Restarting Neglected Tropical Diseases Programs in West Africa during the COVID-19 Pandemic: Lessons Learned and Best Practices

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  • 1 FHI 360, Washington, District of Columbia;
  • | 2 FHI 360, Accra, Ghana;
  • | 3 FHI 360, Abidjan, Cote d’Ivoire;
  • | 4 FHI 360, Dakar, Senegal;
  • | 5 FHI 360, Cotonou, Benin;
  • | 6 Helen Keller International, New York, New York;
  • | 7 Helen Keller International, Dakar, Senegal;
  • | 8 Health and Development International, Newburyport, Massachusetts;
  • | 9 Health and Development International, Lomé, Togo;
  • | 10 Health and Development International, Fjellstrand, Norway;
  • | 11 Neglected Tropical Diseases Division, Office of Infectious Diseases, Global Health Bureau, USAID, Washington, District of Columbia

Countries across West Africa began reporting COVID-19 cases in February 2020. By March, the pandemic began disrupting activities to control and eliminate neglected tropical diseases (NTDs) as health ministries ramped up COVID-19–related policies and prevention measures. This was followed by interim guidance from the WHO in April 2020 to temporarily pause mass drug administration (MDA) and community-based surveys for NTDs. While the pandemic was quickly evolving worldwide, in most of West Africa, governments and health ministries took quick action to implement mitigation measures to slow the spread. The U.S. Agency for International Development (USAID) Act to End NTDs | West program (Act | West) began liaising with national NTD programs in April 2020 to pave a path toward the eventual resumption of activities. This process consisted of first collecting and analyzing COVID-19 epidemiological data, policies, and standard operating procedures across the program’s 11 countries. The program then developed an NTD activity restart matrix that compiled essential considerations to restart activities. By December 2020, all 11 countries in Act | West safely restarted MDA and certain surveys to monitor NTD prevalence or intervention impact. Preliminary results show satisfactory MDA program coverage, meaning that enough people are taking the medicine to keep countries on track toward achieving their NTD disease control and elimination goals, and community perceptions have remained positive. The purpose of this article is to share the lessons and best practices that have emerged from the adoption of strategies to limit the spread of the novel coronavirus during MDA and other program activities.

Author Notes

Address correspondence to Achille Kabore, 1825 Connecticut Avenue NW, 8th floor, Washington, DC 20009. E-mail:

Authors’ addresses: Achille Kabore, Stephanie L. Palmer, Daniel Tesfaye, Kisito Ogoussan, Diana Stukel, Katherine Sanchez, and Bolivar Pou, FHI 360 Washington, IDHS—Neglected Tropical Diseases (NTDs), Washington, DC, E-mails:,,,,,, and Ernest Mensah and Justin Tine, FHI39 Accra, Ghana, IDHS—NTDs, Accra, Ghana, E-mails: and Virginie Ettiegne-Traore, FHI360 Cote d’Ivoire, IDHS—NTDs, Abidjan, Cote d’Ivoire, E-mail: Rose Monteil, FHI360 Senegal, IDHS—NTDs, Dakar, Senegal, E-mail: Franck Sintondji, FHI360 Benin, IDHS—NTDs, Cotonou, Benin, E-mail: Brian B. Fuller, Helen Keller International, Health, Washington, DC, E-mail: Benoit Dembele, Helen Keller International, Health, Dakar, Senegal, E-mail: Angela Weaver and Steven Reid, Helen Keller International, Health, New York, NY, E-mails: and Marie Denise Milord, Health & Development International, Newburyport, MA, E-mail: Yao Kassankogno, Health and Development International, Lomé, Togo, E-mail: Anders Seim, Health and Development International, Fjellstrand, Norway, E-mail: Joseph Shott, USAID, NTD Division, Office of Infectious Diseases, Global Health Bureau, Washington, DC, E-mail: