Data for decision making at regional and global level

“To eliminate a disease, the critical step is knowing where it is – otherwise you are just shooting in the dark” Anthony Solomon, Medical Officer for Trachoma, WHO.

Colleagues in other sectors often bemoan data – that what they have are out of date, inaccurate, poor quality, not readily accessible and so on. In many cases that might be true, but it’s not the case for the global trachoma community.

In 2011, with the best available data at the time, our understanding of the global profile of trachoma was limited and full of assumptions. Since then, with the results of the Global Trachoma Mapping Project (2012 – 2015), the analysis behind the Global SAFE Implementation Cost Estimates, the release of Eliminating Trachoma: Accelerating Towards 2020, and the launch of Tropical Data, to name a few, the trachoma community has never had such good access to high quality data.

Using data for trachoma elimination

The global trachoma community largely knows:

• Where additional mapping for trachoma prevalence is required
• Where SAFE interventions are needed, where they are not, and at what scale and priority they must be undertaken
• The rough cost of implementing SAFE in different operating environments
• The funding gap that needs to be secured to achieve global trachoma elimination by 2020.

Eliminating trachoma from the world as a public health problem will cost about US$1 billion. Of this US$200 – $300 million is already committed – a billion dollars for a disease that causes estimated productivity losses of up to US$8 billion.

Data from the WHO GET2020 database provide the credibility and confidence for global and national stakeholders to make data driven decisions. Importantly these data are owned by the countries and accessed through a secured cloud based encrypted site.

Diverse stakeholders use trachoma data in a number of ways at global and regional level.

Global level

• Mobilise global partnerships: the members of the GET2020 Alliance meet annually to discuss progress towards global trachoma elimination. In April 2016 they developed a blueprint for urgent and coordinated action to advance GET2020 goals based on the latest data.

• Mobilise funding: Public and private donors use the data to understand the scale of the problem and where support and investment are most needed. Data are also needed to attract additional supporters for trachoma elimination. For example see this report from the UK government on its development programme in Nigeria.

• Strategic advocacy and resource mobilisation: National trachoma and neglected tropical disease (NTD) task forces engage with the International Coalition for Trachoma Control (ICTC) to inform efforts to prioritise strategic resource mobilisation and advocacy for GET2020.

• Coordinating global antibiotic donations: the Trachoma Expert Committee of the International Trachoma Initiative (ITI) meets twice a year. They use data from various sources – including prevalence and coverage surveys – to determine whether districts applying for donated antibiotics should receive them.

• Developing and sharing preferred practices: The Network of WHO Collaborating Centres for Trachoma seeks to build evidence for SAFE implementation and to address the knowledge gaps which hinder progress to trachoma elimination. ICTC disseminates preferred practices.

• Discussion of evidence and academic progress: Presenters at global, regional and national conferences and authors of peer reviewed publications – who seek to illustrate the progress made, the scale of need yet to be addressed and the latest evidence about SAFE.

• Open Access sharing: the Global Atlas of Trachoma publishes EU-level prevalence data provided by health ministries.

• Establishing partnerships: The GET2020 Alliance and ICTC are powerful platforms for collaboration. Uniting to combat NTDs produces an annual progress report and scorecard for NTDs including trachoma.

Regional and national level

• Strategic regional decisions: Regional groups like the East Africa Trachoma and NTD Cross Border Partnership, the Eastern Mediterranean Region Alliance for Trachoma Control and similar groups in francophone Africa and the Pacific inform programme planning and priorities, engagement and resource mobilisation efforts with local funders.

• Guide grant managers of the large-scale multi-country funded programmes: Quarterly and annual review meetings in-country inform progress and assist with realignment of programme implementation.

• Governments of endemic countries: Governments plan for TT surgeries; target MDA to endemic districts; establish improvements in access to water, sanitation and hygiene; upgrade national monitoring and evaluation systems. They also, when the time is right, use their best available data to prepare applications to WHO for the validation of elimination of trachoma as a public health problem.

High quality data – it’s a serious business, everyone’s business!

Poor data affect our ability to make informed decisions. Rich data provide credibility to our work and confidence that we will know whether programme interventions are effective, decisions about priorities are sound, and available resources have been effectively allocated to address the most urgent and serious need.