Abstract
Neglected Tropical Diseases (NTDs) are both drivers and manifestations of poverty and social inequality. Increased advocacy efforts since the mid-2000s have led to ambitious new control and elimination targets set for 2020 by the World Health Organisation. While these global aspirations represent significant policy momentum, there are multifaceted challenges in controlling infectious diseases in resource-poor local contexts that need to be acknowledged, understood and engaged. However a number of recent publications have emphasised the “neglected” status of applied social science research on NTDs. In light of the 2020 targets, this paper explores the social science/NTD literature and unpacks some of the ways in which social inquiry can help support effective and sustainable interventions. Five priority areas are discussed, including on policy processes, health systems capacity, compliance and resistance to interventions, education and behaviour change, and community participation. The paper shows that despite the multifaceted value of having anthropological and sociological perspectives integrated into NTD programmes, contemporary efforts underutilise this potential. This is reflective of the dominance of top-down information flows and technocratic approaches in global health. To counter this tendency, social research needs to be more than an afterthought; integrating social inquiry into the planning, monitoring and evaluating process will help ensure that flexibility and adaptability to local realities are built into interventions. More emphasis on social science perspectives can also help link NTD control to broader social determinants of health, especially important given the major social and economic inequalities that continue to underpin transmission in endemic countries.Electronic supplementary materialThe online version of this article (doi:10.1186/2049-9957-3-35) contains supplementary material, which is available to authorized users.
Highlights
Influenced by certain ecological conditions and transmitted through various vectors and animals, Neglected Tropical Diseases (NTDs) are a heterogeneous group of some 17 parasitic, bacterial, viral and fungal infections that burden the poor and marginalised in developing countries where they cause much human suffering and poverty
NTDs are thought to be second to HIV/AIDS in terms of infectious disease burden yet they receive only a small proportion of development assistance allocated to health [4]
NTD control has been linked to meeting multiple Millennium Development Goals (MDGs); numerous public-private partnerships, greater funding into scientific research and drug/diagnostic product development, significant donation of medicines by the pharmaceutical industry, and new and reinvigorated donor and country programmes have followed
Summary
Influenced by certain ecological conditions and transmitted through various vectors and animals, Neglected Tropical Diseases (NTDs) are a heterogeneous group of some 17 parasitic, bacterial, viral and fungal infections that. The success of case detection strategies and surveillance, for example in visceral leishmaniasis control in South Asia [84], can depend substantially on whether communities prefer public or private health systems and how projects engage with different providers Conducting such studies prior to a biomedical research or control programme can avoid many costly (and unnecessary) operational blunders. “Communities” rarely adhere to geographical locations, which are composed of a diversity of sub-groups with differences in needs, capacities and constraints This may present challenges for approaches that seek the broad involvement of the community; for example, community-led total sanitation (CLTS) – a participatory sanitation programme where people are encouraged to build their own locally-sourced pit latrines and recently promoted by NTD advocates – may face challenges in addressing entrenched gender dynamics in Africa [119].
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