Across the whole spectrum of essential health services, NTD interventions have been found to be among the most frequently and most severely affected by the COVID-19 pandemic.

A recent survey indicated that, as of early 2021, disruptions occurred in 44% of countries (48/109); this percentage was second only to services targeting mental, neurological, and substance use disorders. In addition, the proportion of countries reporting severe disruptions of NTD activities was the highest among all health services (19%).

NTD disruptions have been mainly reported from middle- and low-income countries, where health services already face a number of challenges. Countries in the South-East Asian, America, Eastern Mediterranean and African regions are the most hit.

The mechanisms through which the COVID-19 pandemic has affected NTD programmes include:

• Disruption of community-based interventions (mass treatment/preventive chemotherapy; active case finding; vector control; veterinary public health; WASH, awareness and health education campaigns; support for self-care, rehabilitation and psychosocial services); notably, mass treatment/preventive chemotherapy is both the most frequently and most severely affected of all NTD services;
• Delays in diagnosis, treatment and care and other health facility-based services (including surgery, morbidity management and disability prevention);
• Discontinuation of monitoring & evaluation activities, including routine surveillance and population-based surveys;
• Delays in manufacture, shipment, transport and delivery of NTD medicines and consumables to endemic countries and in their distribution within countries;
• Diversion of financial resources and reassignment of NTD personnel to support the COVID-19 response, and absence from work of NTD personnel due to illness, care-giving responsibilities and government-mandated movement restriction.

The main public-health consequences of these disruptions have been:

• A (projected) increased burden of NTDs, in terms of both mortality and morbidity;
• Delays in achieving the public-health goals set for relevant NTDs, including elimination as a public-health problem, elimination of transmission and eradication;
• Reduced collection, analysis and utilization of epidemiological data for planning purposes.

Mitigating the impact of the COVID-19 pandemic

Since the beginning of the pandemic, WHO has deployed measures to tackle the impact of COVID-19 on NTD services, which can be summarized as:

• Development of guidance, training modules and online resources on safe implementation (please see below)

• Advocacy, consolidation of leadership, dissemination of information and provision of tailored technical advice to Member States and partners by the three levels of WHO;
• Advice on adapting NTD platforms to accommodate COVID-19 activities, including community handwashing, contact tracing, raising awareness, addressing misinformation and providing sanitation supplies;
• Close follow-up on production, shipment, delivery and distribution of NTD medicines and other medical consumables with all relevant actors;
• Mathematical modelling to assess the impact of disruption on timeline for public-health targets set for selected NTDs, and the benefit brought by the implementation of remedial strategies.

In some countries, the above actions have resulted in a gradual and progressive resumption of community-based interventions, especially preventive chemotherapy, and a general improvement of NTD activities overall, although significant service gaps still remain unaddressed in many parts of the world. WHO continues to monitor the situation and take action as necessary.