Neglected tropical diseases: from progress to persistent challenges in achieving global elimination

Neglected tropical diseases (NTDs) are an umbrella term that represents 20 major diseases, as classified by the World Health Organisation (WHO), that disproportionately affect the marginalised communities of tropical and subtropical areas.1 These are also referred to as ancient diseases of poverty. They impose an immense human, social, and economic burden on over one and a half billion people worldwide. This article underscores the successes and challenges of the WHO 2021-2030 roadmap, and the latest epidemiological data, offering a comprehensive overview of the global elimination efforts to combat NTDs. The key focuses of the World Health Organisation’s (WHO) NTDs 2021-2030 roadmap are to achieve a 90% reduction in the percentage of people requiring interventions, eliminate at least 1 NTD in 100 countries, and eradicate 2 NTDs by 2030.1 There has been remarkable progress in the fight against NTDs that demonstrates the efficacy of current interventions. By December 2023, 50 countries had successfully eliminated at least one NTD, marking the halfway point toward the WHO 2030 target of 100 countries.2 The number of people requiring interventions for NTDs also decreased by 80 million from 2020 to 2021. Still, the speed of decline falls short of the 2030 targets. The most recent epidemiological data presents a picture of the suffering that NTDs continue to inflict. Examining specific NTDs further emphasizes the urgency of the situation as concluded in Table 1. The control and elimination of NTDs are hindered by a complex interplay of obstacles and challenges. Weak health systems in endemic regions hinder efficacy due to poor data recording, inadequate drug logistics, and insufficient monitoring.3 Many initiatives depend on international donors, making them vulnerable to changing global priorities and economic crises. In conflict zones, healthcare disruption, lack of government ownership, population displacement, and insecurity obstruct intervention implementation.4 Several countries struggle to adopt WHO's multisectoral approaches due to limited coordination and resources.5 Community perceptions can affect participation in mass drug administration. Additionally, climate change alters transmission patterns and expands affected areas. NTD control demands urgent targeted action. Prioritizing high-burden countries, strengthening surveillance, integrating programs into national health systems, and ensuring sustainable funding are critical. Addressing social determinants like water and sanitation remains essential. National ownership must align efforts with local needs. Enhancing research capacity and fostering international collaboration will accelerate innovations. A unified global response is imperative—not just ethically, but to achieve true health equity.