M&E Workstream teleconference
February 10, 2016, 8:30am EST

Chair, Vicente (Jun) Belizario

Participants:
AkudoAnyanwu, CWW
Kim Koporc, CWW
Allison Snyder, CWW
JayaramParasa, LEPRA Society
Joan Fahy, LSTM NTDs
Mark Bradley, GSK
Michael Deming, CDC
Philip Downs, RTI
Bill Lin, J&J
Jun Belizario, DOH Philippines

Background:

The 2020 WHO goal is: “less than 1% of countries requiring preventative chemotherapy for STH have infection of high or moderate intensity.” Our main question is how can it be measured and confirmed? The M&E Workstream collaborated to develop outcome indicators to address this question in the STH Coalition Workplan, and the purpose of this call is to review and finalize the proposed outcome indicators.

Discussion Points:

The two proposed Outcome Indicators for the STH Coalition M&E Workstream Workplan:

  1. WHO supports roll out and measurement of intensity of STH infections through surveillance in sentinel sites
  2. Quality control must be built into surveillance site procedures
  1. London Declaration Scorecard allows tracking of STH milestones
  2. Milestones of the scorecard need to be determined so as to take periodic stock of progress

Discussion Regarding Outcome Indicator 1:

-Diagnostic tools:

  • The current methodology (Kato Katz) is not practical in many settings where the 1stindicator needs to be measured (due to cultural, social, logistical, and technical challenges). Perhaps the STH Coalition M&E Workstream can try to push WHO towards prioritizing a better gold standard.
  • How do we get WHO to prioritize a better gold standard?
  • The responsibility comes from researchers to prepare diagnostic platforms.
  • It is also our role to advocate for change and make sure the issue is seen as important.
  • Once research is conducted, WHO can debate merits of studies and then WHO can make recommendations. The comparative studies have not been designed yet and it seems researchers are not yet ready toconduct comparative trials.
  • Can outcome indicators be appropriately measured with current tools?
  • The inadequacies of Kato Katz do no prevent us from moving forward with monitoring and we must understand that we are free to design survey size and structure.
  • All tests have limitations. What we’re looking for now is a more effective and more socially acceptable diagnostics that will reduce costs and be more effective.
  • There is a need to be mindful of potential new tests and their ability to measure intensity as well as prevalence.

-Sample size and survey design

  • There are potential statistical sample size issues as well.
  • There is a need to think about realistic sample size and the survey options need to be reviewed carefully and measured appropriately.
  • Need to understand where we can adopt such an approach. Will need some parameters and need to estimate costs and accurately compare. This could possibly be part of the research agenda.

-Presenting the STH Coalition M&E Workstream opinion to WHO

  • To move the needle on the issue of diagnostics, WHO will have to spur the change.That is why it’s important that this issue remains on their radar and is brought forth in meetings like the STAG.In terms of being the WHO catalyst, we need someone to articulate that this is a major gap so the need will be clear and funding and resources will be allocated.
  • It was proposed that Juerg can table these concerns at the upcoming meeting in Geneva since he’s a member. Akudo would be happy to pull together documents to send forward to Juerg on Jun’s behalf, and request that this is brought up at the STAG.
  • Request to Juerg tobring forward the outcomes that are taking place on the Advisory Committee and STH coalition M&E workstream and underscore the importance of this issue.

Action Item: CWW will supply Juerg the necessary documents and request he present this issue at the 6th meeting of STAG Working Group on Monitoring & Evaluation, Geneva, February 15-16, 2016.

Additional Comments:

  • One comment on the wording with sentinel sites: It was noted that the indicator should reflect a broader definition (above and beyond “sentinel sites.”)
  • It was proposed that the wording be changed to: “WHO supports roll out and measurement of intensity of STH infections through surveillance or survey.”
  • Milestone action items: once there’s agreement we can include this as part of the official workplan for the M&E workstream.

Discussion Regarding Outcome Indicator 2:

-There was a question about indicator #2 and if it aligned with the WASH NTD strategy and MDG/SDG goals. CWW will verify that they are aligned.

-On this indicator, there may be an opportunity to request technical direction from WHO. The techniques are laid out but we know that there are major limitations and perhaps they could be improved or revised.

The finalized Outcome Indicators, as agreed upon during the call:

  1. WHO supports roll out and measurement of intensity of STH infections through surveillance or survey
  2. Quality control must be built into surveillance site procedures
  1. London Declaration Scorecard allows tracking of STH milestones
  2. Milestones of the scorecard need to be determined so as to take periodic stock of progress