Panel - Integrating PC-NTD and IDM Disease Programs: Benefits and Unintended Consequences

This entry describes a panel discussion to take place at the annual meeting of the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD). Questions for the panel are welcome and can be sent to

In the struggle to integrate neglected tropical disease (NTD) programs, NTDs were organized into two primary programmatic approaches: preventive chemotherapy (PC) NTDs, which aim to interrupt transmission through mass drug administration (MDA), and innovative disease management (IDM) diseases – also known as integrated case management diseases – which focus on addressing symptoms.  This programmatic approach strengthened the focus of these efforts and generated synergies between diseases based on similar treatment strategies. 

A side effect of this approach, however, has been that the disease areas have been somewhat artificially divided. This division does not capture all the elements of a full NTD program, and may misrepresent certain diseases and strategies altogether.  For instance, morbidity management and disability prevention (MMDP) – most commonly used in tandem with MDA programs for PC-NTDs  – is more in-line with the needs of case management and relevance to the primary health care system. Similarly, leprosy is now using an approach resembling MDA to treat contacts of newly identified leprosy patients. 

A recent commentary from Rosenberg, Utzinger and Addiss argued that “it is time to seriously rethink the practice of dividing NTDs into the allegedly dichotomous categories of PCT versus IDM diseases because the unintended consequences—the “collateral damage”—of using them is starting to outweigh the benefits.”[1] The question now at hand is whether looking at NTDs more holistically will ensure that the right tool is used at the right time and will shed light on synergies where they have not been recognized.  This integration could improve program impact and delivery efficiency, but may also introduce untended consequences itself. 

This panel will discuss those possibilities, focusing on how to maximize treatment coverage for both disease types where primary health care is poor.

 Confirmed panelists include:

  • David Addiss, Children Without Worms – Panel Chair
  • Daniel Argaw Dagne, World Health Organization
  • Suma Krishnasastry, Government TD Medical College, India
  • Edridah Muheki, Ministry of Health, Uganda
  • Matt Steele, Bill and Melinda Gates Foundation
  • Wim van Brakel,  Netherlands Leprosy Relief

[1] Rosenberg M, Utzinger J, Addiss DG (2016) Preventive Chemotherapy Versus Innovative and Intensified Disease Management in Neglected Tropical Diseases: A Distinction Whose Shelf Life Has Expired. PLoS Negl Trop Dis 10(4): e0004521. doi: 10.1371/journal.pntd.0004521