has documented a 56% decline in human cases and a 24% reduction in dog infections from the same period in 2019.
Other programs were more directly affected. In accordance with the World Health Organization’s April 2020 guidance to suspend many interventions, The Carter Center paused field activities, including mass drug administration (MDA), community-based surveys, and active case finding, for onchocerciasis (river blindness), lymphatic filariasis (LF), and trachoma.
In July, the WHO provided guidance for mass outreach campaigns within the COVID-19 context. In response, the Center’s Trachoma Control Program implemented a risk assessment and mitigation action tool developed by Sightsavers Inc. to resume activities while mitigating community transmission of COVID-19. As a result, we resumed assisting MDA with Zithromax® (donated by Pfizer) in Sudan and South Sudan. In addition, our program collaborated with the NTD Modelling Consortium to model the effects of COVID-19 on disease prevalence in the face of skipped or delayed MDA.
As with trachoma, all countries assisted by our river blindness and LF elimination programs have conducted or are conducting risk assessments to safely resume interventions.
The first large-scale MDA took place in August in Uganda. The Carter Center, with support from the ELMA Foundation and USAID’s Act to End NTDs | East program, led by RTI International, assisted Uganda’s Ministry of Health in distributing 1.4 million Mectizan® treatments (donated by Merck & Co. Inc.) for river blindness. A second round of treatments began in November. In September, MDA for river blindness occurred in a hot spot in Ethiopia’s Amhara region. Treatments also are being provided to indigenous populations in Brazil. In Haiti, where The Carter Center leads community engagement efforts for malaria elimination in Grand Anse region, COVID-19 prevention messages were integrated with anti-malaria awareness campaigns as early as March. The Center also recently conducted health worker trainings to expand clinical services for LF, maintained a pilot program of integrated mental health care for patients, and prepared for a December MDA.
In October, the International Task Force for Disease Elimination, convened by The Carter Center, reviewed the impact of COVID-19 on public health programs. COVID-19 cannot stop us. We remain optimistic and focused on fully recovering from the effects of the pandemic to defeat NTDs for the benefit of humanity.