What is mass drug administration?

Step one: Identify where treatment is needed

One way Sightsavers works with countries to identify where treatment is needed is through mapping surveys. Two examples of these are:

• The Tropical Data project, a data-collection initiative that helps countries carry out surveys as they work towards eliminating trachoma.
• The Onchocerciasis Elimination Mapping Project, which is used to map the spread and transmission of river blindness.

Both projects use smartphone technology to collect high-quality, standardised data so ministries of health are able to pinpoint exactly where to run treatment programmes.

Step two: Raise awareness in communities

Mobilisers go out to the communities where treatment is needed to raise awareness of the disease and treatment process. Then, planning meetings are held to clearly lay out the roles and responsibilities of everyone involved.

The information about the disease and planned MDA is often then shared with those who need the treatment via community gatherings at a local church or school.

Step three: Train community volunteers to distribute treatment

Local community volunteers are nominated by their communities to distribute treatments. Many have experienced how NTDs affect lives and understand their community’s dynamics and customs. This enables them to reach people who need help the most, and ensures that vital drugs are distributed in even the poorest and most remote places.

The volunteers go through training to learn more about the diseases, as well as how to properly distribute the treatment. For example, they are each given a dose pole, a light universal device used to measure the height of patients and to calculate the correct dose depending on how tall they are.

This community-focused approach means the communities themselves are at the centre of efforts to combat NTDs, ensuring long-term and sustainable solutions.

Step four: Ship treatments to the communities

Treatments for the five NTDs that Sightsavers treat are generously donated by pharmaceutical companies including Pfizer, Merck & Co, GlaxoSmithKline, Merck Serono and Johnson & Johnson. They are shipped to the countries which require intervention, and once they arrive they are distributed to the local communities where the MDA will be carried out.

Step five: Distribute treatment to entire population

The communities are notified that an MDA will be happening and are advised to stay near their homes. Treatments are then most often distributed at a central point, for instance a school, but volunteers will also go house-to-house to ensure they reach everybody. During MDAs, volunteers can walk several miles a day to deliver treatment.

They make a record of treatments given in logbooks, to ensure they have reached the correct households. If a household member is absent during the day of an MDA, volunteers arrange follow-up visits to try and reach them.

This means that even in hard-to-reach rural areas, Sightsavers is able to protect those most in need.

Step six: Evaluate impact

On completion of the MDA campaign, logbooks are collected and the data is summarised and then observed by the local Ministry of Health and The World Health Organization (WHO), to evaluate coverage and determine next steps. MDAs will usually be carried out at recurring intervals until the WHO determines the area is free of the disease.