A new World Health Organization (WHO) road map for neglected tropical diseases (NTDs) proposes ambitious targets and innovative approaches to tackle 20 diseases which affect more than a billion mainly poor people and which thrive in areas where access to quality health services, clean water and sanitation is scarce.
Targets include the eradication of dracunculiasis (guinea worm) and yaws and a 90% reduction in the need for treatment for NTDs by 2030. ‘Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030´ aims to accelerate programmatic action and renew momentum by proposing concrete actions focused on integrated platforms for delivery of interventions, and thereby improve programme cost– effectiveness and coverage. It was endorsed by the World Health Assembly (WHA 73(33)) in November 2020.
“If we are to end the scourge of neglected tropical diseases, we urgently need to do things differently,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This means injecting new energy into our efforts and working together in new ways to get prevention and treatment for all these diseases, to everyone who needs it.”
People-centered approach
The road map is designed to address critical gaps across multiple diseases by integrating and mainstreaming approaches and actions within national health systems, and across sectors.
“At its core, this road map aims to put people first. It involves working across sectors in delivering programmes for all the 20 NTDs and promote equity and country ownership” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases. “To do so programmes have to be sustainable with measurable outcomes, backed by adequate domestic financing.”
The 2030 targets
The road map, developed through a wide consultative process involving countries, partners, stakeholders, the scientific community and academia, provides opportunities to evaluate, assess and adjust programmatic actions as and when needed over the next decade, by setting clear targets and milestones. Another distinct feature is to drive greater ownership by national and local governments, including communities. The overarching 2030 global targets are:
- reduce by 90% the number of people requiring treatment for NTDs
- at least 100 countries to have eliminated at least one NTD
- eradicate two diseases (dracunculiasis and yaws)
- reduce by 75% the disability-adjusted life years (DALYs) related to NTD
Additionally, the road map will track 10 cross-cutting targets and disease specific targets that include a reduction by more than 75% in the number of deaths from vector-borne NTDs such as dengue, leishmaniasis and others, promote full access to basic water supply, sanitation and hygiene in areas endemic for NTDs and achieve greater improvement in collecting and reporting NTD data disaggregated by gender.
Despite progress, challenges must be overcome
In the past decade, substantial gains have been made, resulting in 600 million fewer people at risk of NTDs than a decade ago and with 42 countries eliminating at least one NTD, including some defeating multiple NTDs.
Furthermore, global programmes treated more than 1 billion people a year1 for 5 consecutive years between 2015 – 2019.
Nevertheless, significant challenges remain, including climate change, conflict, emerging zoonotic and environmental health threats, as well as continued inequalities in access to healthcare services, adequate housing, safe water and sanitation. There are also major gaps in current intervention packages of diagnostics, treatment and service delivery models.
Neglected tropical diseases
NTDs affect over 1 billion people globally and cause pain and disability, creating lasting health, social and economic consequences for individuals and societies. They prevent children from going to school and adults from going to work, trapping communities in cycles of poverty and inequity. People affected by disabilities and impairments caused by NTDs often experience stigma within their communities, hindering their access to needed care and leading to social isolation.
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1 Coverage averaging 60% or more of the 1.7 billion who require treatment.