Resource Mobilization for Morbidity Management
July 26th, 2017
The END in Africa project focuses on the control and elimination of seven neglected tropical diseases (NTDs) that can be targeted with preventive chemotherapy, including: lymphatic filariasis (LF), blinding trachoma, onchocerciasis, schistosomiasis and three soil-transmitted helminthiases (STH). In addition to causing sickness, several of these diseases can also lead to severe and lifelong morbidity and disability.
An estimated 40 million people worldwide suffer from clinically significant manifestations of LF, leading to physical impairments, reduced economic productivity, and stigma and discrimination. Incorporating morbidity management components into NTD programs not only alleviates suffering and improves quality of life, but also enhances compliance with mass drug administration and prevents new infections. While countries often have morbidity management responses in their annual work plans, many lack the necessary resources to implement these activities. To address the funding gaps, neglected tropical disease programs (NTDPs) should use financial analysis tools to identify resource needs as well as advocacy and partnership techniques to engage stakeholders and catalyze action.
• Financial Analysis: Across many countries, funding for morbidity management activities remains inadequate to meet the 2020 control and elimination objectives, but there is increasing momentum to address this challenge in the END in Africa countries. Financial analysis allows countries to account for all available resources, project financing needs based on program requirements and trajectory, and align resource management with broader, strategic NTDP objectives. If countries align their work plans with forecasted funds, they will identify the amount of dedicated funding available for morbidity management and know the funding risks.
In Togo, Cote d’Ivoire, and Ghana, the national NTDPs used the Tool for Integrated Planning and Costing (TIPAC) to analyze the funding for morbidity management. After identifying the funding gaps, Togo’s NTDP used this knowledge to prioritize morbidity management activities in further funding requests. Based on the country’s TIPAC data, Togo went from no funding for morbidity management in 2014, to 84% funded in 2017.
• Advocacy and Communications: Once countries have a better understanding of the funding gap for morbidity management activities, they can use strategic communications and advocacy platforms to articulate the value to potential stakeholders, raise awareness, and influence a desired action. Developing national policies, pursuing partnerships, and identifying points of integration with other health programs, can support work plan activities for morbidity management.
Over the past few years in Ghana, there has been little to no funding for morbidity management. To address the funding gap, the NTDP created a business case for private sector stakeholders using financial analysis results. The business case developed by the NTDP enabled the country to receive a two-year grant covering hydrocele surgery and treatment from Unibank. This grant was the only source of funding for morbidity management activities in Ghana between 2015 and 2016.
Although there is currently no funding for morbidity management activities in 2017, Ghana is making a strong value proposition to private sector foundations and corporate social responsibility bodies, showing that support for morbidity management activities such as educational campaigns and surgeries translates into improved health outcomes leading to increased participation and productivity in their workforce and stronger communities for their customers. In addition to private sector advocacy, countries are advocating with international donors and local governments to increase funding and attention for morbidity management by using data to show the positive health and economic outcomes from this investment.
To achieve global and national NTD elimination targets, morbidity management is essential and financial analysis and strategic advocacy can be effective tools for obtaining funds for activities that can dramatically improve quality of life for people suffering from the consequences of disease.
 Weekly epidemiological record: Managing morbidity and preventing disability in the Global Programme to Eliminate Lymphatic Filariasis (2011). World Health Organization, No. 51-52, 86, 581-588.