To help Fiji and the Solomon Islands to better control neglected tropical diseases (NTDs) in the population, John is working with governments from both countries to examine current measures, identify gaps and conduct research to fill those gaps, ultimately reducing the rates of disease and relieving the public medical system.
The Challenge: Controlling neglected tropical diseases requires a systematic approach
Neglected Tropical Diseases, or NTDs, cause substantial and chronic health problems that restrict an individual’s opportunities for personal and social development. A number of important NTDs are present in various Pacific countries, including lymphatic filariasis, soil-transmitted helminths, trachoma, yaws and
scabies.
Controlling NTDs typically requires an integrated approach that brings together medical, social, behavioural and environmental measures. Countries in the Pacific have limited resources, small dispersed populations, and they generally lack expertise in the research methodologies required to support decision-making, including health systems analysis, epidemiological surveillance and health economics. Controlling NTDs is challenging for small countries because program activities are driven by global initiatives, making it hard to adapt them to a country setting.
UNSW’s solution: Work with government to answer key policy questions through world-class research
The Kirby Institute, along with other Australian research partners and national ministries of health, has been involved in successful NTD research collaboration in both Fiji and the Solomon Islands. In both countries, the Kirby Institute has been involved in prevention trials which led to a 90% reduction in scabies prevalence. The trial in the Solomon Islands was the world’s largest trial for the control of both trachoma and scabies. Together with its partners, the Kirby is now scaling up the interventions used in this trial, and trialling simplified approaches to drug regimens. In both countries, the research projects have enabled the investigators to gain an excellent understanding of the government’s operational structures and areas.
In 2018, John’s team will work with ministries of health and other key stakeholders, including WHO, to confirm the objectives and processes of a review, and obtain access to documents and data. A report will be prepared on the current status of NTD programs in both countries, identifying the potential research and information gaps. A two day workshop will then be held in country to address findings of the report. Following the workshop, a final report making recommendations to the Ministries of Health and its partners on opportunities for research will be delivered to each country. John has been building up the NTD research team at the Kirby Institute, and was recently awarded funding to establish a NHMRC Centre of Research Excellence in the control of NTDs at UNSW, which will focus on countries of the Pacific, South East Asia, and remote communities of Australia.
The Impact: Improve reach of NTD programs, reduce NTD rates, create efficiencies
John and his team’s work will help both countries achieve a more a systematic approach to documenting the activities and outcomes of their NTD programs. Ministries of Health will better understand the gaps in strategic information and research, and they will be supported in developing a plan to conduct the research needed to fill those gaps. The outcome will be that both countries will be better placed to reduce the number of people experiencing or at risk of experiencing NTDs, alleviating NTD-related burdens on local health systems.
Lead Researcher
John Kaldor is a NHMRC Senior Principal Research Fellow and UNSW Scientia Professor. For over 25 years he has built and led internationally recognised research programs on the epidemiology and prevention of infectious diseases. His work has guided policy in disease control, particularly in relation to the prevention of HIV infection and other sexually transmitted infections, viral hepatitis and neglected tropical diseases, in Australia and a number of countries in the Asia-Pacific Region. John is a past President of the Australasian Epidemiological Association, and currently serves as a ministerially appointed member of the Repatriation Medical Authority.