03382nas a2200313   4500000000100000008004100001260003700042653001300079653001900092653002700111653001800138100001500156700001300171700001300184700001600197700001600213700001400229700001800243700001200261700001500273700001500288700001200303245014500315856009900460300000900559490000700568520247900575022001403054       2024                            d  bPublic Library of Science (PLoS)10aCovid-1910aHealth systems10aNTD control strategies10aNTD programme1 aJaworski A1 aCraig AT1 aDyer CEF1 aGoncalves J1 aNeuendorf N1 aNewland J1 aKelly-Hanku A1 aPomat W1 aMaclaren D1 aVaz Nery S1 aZhang F00aUnderstanding how neglected tropical diseases programs in five Asia-Pacific countries adjusted to the COVID-19 pandemic: A qualitative study  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0012221&type=printable  a1-170 v183 a<p><strong>Background:&nbsp;</strong>Following the COVID-19 pandemic declaration, the World Health Organization recommended suspending neglected tropical diseases (NTD) control activities as part of sweeping strategies to minimise COVID-19 transmission. Understanding how NTD programs were impacted and resumed operations will inform contingency planning for future emergencies. This is the first study that documents how South-East Asian and Pacific NTD programs addressed challenges experienced during the COVID-19 pandemic.</p>

<p><strong>Methodology:</strong> Data was collected through semi-structured interviews with 11 NTD Program Coordinators and related personnel from Fiji, Papua New Guinea, The Philippines, Timor-Leste, and Vanuatu. Constructivist grounded theory methods were drawn on to generate an explanation of factors that enabled or hindered NTD program operations during the COVID-19 pandemic.</p>

<p><strong>Principal findings:</strong>The COVID-19 pandemic disrupted NTD programs in all countries. Some programs implemented novel strategies by partnering with services deemed essential or used new communications technology to continue (albeit scaled-back) NTD activities. Strong relationships to initiate cross-program integration, sufficient resources to implement adapted activities, and dedicated administrative systems were key enabling factors for recommencement. As the COVID-19 pandemic continued, exacerbating health resources scarcity, programs faced funding shortages and participants needed to find efficiencies through greater integration and activity prioritisation within their NTD units. Emphasising community-led approaches to restore trust and engagement was critical after widespread social anxiety and disconnection.</p>

<p><strong>Conclusions: </strong>Sustaining effective NTD programs during a global emergency goes beyond managing immediate activity disruptions and requires attention to how NTD programs can be better ensconced within wider health programs, administrative, and social systems. This study underscores the importance of pre-emergency planning that reinforces NTD control programs as a critical service at all health systems levels, accompanied by governance arrangements that increase NTD staff control over their operations and strategies to maintain strong community relationships. Ensuring NTD units are supported via appropriate funding, personnel, and bureaucratic resources is also required.</p>
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