Reflections on the decade of the neglected tropical diseases.
Neglected tropical diseases (NTDs) are a group of diseases that disproportionately affect the poorest of the poor. While for years attention has focused on single diseases within this group, efforts during the past decade have resulted in their being grouped together to highlight that they are fundamentally diseases of neglected populations. The formation of a World Health Organization department to address these diseases consolidated the efforts of the many stakeholders involved. In the past decade, focus has shifted from the Millennium Development Goals (MDGs), where NTDs are not mentioned, to the Sustainable Development Goals (SDGs), where NTDs are not only mentioned, but clear indicators are provided to measure progress. It has also been a decade where many NTD programmes have scaled up rapidly thanks to work by affected countries through their master plans, the commitment of partners and the unprecedented donations of pharmaceutical manufacturers. This decade has also seen the scaling down of programmes and acknowledgement of the elimination of some diseases in several countries. Given the successes to date, the challenges identified over the past decade and the opportunities of the coming decade, the NTD Programme at the WHO is working with partners and stakeholders to prepare the new NTD roadmap for 2021 to 2030. The focus is on three major paradigm shifts: a change of orientation from process to impact, a change in technical focus from diseases to delivery platforms and a change from an external-based agenda and funding to a more country-led and funded implementation within health systems. This article reviews the past decade and offers a glimpse of what the future might hold for NTDs as a litmus test of SDG achievements.