Community Involvement in Mass Drug Administration: Haiti's Key to Reaching Neglected Tropical Disease Elimination by 2020

Over 70% of Haiti's population is at risk for Lymphatic Filariasis (LF), a Neglected Tropical Disease (NTD) that can cause extreme suffering, disability and isolation.  LF, commonly known as "elephantiasis," and Soil-Transmitted Helminthes (STHs), intestinal worms mostly affecting children, are two NTDs of greatest concern in Haiti.  The Ministry of Health and Population leads the Haiti NTD Control Program and plans to control and eliminate NTDs by 2020.  Mass drug administration (MDA) for STH and LF has been integrated to provide an annual combination of drugs for prevention of STH and LF in affected areas. Through its partners, the NTD Control Program has been able to increase MDA coverage from 26 communes in 2008 to 106 communes in 2012, achieving 90% coverage rates. In 2013, Haiti reached the World Health Organization’s recommended 5 rounds of MDA needed to control LF and STH in over half the country.  Over 18,000 community drug distributors (CDDs) have been trained to sensitize communities, oversee distribution posts, distribute treatment, and track MDA distribution. Pre-MDA also includes intense community sensitization and education. Effective community mobilization, including high rates of retention of the CDDs and use of existing community channels such as community meetings and local radio have contributed to the success and cost-effectiveness of the NTD Control Program.