Fitzpatrick Alyssa, Al-Kobaisi Noor Saad M S, Beitman Maya Jessica, Ren Chung Yu, Duhan Satyender, Elbegdorj Erdene, Jain Sushant, Kuhn Edward, Nastase Alexandra, Ahmed Be-Nazir, Olliaro Piero
Blavatnik School of Government, University of Oxford, Oxford, United Kingdom.
National Institute of Preventive and Social Medicine, Dhaka, Bangladesh.
PLoS Negl Trop Dis. 2017 Dec 12;11(12):e0006081. doi: 10.1371/journal.pntd.0006081. eCollection 2017 Dec.
Bangladesh has made significant progress towards elimination of visceral leishmaniasis, and is on track to achieve its target of less than one case per 10,000 inhabitants in each subdistrict in 2017. As the incidence of disease falls, it is likely that the political capital and financial resources dedicated towards the elimination of visceral leishmaniasis may decrease, raising the prospect of disease resurgence. Policy memos may play a crucial role during the transition of the elimination plan from the 'attack' to the 'consolidation' and 'maintenance' phases, highlighting key stakeholders and areas where ongoing investment is crucial. An example of a policy brief is outlined in this paper. The background to the current elimination efforts is highlighted, with emphasis on remaining uncertainties including the impact of disease reservoirs and sustainable surveillance strategies. A stakeholder map is provided outlining the current and projected future activities of key bodies. Identification of key stakeholders subsequently frames the discussion of three key policy recommendations in the Bangladeshi context for the transition to the consolidation and maintenance phases of the elimination program. Recommendations include determining optimal vector control and surveillance strategies, shifting the emphasis towards horizontal integration of disease programs, and prioritising remaining research questions with a focus on operational and technical capacity. Achieving elimination is as much a political as a scientific question. Integrating the discussion of key stakeholders with policy priorities and the research agenda provides a novel insight into potential pathways forwards in the elimination of visceral leishmaniasis in Bangladesh and in the rest of the Indian subcontinent.
孟加拉国在消除内脏利什曼病方面取得了重大进展，并有望在2017年实现每个分区每10000名居民中病例数少于1例的目标。随着疾病发病率的下降，用于消除内脏利什曼病的政治资本和财政资源可能会减少，从而增加疾病卷土重来的可能性。在消除计划从“攻击”阶段过渡到“巩固”和“维持”阶段的过程中，政策备忘录可能会发挥关键作用，突出关键利益相关者以及持续投资至关重要的领域。本文概述了一份政策简报的示例。强调了当前消除工作的背景，重点关注包括疾病储存库的影响和可持续监测策略在内的尚存不确定性。提供了一份利益相关者地图，概述了关键机构当前和预计未来的活动。确定关键利益相关者随后为孟加拉国向消除计划的巩固和维持阶段过渡的背景下的三项关键政策建议的讨论奠定了框架。建议包括确定最佳病媒控制和监测策略，将重点转向疾病项目的横向整合，并优先考虑剩余的研究问题，重点是业务和技术能力。实现消除既是一个政治问题，也是一个科学问题。将关键利益相关者的讨论与政策优先事项和研究议程相结合，为孟加拉国及印度次大陆其他地区消除内脏利什曼病的潜在前进途径提供了新的见解。
