Neglected tropical diseases: an effective global response to local poverty-related disease priorities

Abstract

Background: Neglected tropical diseases (NTDs) have long been overlooked in the global health agenda. They are intimately related to poverty, cause important local burdens of disease, but individually do not represent global priorities. Yet, NTDs were estimated to affect close to 2 billion people at the turn of the millennium, with a collective burden equivalent to HIV/AIDS, tuberculosis, or malaria. A global response was therefore warranted.

Main text: The World Health Organization (WHO) conceived an innovative strategy in the early 2000s to combat NTDs as a group of diseases, based on a combination of five public health interventions. Access to essential NTD medicines has hugely improved thanks to strong public-private partnership involving the pharmaceutical sector. The combination of a WHO NTD roadmap with clear targets to be achieved by 2020 and game-changing partner commitments endorsed in the London Declaration on Neglected Tropical Diseases, have led to unprecedented progress in the implementation of large-scale preventive treatment, case management and care of NTDs. The coming decade will see as challenges the mainstreaming of these NTD interventions into Universal Health Coverage and the coordination with other sectors to get to the roots of poverty and scale up transmission-breaking interventions. Chinese expertise with the elimination of multiple NTDs, together with poverty reduction and intersectoral action piloted by municipalities and local governments, can serve as a model for the latter. The international community will also need to keep a specific focus on NTDs in order to further steer this global response, manage the scaling up and sustainment of NTD interventions globally, and develop novel products and implementation strategies for NTDs that are still lagging behind.

Conclusions: The year 2020 will be crucial for the future of the global response to NTDs. Progress against the 2020 roadmap targets will be assessed, a new 2021-2030 NTD roadmap will be launched, and the London Declaration commitments will need to be renewed. It is hoped that during the coming decade the global response will be able to further build on today's successes, align with the new global health and development frameworks, but also keep focused attention on NTDs and mobilize enough resources to see the effort effectively through to 2030.

Keywords: Diseases of poverty; Global health priorities; Integrated control; Neglected tropical diseases.

Fig. 1

The five public health interventions recommended by WHO to overcome the impact of NTDs. NTDs: Neglected tropical diseases

Fig. 2

Announcement of the London Declaration on NTDs in January 2012 by representatives of key partner groups in the global effort to combat NTDs, the World Health Organization, bilateral donor agencies (UKAID and USAID), ministries of health of endemic countries (Mozambique and Tanzania), pharmaceutical companies (GSK, Merck KGaA, and Esai), and philanthropic foundations (Bill and Melinda Gates Foundation). NTDs: Neglected tropical diseases

Fig. 3

Environmental measures to limit transmission sources of schistosomiasis and soil-transmitted helminthiasis in China (a Environmental modification performed by cementing along both sides of a canal where was the habitat of Oncomelania snails; b Safe water provided to each household by subsidy programmes from local government; c This new village latrine was built in a hyper-endemic village of schistosomiasis; d New irrigation system being built in farmland that was the habitat of Oncomelania snails; e The diagram of bio-gas chambers for faecal fermentation to eliminate eggs of schistosomes; f A housewife is cooking a meal in her kitchen room with the energy supplied by bio-gas transferred by a tube connected to the faecal fermentation chambers)