Challenges for the integration of mass drug administrations against multiple 'neglected tropical diseases'.

Simple and safe medications for some of the common, but often neglected, diseases that afflict the poor are not only available but are often donated. Other medications indicated for neglected diseases are extremely cheap and cost-effective. These drugs can be administered together and combined, when feasible, into rapid-intervention packages based on mass drug administrations. It is therefore logical to integrate mass drug administrations when possible. Integration is, however, not always as simple as it seems, and 'integration' means different things to different people. Drugs are needed at different frequencies for different lengths of time, sometimes for the whole population, sometimes only for children. Care has to be taken that parallel systems are not created that bypass primary healthcare. Much can be achieved, however, by sensible integration, whether it be in the mapping of diseases or the setting up of treatment platforms that tackle several diseases at once. As governments and international organizations seek to create policies for integration that include not only mass drug administration but also morbidity control, and as various partnerships develop for implementation, there is the possibility to scale up health interventions, which will have a very positive impact on the poorest communities globally. Nevertheless, integration should not be forced for the sake of policy. Where things fit well they should be developed, where not, coordination within the primary-healthcare system can produce an equally long-lasting impact.