Neglected Tropical Diseases: Global Perspectives

Dear Editor,

Twenty diseases are classified as neglected tropical diseases (NTDs), including Buruli ulcer, Chagas disease, dengue and chikungunya, dracunculiasis (Guinea-worm disease), echinococcosis, foodborne trematodiases, human African trypanosomiasis (sleeping sickness), leishmaniasis, leprosy (Hansen's disease), lymphatic filariasis, mycetoma, chromoblastomycosis and other deep mycoses, onchocerciasis (river blindness), rabies, scabies and other ectoparasitoses, schistosomiasis, soil-transmitted helminthiases, snakebite envenoming, taeniasis/cysticercosis, trachoma, and yaws and other endemic treponematoses. More than a billion people worldwide are affected by NTD, mostly in tropical nations and areas of armed conflict. The major nations reporting NTDs included Brazil and the Amazon region, the Gran Chaco, Mesoamerica, and Texas of the Americas, the Democratic Republic of the Congo (DRC), and Adjoining Nations: South Sudan, Northern Uganda, and Angola; Nigeria, Chad, Niger, and Mali; and Adjoining Sahelian Areas of Sub-Saharan Africa; Indonesia; and Papua New Guinea of Asia; and Oceania.^1,2

Control of NTDs is considered as a public health challenge due to their complex epidemiology, intricate interrelationships with poverty and ecological systems like vectors, animals and its devastating effect on health, social and economic system of tropical countries. NTDs results in permanent disabilities, disfigurement with mental and emotional effects, sometimes fatal if untreated. Among the 20 NTDs, at least 10 diseases are amenable for the progression towards Sustainable Development Goal's target;

• Guinea worm disease for eradication

• Leprosy, lymphatic filariasis, sleeping sickness and blinding trachoma for elimination

• Soil-transmitted helminthes, schistosomia-sis, chagas disease, visceral leishmaniasis and river blindness for control^3,4

Moreover, World Health organization has divided the NTDs into two major categories for better management and control such as innovative and intensified disease management (IDM) NTDs and preventive chemotherapy and transmission control (PCT) NTDs (Table 1).

Due to the COVID Pandemic, surveillance, case detection, transmission assessment surveys, community-based interventions like Mass Drug Administration (coverage of preventive chemotherapy treatment), and large-scale treatment programmes were disrupted in 2020, increasing the burden of NTDs and delaying the achievement of public health goals set for NTDs. In 2021-22, the services were gradually resumed by innovative services and adaptation complemented with collaboration and integrated management.^2,5

The World Health Organization created a new road map titled “Ending the Neglect to Achieve the Sustainable Development Goals: A Road Map for Neglected Tropical Diseases 2021-2030” to help accelerate progress towards the prevention, control, elimination, and eradication of NTDs. This road map focuses on assessing impact, cross-sector collaboration, and country-owned and country-financed programmes with a strategic shift in mind. It also involves three foundational pillars such as accelerating programmatic action, intensifying cross-cutting approaches and changing operating models and culture to facilitate country ownership. Target 3.3 of SDG 3, which was extended beyond three diseases such as HIV, TB and malaria to include many NTDs and set to ‘end the epidemic of NTDs by 2030’. Other SDG targets that are relevant to the control and elimination of NTDs, includes 3.8 with Universal Health Coverage, 6.1 with water and 6.2 with sanitation.⁶

Seventy fourth World Health Assembly meeting adopted a decision to recognize 30th January as World NTD Day. This will incentivize, accelerate and motivate stakeholders across the sectors to implement the new road map for freeing more than one billion populations from NTDs at global, national and regional level effectively.^4,6 To conclude, Advancing Research & Development, ensuring access to improved living conditions, clean water & basic sanitation, adequate funding, enhancing collaborations and coordination between sectors at national and international levels and providing technical support will end the NTDs by 2030.