Dr Mwelecele Ntuli Malecela
Director, Department of Control of Neglected Tropical Diseases, World Health Organization
A new road map highlights the need for integrated efforts to fight NTDs through collaboration and multi-sectoral action.
There are two crucial things to know about neglected tropical diseases (NTDs). Firstly, they are diverse and debilitating bacterial, viral, parasitic and fungal conditions, in addition to snakebite envenoming. When we look at these diseases collectively, they all have complex causes and risk factors that make them extremely challenging to control. Many can be fatal, and overall, there are 1.7 billion people worldwide who require treatment for at least one NTD.
Secondly, these are diseases of the voiceless. Those who are affected by NTDs are often the poorest and most marginalised in society. The dreadful irony is that NTDs keep those affected trapped in a vicious cycle of poverty by exerting a terrible toll on their bodies and their mental health.
We need to address the root causes of NTDs. That’s why the World Health Organization’s (WHO) 2030 Road map — co-created by the NTD community and launched last January — calls for greater commitment by everyone, and values everyone’s support, no matter how small.
There are 1.7 billion people worldwide who require treatment for at least one NTD.
Measuring impacts and implementing this approach
The WHO’s first NTD Road map (2012 – 2020) stressed the importance of coalescing partners (such as governments, pharma companies, NGOs and funders) around common goals and targets. Sadly, many of those targets were not met, although the Herculean efforts made did yield some impressive results. For example, one billion treatments are now administered every year and 43 countries have eliminated at least one neglected tropical disease.
Moving forward, the 2030 Road map recognises the need for a more concerted effort in measuring impacts, increasing accountability and ensuring we are on course to meet the targets set. We cannot reach 2030 and wonder where we went wrong. We also need stronger integration of key players, and a cross-sectoral approach involving those in NTD programmes, in other health areas, and then in nutrition, education, water, sanitation, mental health and so on; we need to invest in One Health to tackle NTDs from all angles.
This broader, multi-disciplinary stance must engage stakeholders at every level — especially the inclusion of local communities — to help break down barriers to development and maximise efficiencies. In addition, we need to move away from partner-led programmes to ones that are country owned and country driven.
The global pandemic has had a disruptive effect on the fight against NTDs, although, COVID-19 has also highlighted exciting innovations like mRNA technology and shown what can be achieved when stakeholders work closely together. The rapid development and distribution of COVID-19 vaccines and diagnostic products due to speed and innovation is exactly what the NTD community needs. The same approach directed towards COVID-19 must now be applied to the field of neglected tropical diseases.