Challenges, barriers and opportunities for neglected tropical disease programs of conflict-affected African countries

Insecurity and conflict threaten achievement of global neglected tropical disease (NTD) targets. Identifying conflict-associated challenges and mitigation strategies can inform NTD programmatic decision-making.

In-depth interviews were conducted with key stakeholders to explore their experiences of implementing NTD programs in conflict-affected regions in sub-Saharan Africa. Study 1 included a variety of stakeholders in Nigeria and study 2 included the NTD program managers from multiple countries. Thematic analysis was used to identify and extract key themes.

Fourteen participants (seven participants per study) from six countries and several NTD programs reported an array of complex challenges that were categorised into three common program-specific activity themes (implementation, community engagement, sustainability) and five common external influencing themes (access to areas; water, sanitation and hygiene; inclusivity; stakeholder partnering; financial resources). Study 1 included a unique theme for solutions. Several common subthemes (surveillance, community education, displaced populations, access for women) and unique study 1 subthemes were reported.

Many complex interacting factors hinder NTD programs in conflict-affected NTD-endemic areas. The scale and breadth of the common and unique challenges and potential solutions require more investigation to enable the development of a practical framework to support programs in achieving the global NTD goals of 2030.