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Aja Koul


Aja is the Country Lead for the ASCEND programme in South Sudan. ASCEND is supporting South Sudan through Mass Drug Administration’s (MDAs) targeting Lymphatic Filariasis (LF), Onchocerciasis, Schistosomiasis and Trachoma. The team is also providing curative treatment, morbidity management and disability prevention services. ASCEND is increasing coverage of appropriate preventive measures, including hygiene promotion, behaviour change communications and improved WASH/NTD sector coordination within the country, and as the Country Lead, Aja is key to its success.

What is your specific involvement in the ASCEND programme?

I am the Country Lead for ASCEND in South Sudan; my job involves the day-to-day management of the programme. I am accountable for building strong relationships with South Sudan governmental representatives, DFID the World Health Organisation, and NTD implementing partners for Ascend in country. I’m based out of the Crown Agents’ Health Pooled Fund office in Juba, and I work closely with the ASCEND Nairobi Hubs, Crown Agents HQ and ASCEND consortium members to obtain the necessary support to run the programme effectively in South Sudan.

What most excites you about the work we are carrying out under the ASCEND programme and what are your hopes for what it can achieve?

ASCEND is a very demanding and high-profile programme aimed at controlling and eliminating Neglected Tropical Diseases. Focussed on measurable outputs, we assess progress on an ongoing basis in South Sudan. We work closely with the Government to build programme capacity, champion more integrated approaches to tackling NTDs and provide sustainable solutions. This collaborative approach is quite different from other NTD programmes I have managed in the past.

For example, we work directly with the NTD Department in country to strengthen the ASCEND supply chain system and have dedicated a full-time senior Technical Advisor on supply chains, to ensure NTDs are integrated in the overall health supply chain system. We also work with the Ministry of Health (MoH) to strengthen the monitoring and evaluation of NTDs. Recently, we’ve been developing the first ever South Sudanese National Strategy for Harmonized NTD/WASH Social Mobilization and Behaviour Change Communication 2020-2025. This strategy will be launched soon by the MoH and ASCEND will fully support its implementation.

My hopes for ASCEND include that the programme will be recognised by the government, country and the programmes beneficiaries as an outlet that provides sustainable capacity building approaches in relation to NTDs, achieving the long-term integration of efforts to combat all five priority NTDs into public health systems.

Do you think enough is being done to tackle NTDs globally? If not, what could be done to improve the situation?

A lot has been done to tackle NTDs globally. However, a lot is also needed to help countries commit to NTD programmes, for example, by increasing domestic funding and reducing dependency on external donor support. Also, more efforts are needed to control NTD vectors.

What do you think the impact will be on NTD programmes such as ASCEND from the Covid-19 pandemic and how could they react?

There is a risk of not achieving the targets set by the programme due to the constraints on community -based interventions such as prevalence and impact surveys and mass drugs administrations (MDA), caused by the pandemic. This is likely to affect the absorption of funding and implementation rates.  However we are working with the Ministry of Health, DFID and WHO to adapt NTD activities so we can mitigate the risk of spreading C-19, and we are working on a ‘catch-up’ strategy for MDAs, with reference to research from the NTD modelling consortium.

Lastly, is there a moment of your career that you are particularly proud of?

I am particularly proud of being part of the ASCEND programme. The South Sudan programme of Ascend is one the largest – including all 5 of the diseases we are tackling.  Also, whilst I was working with the ministry, I participated in a large mapping exercise for NTDs as a national supervisor and coordinator, and I was very pleased that it concluded successfully despite all the difficulties we faced in the country.