Since 27th July 2020 with the release of interim guidance from WHO, countries have been working towards safely resuming neglected tropical disease (NTD) activities following an almost four month recommended postponement of community-based surveys, active case-finding activities, and mass treatment campaigns for NTDs. The guidance proposed a two-part decision-making framework:

• Part 1 was a risk-benefit assessment carried out by the governments to decide if the planned activity should proceed;
• Part 2 was an examination of a list of measures that should be applied with the aim of decreasing the risk of transmission of COVID-19 associated with the activity.

Working with various non-government organisations (NGO) and government partners, the Ascend programme quickly adapted to navigate this uncertainty. This meant that countries wishing to restart NTD activities could be accommodated by creating a process that gave them the best chance of doing so successfully. By adapting an existing WHO risk assessment tool for mass gatherings, the Ascend Lot 2 programme was able to specifically address key considerations for NTDs.

The RAMA Tool

The Risk Assessment and Mitigation Action (RAMA) tool was developed by Sightsavers in collaboration with partners working in NTDs who identified the need for a systematic assessment of the risk posed by the COVID-19 pandemic against the country specific context.

This learning brief shares the experiences of applying the RAMA process across different countries. Similarities and differences offer key learnings for current and future risk management in national NTD programmes. Suggestions provide potential for further adaptation and application in countries where NTD activities are implemented.