January 30th is World Neglected Tropical Disease Day, an observation that was recognised by WHO in May 2021. WHO describes the purpose of the Day as an opportunity to
“raise the profile of neglected tropical diseases, the suffering they cause, and to garner support towards their control, elimination, and eradication”
These efforts align with programmatic targets from 2021 and commitments from the 2022 Kigali declaration. This year, WHO calls on the global community to “unite and act to address the inequalities that drive neglected tropical diseases” and to “make bold, sustainable investments”.
What are NTDs?
WHO describes neglected tropical diseases (NTDs) as a “diverse group of conditions” that are caused by a “variety of pathogens” and are associated with “devastating health, social, and economic consequences”. Although they are “mainly prevalent” in “impoverished communities in tropical areas”, some have a greater geographical distribution.
NTDs are estimated to affect “more than 1 billion people”, and the number of people who require interventions (either preventative or curative) is 1.6 billion. Further to “significant mortality and morbidity”, NTDs cost developing communities “the equivalent of billions of United States dollars” each year in direct health costs, loss of productivity, and reduced socioeconomic and educational attainment.
“The epidemiology of NTDs is complex and often related to environmental conditions. Many of them are vector-borne, have animal reservoirs, and are associated with complex life cycles. All these factors make their public health control challenging.”
Despite the significant effects of NTDs and associated challenges, they have “historically ranked very low” in global health goals.
The challenge of vaccines
In 2019, Professor Peter Hotez and Dr Maria Elena Bottazzi explored the “formidable challenges” of vaccine development for NTDs. They recognise that the “return on investments” for several vaccines point to “major economic returns” from considerations such as improved productivity and “other social goods” that “translate into overall national development”. However, these are “not yet” sufficient promoters of “substantial and timely global investments”.
“In the end, the long-time horizons, risk of failure, and absence of robust commercial markets make vaccines daunting financial investment prospects.”
If financial investment can be secured, vaccine candidates “require help to advance towards licensure and successfully enter the market”, particularly as they “do not even have the option of both public and private markets”.
“Knowledge gaps about the mechanism of protection, the lack of clear understanding of the burden of disease especially in areas of different endemicities and intensities, and a clear picture of the cost-of-illness in a region or a given country makes a difficult argument for how to establish the value proposition.”
Both Professor Hotez and Dr Bottazzi are rising to these challenges, and we’d love to hear from more members of our community who are working to ease the burden of NTDs. We’ll consider NTDs from a few perspectives, including how and why we classify them, at the Congress in Washington this April, so get your tickets for that here if you hope to join us! Don’t forget to subscribe to our weekly newsletters for other health insights.
