Sustainability Framework Offers Possible Roadmap to Lasting Impact on NTDs

July 26th, 2016

Ghana public health supervision and survey teams discussing a survey. Photo: FHI 360

Ghana public health supervision and survey teams discussing a survey. Photo: FHI 360

Neglected Tropical Disease Programs (NTDPs) across West Africa have achieved tremendous success in efforts to control and eliminate highly debilitating, but not typically well-known, diseases. Recently, the country of Togo achieved one of the most significant accomplishments to date when it was declared free of lymphatic filariasis (LF) by the World Health Organization (WHO) in 2015.[1] Ghana and Burkina Faso anticipate reaching this same milestone in 2017. As we celebrate these successes, it is important to look toward the future: how can countries sustain the results and impact they have achieved and create healthier, stronger communities?

When discussing program sustainability, the primary focus tends to be on resource mobilization. However, endeavors to provide true program sustainability require a much broader approach. NTDP experience suggests that the ability to sustain impact depends on multiple, interdependent elements: financial analysis and a financial strategy, advocacy and communication, strategic partnerships, and organizational capacity. Together, these elements are the building blocks of what is known as the Sustainability Framework.

Pieces of the Sustainability Framework Puzzle

NTDPs may benefit from conducting regular financial analysis and developing a robust financial strategy. Together, financial analysis and a financial strategy can enable NTDPs to account for all available resources, estimate program needs, assess and manage imminent financial risk, and align resource management with broader, strategic program objectives. Research and experience in various countries has shown that the long-term success of national NTDPs is inherently linked to their capacity to identify, gather, and effectively manage their resources.[2] Our “Finance strategy: a must for NTD program sustainability” post covers this topic in more detail.

Strategic partnerships with public, private, and social sector stakeholders can help NTDPs mobilize the resources required to achieve and sustain impact by offering them both financial and non-financial benefits. Unlike in philanthropic relationships, where benefits flow one way, from donor to recipient, strategic partnerships recognize that both sides have inherent assets and may realize mutual, shared value through collaboration. In the process, these partnerships enable NTDPs to provide more efficient, effective, and sustainable interventions. For example in Ghana, the national NTDP created a strategic partnership with a private Ghanaian bank. Through this partnership, the NTDP offers the bank access to new markets and greater brand recognition among potential customers, while the bank offers the NTDP access to human and financial resources.

Advocacy and communications articulate to stakeholders the value that the NTDP provides. To increase the effectiveness of advocacy and communications, messages should be targeted to specific stakeholders and have clearly stated outcomes. A strong advocacy platform enables an NTDP to create symbiotic relationships and raise NTD awareness among specific stakeholders, who may lend their support to effect change.

Strong organizational capacity within an NTDP may create a culture of performance focused on achieving sustainable programming. NTDPs require capabilities in leadership, management, data analysis and use, workforce planning, and information technology in order to adapt to evolving country circumstances and program needs. Employees should be equipped with skills in collaboration and management, and motivated to apply those skills to execute the NTDP’s financial strategy, pursue partnerships, and conduct effective advocacy. In the words of Ghana NTD Program Manager Dr. Nana-Kwadwo Biritwum, “the increased management capacity of [Ghana Health Services] staff contributes to productive interactions with colleagues across the Ministry of Health. Combining both management skills and epidemiological knowledge improves efficiency and effectiveness of NTD surveillance and [mass drug administration impact] in Ghana.”

Country programs like Ghana’s NTDP are demonstrating that a finance strategy, strategic partnerships, and an advocacy and communications strategy, implemented by staff with strong organizational capabilities, can equip programs to yield high quality results.[3] With stronger organizational capacities gained through the Sustainability Framework, the results that the NTDPs are beginning to produce, like the NTDPs themselves, are likely to endure.

[1] End Neglected Tropical Diseases in Africa, End in Africa’s five-year report card. Retrieved from

[2] Chawla M., Bernan P., Developing and implementing a resource mobilization strategy. Retrieved from

[3] End Neglected Tropical Diseases in Africa, End in Africa’s five-year report card. Retrieved from