During the last two years, six countries from the Region were validated by WHO as having eliminated lymphatic filariasis (LF) as a public health problem. Two countries have also been validated for having eliminated trachoma as a public health problem in 2017. A few more countries are in the pipeline for validation of LF elimination in 2017 and many other endemic areas in other countries have completed the required rounds of mass drug administration (MDA) and are currently conducting post-MDA surveillance activities. However, there is a risk of recrudescence from remaining local pockets of transmission leading to re-emergence of diseases as a public health problem and possible reintroduction of diseases to areas that have achieved elimination from other countries and areas of the WHO Western Pacific Region and in neighbouring regions where active transmission is still present. There is an urgent need to establish post-elimination surveillance that can be integrated and sustained within the general health system.
The Informal Consultation on Post-elimination Surveillance of Neglected Tropical Diseases agreed that the objectives of post-elimination surveillance are to help ensure re-emergence does not happen and ultimately in the longer term to confirm interruption of transmission.
There is limited evidence at present for WHO to recommend any specific post-elimination surveillance strategies. However, it is clear that post-elimination surveillance will need to be country specific and should be prioritized in geographical areas with potential risks of resurgence of transmission or specific population groups with risks of introduction of transmission. This could include areas with persistent presence of positives in originally endemic areas, specific high-risk occupation groups and migrants from other endemic countries. Also, post-elimination surveillance should be feasible and thus integrated within the country’s health system for its sustainability.
The Consultation developed a list of priority operational research items to generate further evidence to define risk areas or population groups for which post-elimination surveillance should be prioritized and to determine feasible, cost-effective and sustainable post-elimination surveillance options for neglected tropical diseases (NTDs).
In the meantime, relevant countries are encouraged to determine risk areas or population groups to prioritize post-elimination surveillance as well as to identify and pilot opportunities of existing regular national and subnational representative surveys and sentinel surveillance activities to integrate and sustain post-elimination surveillance.
WHO should collaborate with partners and assist Member States in implementing the priority operational research agenda identified at the Consultation to generate needed evidence to determine feasible, cost-effective and sustainable post-elimination surveillance options for NTDs.