Neglected Tropical Diseases (NTDs), sometimes referred to also as Neglected Infectious Diseases, are a group defined by the World Health Organization (WHO) of 20 diseases and disease groups caused by viral, bacterial, fungal, protozoan and parasitic infections, and envenoming. These varied conditions, which cause suffering and death, have been grouped together due to their tendency to affect groups and individuals living in conditions of poverty, their association with stigmatisation and exclusion, and their consequent historical neglect within public health systems.
Affecting over a billion people across 149 countries, NTDs represent a significant public health burden and undermine the achievement of the sustainable development agenda by exacerbating poverty and inequality.
NTDs include:
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), podoconiosis, rabies, scabies and other ectoparasitoses, schistosomiasis, soil-transmitted helminthiases, snakebite envenoming, taeniasis/cysticercosis, trachoma, and yaws and other endemic treponematoses.
NTD programmes and interventions
Tackling NTDs requires interventions on a number of fronts – behavioural change, environmental improvements, social inclusion and treatment and care interventions and services. Such actions may require the delivery of services outside of the healthcare system and across multiple sectors.
According to the NTD road map issued by WHO in 2021, key intervention areas for NTDs include:
· Social mobilization: Joint awareness-building and community education on all NTDs, e.g. behavioural change, mass drug administration scheduling, availability of care, anti-stigmatization and discrimination
· Preventive chemotherapy: Mass community and school distribution and administration of drugs
· Active case-finding: Combined search for and contact with suspected cases of NTDs in a defined population for whom early diagnosis is essential to reduce morbidity and mortality or to prevent further transmission
· Targeted prevention: Administration of preventive interventions to selected groups considered at high risk of contracting a specific NTD, e.g. vaccines, treatment for contacts of leprosy cases
· Vector control: Prevention and control of human–vector interaction, supplementing control of targeted vectors
· One Health approaches: Integrated approaches to building understanding of human–animal transmission of NTDs with an animal interface
· Point-of-care diagnosis to test populations for multiple endemic NTDs simultaneously
· Support networks: Developing and referring patients to community support network services to help with stigmatization and discrimination common to diseases associated with long-term disability or disfigurement
· Self-care: Provision of and support for self-care packages and training for patients whose disease involves a component of self-care for morbidity management
· Counselling and psychological support: Provision of counselling and other support for NTD patients who require mental and emotional health care
· Health care worker training: Building the capacity of health care workers to diagnose, treat and care for patients with NTDs.
The Kigali Declaration, launched on 27 January 2022, is a major milestone in global health, with commitments by governments, industry and NGO partners to deliver ambitious targets of the World Health Organization’s NTD Roadmap 2021-30 on over 20 NTDs, ranging from blinding trachoma to schistosomiasis and parasitic worms to skin infections such as leprosy and scabies. It builds on the progress made by the London Declaration on NTDs, which for the first time brought together funders, researchers and policymakers to prioritise the treatment and prevention of NTDs.
The Kigali Declaration was intended to be linked to the 26th Commonwealth Heads of Government Meeting (CHOGM) but was twice delayed by Covid-19. A series of virtual events was held around the launch in January 2022, hosted by WHO, the umbrella group Uniting to Combat NTDs and others. The Government of Rwanda was also keen to mark 30 January, World NTDs Day, with a real-life event in Kigali to highlight how Rwanda is at the forefront of progress on NTDs.