Mass drug administration (MDA) is an important strategy in the fight to control, eliminate and eradicate neglected tropical diseases (NTDs).1 MDA is typically undertaken in NTD-endemic populations once or twice per year. Where multiple NTDs are co-endemic, it may be cheaper and more time-efficient—for both healthcare personnel and recipients—if MDA medicines could be co-administered, rather than being given in separate campaigns. Doing so is only possible if co-administration is safe and effective.
The combination of co-administered ivermectin, diethylcarbamazine plus albendazole MDA is already recommended by WHO in certain epidemiological contexts for the elimination of lymphatic filariasis as a public health problem. This recommendation is given in the 2017 WHO Guideline: Alternative mass drug administration regimens to eliminate lymphatic filariasis.2 (Ivermectin is also a WHO-recommended medicine for MDA against onchocerciasis,3 scabies4 and strongyloidiasis5; albendazole is also a WHO-recommended medicine for MDA against soil-transmitted helminthiases.6) Azithromycin MDA is recommended by WHO for the eradication of yaws,7 the elimination of trachoma as a public health problem,8 and, in certain contexts, for reducing under-five mortality.9 However, to avoid potential drug-drug interactions, azithromycin MDA is generally undertaken at least a week before or after MDA of other medicines.
To address this issue, WHO proposes to develop a guideline on the safety and effectiveness of co-administration of albendazole, diethylcarbamazine and ivermectin plus azithromycin, in the context of MDA as applicable to NTD programmes, in locations in which lymphatic filariasis and trachoma or yaws are present. It will contribute to the evidence base underlying the NTD road map’s desired strategic shift from disease-specific activities to activities that are integrated across the spectrum of the 20 NTDs.1 The guideline is intended to be a living guideline, with other possible combinations of MDA medicines, and other possible NTD indications, being added in the future as the evidence evolves.
Twelve experts from various backgrounds worldwide have been identified to form the Guideline Development Group. Guideline Development Groups provide technical and/or normative advice and recommendations to WHO.
The names and brief biographies of individuals being considered for participation in the Guideline Development Group are hereby published for public notice and comment.
Comments and perceptions brought to the knowledge of WHO through this process are an integral component of WHO’s Conflicts of Interest assessment policy as to strengthen public trust and transparency in connection with WHO meetings involving the provision of technical/normative advice. Comments and perceptions will be carefully reviewed and treated confidentially. The comments will not be published and will be kept on record.
WHO reserves the right to discuss information received through this process with the relevant expert with no attribution to the provider of such information. Upon review and assessment of the information received through this process, WHO, in its sole discretion, may take appropriate management action in accordance with its policies.
The participation of an expert in a WHO meeting does not imply that they are endorsed or recommended by the World Health Organization, nor does it create a binding relationship between the expert and WHO. The list of participating experts, a summary of relevant interests disclosed by such experts, and any appropriate mitigation measures taken by WHO relating to the management of conflicts of interests, will be reported publicly in accordance with WHO practice.
Comments should be provided by email, and the receipt of these will be acknowledged through generic email notification to the sender.
Please send your comment to neglected.diseases@who.int with the subject, “Public comments on the Guideline Development Group – MDA combinations for NTDs” with indication of the name, nature and contact details of the sender.
The deadline for public comments is Monday 25 November 2024.
Interested parties are also advised that two virtual seats for observers are available for potential end users of the Guideline and members of the general public to attend meetings of this Guideline Development Group. Individuals interested in filling one of these seats should send a brief email expressing their motivation to apply to neglected.diseases@who.int, by Monday 18 November 2024.
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- Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030 (https://apps.who.int/iris/handle/10665/338565, accessed 28 January 2021). Geneva: World Health Organization; 2020.
- Guideline: Alternative mass drug administration regimens to eliminate lymphatic filariasis (WHO/HTM/NTD/PCT/2017.07). Geneva: World Health Organization; 2017.
- Guidelines for stopping mass drug administration and verifying elimination of human onchocerciasis: criteria and procedures (WHO/HTM/NTD/PCT/2016.1). Geneva: World Health Organization; 2016.
- WHO informal consultation on a framework for scabies control, World Health Organization Regional Office for the Western Pacific, Manila, Philippines, 19–21 February 2019: meeting report. Geneva: World Health Organization; 2020.
- WHO guideline on preventive chemotherapy for public health control of strongyloidiasis. Geneva: World Health Organization; 2024.
- Helminth control in school-age children: a guide for managers of control programmes (2nd ed). Geneva: World Health Organization; 2011.
- Eradication of yaws: a guide for programme managers. Geneva: World Health Organization; 2013.
- Solomon AW, Zondervan M, Kuper H, Buchan JC, Mabey DCW, Foster A. Trachoma control: a guide for programme managers. Geneva: World Health Organization; 2006.
- WHO guideline on mass drug administration of azithromycin to children under five years of age to promote child survival. Geneva: World Health Organization; 2020