Abstract
The global burden attributed to Neglected Tropical Diseases (NTDs) is 47.9 million Disability-Adjusted Life Years (DALYs). These diseases predominantly affect disadvantaged populations. Priority for NTDs has grown in recent years, which is observed by their inclusion in the sustainable development goals (SDGs). This study analyzed the process that allowed these diseases to be included on the global health policy agenda. This global policy analysis used the Shiffman and Smith framework to understand the determinants of global health political priority for NTDs. The framework comprises four categories: actor power, ideas, political contexts, and issue characteristics. Global documents and World Health Assembly (WHA) resolutions were examined, key-informant interviews were conducted, and academic publications were reviewed to understand the four categories that comprise the framework. A total of 37 global policy documents, 15 WHA resolutions, and 38 academic publications were examined. Twelve semi-structured interviews were conducted with individuals representing different sectors within the NTD community who have been involved in raising the priority of these diseases. This study found that several factors helped better position NTDs in the global health agenda. These include the leadership of actors that mobilized the global health community, the creation of a label combining these diseases as a group to represent a larger disease burden, the presence of mechanisms aligning the NTD community, and the agreement on ways to present the NTD burden and potential solutions. The process of building the priority of NTDs in the global health agenda shows that several determinants led to positive outcomes, but these diseases continue to have low priority at the global level which requires the implementation of actions to increase their global priority. These include sustaining the commitment of current actors and engaging new ones; increasing the attention given to diseases formerly categorized as “tool-deficient”, including zoonotic NTDs; continue leveraging on policy windows and creating favorable policy moments to sustain commitment, as well as setting realistic targets. Findings from this study can help develop strategies to build the momentum and drive actions to implement the goals of the new Roadmap for NTDs in the pathway to universal health coverage (UHC) and sustainable development.
Highlights
Neglected tropical diseases (NTDs) are diseases of poverty that affect disadvantaged populations living predominantly but not exclusively, in tropical and subtropical environments [1]
Interviewees were employed at academic institutions (n = 5), non-governmental organizations (NGOs) (n = 2), non-profit organizations (NPOs) (n = 1), philanthropic foundations (n = 1), multilateral organizations (n = 1), and pharmaceutical companies (n = 2)
Some of these interviewees were based in endemic countries (n = 2), others had travelled extensively or lived in those settings (n = 5), and most had previous or ongoing NTD projects with stakeholders based in low- and middle-income (LMIC) (n = 10), which allowed them to bring the perspectives from the Global South
Summary
Neglected tropical diseases (NTDs) are diseases of poverty that affect disadvantaged populations living predominantly but not exclusively, in tropical and subtropical environments [1]. Women and children are disproportionately affected by many of these conditions [4] Consequences of these diseases include stigma, social exclusion, disability, and other chronic conditions [2,5]. Their effects inhibit the social and economic development of affected populations and nations [6,7]. Despite their high burden and long-term effects [2,5], this category of diseases has been neglected and absent from the global health agenda when compared to other infectious and tropical diseases such as HIV, malaria, and TB [1,8]
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