From strategy to accountability: monitoring progress on WASH actions to combat NTDs

By the NNN WASH Working Group and Dr Sophie Boisson, World Health Organization

Disclaimer: The opinions expressed in this blog are those of the authors. They do not purport to reflect the opinions or views of the WHO, the NNN or its members and staff.

It is said that the road to hell is paved with good intentions. In the world of international development, a more accurate phrase may be that “the road to poor results is paved with unimplemented strategy documents”. When it comes to strategies that require collaboration across different sectors, special efforts are needed to sustain implementation over time.

On World Water Day, 22 March 2021, the World Health Organization launched a renewed global strategy on water, sanitation and hygiene (WASH) to combat neglected tropical diseases (NTDs) (2021-2030). This launch came only two months after the release by WHO of the new NTD road map: Ending the neglect to attain the Sustainable Development Goals – A road map for neglected tropical diseases 2021–2030. For the first time, the road map includes explicit targets on WASH, aiming to achieve universal access to water, sanitation and hygiene services in endemic areas by 2030.

Like its predecessor 2015-2020 strategy, this renewed strategy has a vision of accelerated and sustained achievement of the NTD road map targets, particularly among the poorest and most vulnerable, through better-targeted and joint WASH and NTD efforts, as well as four strategic objectives:

  1. Increase awareness of the co-benefits of joint action and engagement on WASH and NTDs by sharing experiences and evidence throughout the programme cycle.
  2. Use WASH data in NTD programmes and NTD data in WASH programmes to highlight inequalities, target investment, and track progress.
  3. Strengthen evidence and establish best practices on integrated approaches to NTDs based on robust documentation and analysis, and embed the findings in guidance and national strategies.
  4. Jointly plan, deliver and evaluate programmes to enhance the accountability, sustainability and equity of programme impact.

This time, however, the strategy was developed as a companion document to the NTD road map, sharing the road map’s ambitious pillars and timeline.

On its own, however, a strategy document is not enough. This strategy requires actors from multiple sectors to collaborate in new and different ways that will require a significant shift in existing operational models, funding structures and institutional behaviours; it is therefore essential that progress is tracked to hold those of us in the WASH and NTD communities—spanning government, civil society, academia, foundations and the private sector—to account, as well as to constantly sustain momentum.

This is why in early September, the WHO and the NNN will be collaborating to develop a specific monitoring framework for the strategy. In a participatory consultation to take place during the annual NNN conference, which will bring together hundreds of participants from all over the globe, stakeholders will agree on the type of framework, its indicators and the opportunities for monitoring until 2030. The framework will align with and complement the newly released monitoring and evaluation framework for the NTD road map.

Based on lessons from past monitoring efforts, our intention is for the framework to be one that:

  • Is simple to implement
  • Is easy to interpret
  • Allows comparison across countries
  • Recognises progress, however big or small
  • Does not increased the burden of reporting on country systems

We are hopeful this framework will keep us all on a path to success, and ultimately help achieve improved access to services and better health for all.