If neglected tropical diseases aren’t prioritised, achieving health equity remains impossible

A mother and her daughter remain safe at home during a COVID-19 lockdown in Ambohimiadana village, Madagascar. Credit: Viviane Rakotoarivony/End Fund/SCI Foundation

Neglected tropical diseases (NTDs) negatively affect the health and future prospects of the most marginalised populations in the world. However, over the last decade, unprecedented progress has been achieved by countries, partners across sectors and communities pushing for greater investment and action on these diseases.

For the first time on 30 January, the world commemorates World NTD Day, as a UN-recognised International Day of Awareness. It stands not only as a landmark moment in its own right but serves to highlight the global community’s commitment to control and eliminate NTDs, demonstrating the principles of solidarity and health equity.

Health equity through the NTD lens

Achieving health equity is complex. Nevertheless, when health differences among groups of people are apparent, it is critical to question these differences and look more closely at the various determinants of health at play, including social, economic and environmental factors.

NTDs, like schistosomiasis, are a good example of the way in which health inequities emerge. As a group of largely transmissible infections, they are driven by the environmental and social conditions in which people live such as low-quality housing, inadequate water, sanitation and health services, and political instability. As NTDs often result in chronic disease, disability and stigmatisation, they perpetuate a vicious cycle of ill-health and poverty. Their tendency to affect marginalised groups, and to compound poverty, has led to the political and financial neglect of these diseases that resulted in the coining of the term NTDs.

In addition, the socio-cultural factors, which are often associated with gender roles, interact with NTDs in various ways and can lead to stigma and social exclusion, further exacerbating the neglect and underlining inequity.

Maintaining the progress made on NTDs so far

For many years these diseases were overshadowed by more urgent (or more politically appealing) global health issues, and remained absent from the global health agenda, as well as attracting little commercially-based research and development.

Over the past decade, important efforts have been made to reverse this neglect, with the 2012 London Declaration driving much-needed funding, global attention and vast quantities of donated medicines. Two global road maps on NTDs released by the World Health Organization (WHO) in 2012 and 2021 have set out key strategies for control, elimination and eradication of diseases, to be implemented by a thriving global community of practice. However, achieving health equity continues to be a challenge, especially with the ongoing pandemic and climate change. The insecure funding environment internationally and stretched national budgets also pose a risk to the gains made so far.

Collaboration and country ownership are central to ending the neglect

As outlined in the 2021-30 NTD road map, putting country ownership at the heart of NTD programmes and intensifying cross-cutting approaches, are fundamental to ending NTDs. Encouraging collaboration across sectors, such as addressing water, sanitation and hygiene (WASH) factors, and considering a One Health approach, will strengthen health systems.

As an organisation, we strongly believe that implementing the actions laid out in the road map will not only deliver accelerated progress to beat NTDs, but will advance health equity through disease elimination. World NTD Day therefore provides a timely reminder for the global community to recognise its own role and responsibility in improving equity to ensure no one is left behind.