Neglected Tropical Diseases

Neglected Tropical Diseases are nearing a period of transition in approaches needed for control.

Huge gains have been made in the control of NTD’s through the use of preventive chemotherapy in mass drug administration (MDA) programmes. These programmes have largely been delivered with a “vertical” approach and with specific diseases targets such as schistosomiasis, lymphatic filariasis and onchocerciasis. With the success of these programmes, some countries now face a future in which disease prevalence will fall and control will rely increasingly on interventions delivered through a more integrated approach within routine health services. Some countries, however, have only just started MDA programmes. These tend to be fragile or conflict affected states and success may not come so easily in these more challenging contexts. In addition there is an increasing recognition that some of the NTDs (e.g. trypanosomiasis) are not amenable to mass drug administration approaches, and will require multi-sectoral engagement including health, agriculture and veterinary services. LSTM has supported the science behind mass drug administration for NTDs over many years. There has also substantial work at LSTM developing new diagnostics, drugs and insecticides for the control of NTD’s. Many of these will be transitioning into field use in the next 10 to 20 years. These need to be evaluated in large scale population based studies in relevant disease endemic country settings. Evaluations will require health economic, logistics, delivery and social science inputs.