Full-Text Conference Report (184 pp, PDF with bookmarks to chapters in Table of Contents)

Agenda, Introduction
2002 Opening Ceremony
Lymphatic Filariasis (LF) in the Americas: General Overview and Progress in the Region since the Last Program Manager's Meeting, Guyana 2001

Country Presentations

Summary of Country Presentations

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Group Guidelines
Social Mobilization and Communication
Regional Plan for Morbidity Control

Day 2: Group Presentations
Group 2: Social Mobilization and Communication
Group 3: Regional Plan for Morbidity Control
Group Discussions: Summary
Healthmapper Update and Demonstration

Day 3: Welcome
Hand-on Experience
Refresher Exercise: Reapplication Forms and Annual Reports
Wrap-up
Country Organizational Charts

Annexes
1. Third Regional Lymphatic Filariasis Program Managers' Meeting: Agenda
2. Third Regional Lymphatic Filariasis Program Managers' Meeting: List of Participants
3. Acronyms
4. Implementation of the DEC/SALT Strategy for LF Elimination.
5. Qualitative Analysis of Information Systems of National LF Programs.
- Situation Analysis of Data Collection and Management in Regional LF Programs.

Lymphatic Filariasis Elimination in the Americas:
Regional Program Managers' Meeting

(Port-Au-Prince, Haiti, 4-6 September 2002)

Co-sponsored by members of the Global Alliance, with primary funding from PAHO/WHO and the Bill and Melinda Gates Foundation. The sponsors wish to acknowledge Haiti's Ministry of Health for having hosted the event.

There are many lessons to be learned from the successful experiences of others. Filariasis elimination began in China in the 1950s as an agricultural/economic issue. The success of the program relied on a sustained government commitment to the elimination of lymphatic filariasis (LF). Interventions included mass distribution of a mix of diethylcarbamizine (DEC) tablets and DEC-fortified salt accompanied by intensive surveillance to measure the prevalence of infection. So, while lymphatic filariasis is still considered to be a serious public-health problem in the rest of Asia, intensive, collective efforts allowed China to eliminate lymphatic filariasis as a public-health problem.

The Americas Region could very well be the first to reach the elimination goal. Currently, the prospects for verifying the absence of transmission in three out of the seven endemic countries in the Americas are very good. Recent breakthroughs such as novel drug interventions, new techniques in clinical management, new diagnostic techniques and a better understanding of the dynamics of the infection, including the recognition of LF as a disease of childhood, clearly indicate this is a feasible goal.

This region leads the world in the technical areas of morbidity control and operational research. The potential of integrating control programs into other ongoing public-health initiatives in this Region are good, as are the prospects of implementing the programs in a cost-effective, socially responsible manner through links with other programs.

One of the most important assets sustaining the regional lymphatic filariasis elimination efforts are the partnerships and alliances that have evolved among the countries, the international community, the private sector and non-governmental organizations (NGO). There is an ongoing collaboration between GlaxoSmithKline (GSK) and the World Health Organization (WHO) for the global elimination of LF. As part of this alliance, GSK will donate all the albendazole needed for the entire length of the global program. This company is already supporting operational research and will help provide funds/or human resources in support of program activities.

This Region has made significant progress in re-assessing the status of infection and disease in the seven endemic countries. This important knowledge will now allow the Region to redefine the at risk population, the treatment targets and the implementation units (IU).

Work remains to be done to assess the morbidity status and develop a proper response to tackle this problem. Some of the programs face obstacles, including the lack of both human and financial resources or even political commitment. Thus, the alliance is confronted with the challenge of conducting intensive advocacy among those capable of effective action, including the Ministries of Health, the NGOs, the bilateral agencies and the United Nations system. Among the biggest challenges is the need to implement the massive treatment activities as soon as possible and to upscale efforts in those countries where treatment activities have begun. Furthermore, the Regional initiative must quickly consolidate a rational disability prevention and rehabilitation program to retain the interest of partners and sponsors. The Third Regional Meeting of Program Managers will focus on these challenges.

Expected Outcomes

• Progress made with each of the seven Lymphatic Filariasis Elimination Programs in the Americas Region, with emphasis on the results of the rapid assessment techniques to determine antigenemia.
• Progress of the 2001-2002 treatment-related activities in the Dominican Republic, Haiti and Guyana.
• Morbidity status results (results of rapid morbidity assessments).
• Status of the disability prevention and rehabilitation program and development of a Regional Morbidity Plan.
• 2003 National Program priorities and needs.
• Next steps for Suriname, Trinidad and Tobago and Costa Rica, which are endemic countries approaching the global goal.