COUNTDOWN's research questions respond to key implementation knowledge gaps at international, regional and national levels. They were developed through a consultative
process involving NTD policy-makers, programme staff and researchers and through dialogue with communities involved. Research uptake and capacity strengthening lies at the heart of COUNTDOWN and best practice communications techniques are applied to ensure findings are packaged and disseminated to target audiences through a two-way process of dialogue and exchange to best utilise our excellent international networks for dissemination of policy-relevant research.
COUNTDOWN is working to contribute to reducing the morbidity, mortality, and poverty associated with NTDs through increasing knowledge and evidence for cost-effective scale-up and
sustainable control and elimination of NTDs as a public health problem in line with the WHO 2020 NTD Roadmap. COUNTDOWN will work towards these longer term outcomes:
1. Improved planning and delivery of integrated programmes;
2. Increased and sustained access to NTD drugs;
3. Harmonised inter-sectoral approach and
4. Strong and generalisable evidence base for integrated elimination and control of NTDs.
The countries we work in have been carefully selected bridging West and Central Africa: Liberia (post-conflict with nascent health system and recently started MDA campaign), Cameroon (a maturing MDA campaign progressing toward integrated control targets), Ghana (a sustained MDA campaign in need of better intersectoral consolidation to reach specific control and elimination endpoints) and Nigeria (looking to develop sustained scale-up of MDAs). Context-specific implementation research will be undertaken in each country to reflect their present and future needs, and collectively this diversity allows interpolation across several SSA countries, the broader global NTD contexts and strategically complements EVIDENT, the application from the London Consortium.
COUNTDOWN will develop evidence on the following questions:
Q1) What are the most effective, cost effective, sustainable and acceptable current and complementary strategies to both implement scale-up to meet the 2020 London Declaration goals and strengthen health systems?
Q2) What generalisable factors influence the acceptance, effectiveness, efficiency, and equity impact of scale-up from a health systems approach?
Q3) What are the most effective strategies to work with Community Drug Distributers (CDDs) and Community Health Workers to extend the scaling up of MDA to include hard to reach communities and build the resilience of vulnerable and marginalized groups?
Q4) How can the impact of NTDs on poverty, disability (including mental health) be best measured and addressed to support uptake by Ministries of Health (MoH)/countries?
Q5) How can integrating NTD programmes strengthen health systems, foster cross sector working (e.g. sanitation, water resources and agriculture) to deliver a sustainable impact to overcome
the vulnerability of NTD affected populations?
The research efforts of the COUNTDOWN research consortium follow five themes:
1) Capacity Research: This theme will bring together all existing Neglected Tropical Disease (NTD) literature in one consistent and convenient place. The aim is to make it simpler, clearer and faster for decision makers to find information.
2) Applied Social Science: COUNTDOWN is investigating how different factors within the health system help or hinder the scale-up of Mass Drug Administration (MDA) for NTDs.
3) Health Economics: The health economics theme assesses the efficiency, fairness and value-for-money of NTD programmes by conducting household-level micro-economic surveys.
4) Integrated Control Strategy 1: Macro & Vector - The integrated control strategy theme recognises that the scale-up of MDA for NTDs alone is not enough to achieve the London Declaration 2020 targets. This theme will examine how additional strategies such as vector control, the provision of sanitation and hygiene, new tools, capacity building and better health awareness might accelerate progress toward these goals.
5) Integrated Control Strategy 2: Schistosomiasis & Diagnostics - COUNTDOWN examines how factors such as the expansion of MDA and the integration of community led total sanitation could help the rapid scale-up of treatment for snail fever and intestinal worms, which is required to achieve the 2020 targets.
COUNTDOWN also has a strong focus on capacity development, communications and research uptake.