Thank You for Five Years of Supporting the Elimination of Trachoma and Lymphatic Filariasis

By Kathy Tilford | MMDP Project Director (August 2018 – September 2019), on behalf of the entire MMDP Project team  - September 26, 2019

After five years of intensive effort on the part of many partners, the USAID-funded Morbidity Management and Disability Prevention Project (the MMDP Project) is coming to a close on September 30, 2019. Led by Helen Keller International (HKI), this flagship USAID project to address the consequences of trachoma and lymphatic filariasis (LF) successfully implemented activities in Burkina Faso, Cameroon, and Ethiopia as well as at the global level.

With national Ministries of Health leading program planning and implementation in each country and the steadfast support of USAID, the results have been life-changing for tens of thousands of individuals at risk of losing their sight from trichiasis, the blinding stage of trachoma. And thousands of men whose social and economic well-being was severely handicapped by disfiguring hydroceles (enlarged scrotums due to LF), and men and women with lymphedema, a painful swelling of the limbs, also benefitted from life-changing interventions.

Key partners that worked closely with the Ministries of Health and HKI to provide services included Sightsavers in Cameroon and RTI International (with the Fred Hollows Foundation and Light For The World) in Ethiopia as well as the African Filariasis Morbidity Project and the Kilimanjaro Centre for Community Ophthalmology.

Significant results seen across the three countries include:
• 2.1 million people screened for trichiasis
• 76,000 individuals received trichiasis management, primarily surgery
• 280 trichiasis surgeons trained
• 2,100 men received hydrocele surgery
• 2,200 lymphedema patients trained in self-care
• 200 hydrocele surgeons trained

Improving health care services to prevent blindness and to restore mobility and dignity to men and women affected by hydrocele and lymphedema is only part of the project’s story. With the Ministries of Health leading the way, systems to improve morbidity management were strengthened by: training teams of surgeons and other health care providers; expanding data management systems to better track both those in need of care as well as those who receive services; and ensuring that all services, especially trichiasis and hydrocele surgery, were of the highest quality and incorporated WHO’s standards and international preferred practices.

In addition to the life-changing results at the country level, the project also made important contributions at the global level. By documenting lessons learned, investigating promising practices, and sharing knowledge widely, the MMDP Project improved data availability and use, filled gaps in the trachoma and LF knowledge base, contributed to operational research, and devoted considerable effort to developing tools and resources that the international community is already using in trachoma and LF programs in other countries.

Among the resources developed are a surgical simulator for hydrocele surgery called FASTT along with a manufacturing manual, a guide for training trichiasis surgeons, a resource package for photo taking during trichiasis surgery, and a training package for filaricele surgery. For a description of these and other resources, please go to https://www.hki.org/mmdp-project-resources.

As the project completes its five-year mandate, it is only fitting that it recognizes not only the leadership of Ministries of Health in Burkina Faso, Cameroon, and Ethiopia, the implementing partners in the field, and the generous financial support and technical oversight of USAID but also some of the other principal parties that contributed to its success:

• the thousands of individuals and their supportive families who entrusted their health care to the project-supported activities, contributing to the knowledge base on how best to scale up and improve morbidity management;

• the dedicated community leaders, local authorities, community health workers and volunteers who ensured widespread participation at the community level;

• the devoted staff of RTI, Fred Hollows Foundation, and Light for the World in Ethiopia and HKI in Burkina Faso and Cameroon who spared no efforts in achieving objectives and targets; and

• international organizations such as WHO (including ESPEN), the Centers for Disease Control and Prevention, and the Global Alliance to Eliminate Lymphatic Filariasis for timely technical guidance and continuous support.

The investment made by USAID in each country will last beyond the project in the form of expanded and better-trained human resource pools for providing quality MMDP services; the adoption of internationally recognized preferred practices for morbidity management for trachoma and LF; scaled-up MMDP implementation; strengthened data systems; and most importantly, thousands of lives improved, benefiting not only individuals treated but their families as well.

Although the MMDP Project ends September 30, 2019, USAID’s commitment to end NTDs continues with the Act to End NTDs I West project, led by FHI360 and the Act to End NTDs I East project, managed by RTI International.