Preventive chemotherapy for helminth diseases: progress report, 2014

Overview

 Preventive chemotherapy (PC) is defined as the large-scale delivery of safe, single-administration, quality-assured medicines, either alone or in combination, at regular intervals, to entire population groups. WHO recommends preventive chemotherapy against the 4 main helminth diseases: lymphatic filariasis (LF), onchocerciasis (ONCHO), schistosomiasis (SCH) and soil-transmitted helminthiases (STH). This intervention is also a component of the SAFE strategy for elimination of blinding trachoma (Surgery, Antibiotics, Facial cleanliness and Environmental improvements), and is recommended for controlling morbidity due to food-borne trematodiases and for elimination of yaws.

As part of the global efforts to accelerate expansion of PC for control and elimination of LF, SCH and STH, WHO facilitates the supply of the following medicines donated by the pharmaceutical industry: albendazole (ALB) for LF and STH (donated by GlaxoSmithKline); diethylcarbamazine citrate (DEC) for LF (donated by Eisai); mebendazole (MBD) for STH (donated by John-son & Johnson); praziquantel (PZQ) for SCH (donated by Merck). WHO also coordinates with the Mectizan Donation Programme which supplies ivermectin for ONCHO and LF elimination programmes. Donation of azithromycin for the trachoma elimination programme is managed by the International Trachoma Initiative.

A joint mechanism and a set of application and reporting forms, the Joint Application Package (JAP), has been developed to facilitate the process of application for these PC medicines, review and reporting, as well as to improve coordination and integration among different programmes. The JAP comprises 3 forms: the Joint Request for Selected PC Medicines (JRSM), (ii) the Joint Reporting Form (JRF), and (iii) the PC Epidemiological Data Reporting Form (PC EPIRF). In June 2015, the new release of the JAP was published, addressing feedback received from the countries and partners after 2 years of use. Currently, the JAP is available in 4 languages: English, French, Russian and Spanish, and can be accessed through the WHO website. Countries wishing to receive PC medicines donated through WHO are invited to submit the JAP to WHO throughout the year, but at least 6–8 months before the planned PC intervention and no later than 15 August of the year preceding the year for which medicines are intended to be used, in order to allow time for review and approval of the request, placing order, manufacture of the medicines and shipment to the country. However, countries are always encouraged to submit the JAP as soon as they have finalized implementation of PC without waiting for the deadline; this will avoid receipt of many applications at the same time which can strain the production capacity of the pharmaceutical companies. To facilitate the application process for PC medicines and reporting, WHO has developed training materials which include a user guide and video tutorials with step-by-step instructions on how to complete the JAP. These materials are currently available on the WHO PCT website in English and French, and will soon also be available in Spanish.