Ending the neglect to attain the Sustainable Development Goals - A road map for neglected tropical diseases 2021-2030 Overview - World Health ...
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Ending the neglect to attain the Sustainable Development Goals A road map for neglected tropical diseases 2021–2030 Overview
Targets and strategies for the next decade
This consultative process involved
regional workshops with managers
Neglected tropical diseases of NTD prevention and control
programmes, country workshops with
(NTDs) are a diverse set of stakeholders in NTDs and related areas
of work, input from disease experts,
20 diseases and disease groups disease modellers, donors and partners
obtained through more than 100
with a singular commonality: © WHO/Yoshi Shimizu
bilateral interviews and more than 300
responses from two rounds of online
their impact on impoverished The road map for neglected tropical
consultations. The document therefore
reflects the perspectives of Member
diseases 2021–2030 sets out global
communities. Together they targets for 2030 and milestones to
States and a wide range of stakeholders.
The road map also describes the
prevent, control, eliminate and eradicate
affect more than 1 billion people a diverse set of 20 diseases and disease
groups, as well as cross-cutting targets
integrated approaches needed to
achieve these targets through cross-
with devastating health, social aligned with WHO’s Thirteenth General
Programme of Work, 2019–2023 and
cutting activities that intersect multiple
diseases. It is built on three pillars that
and economic consequences. the Sustainable Development Goals. It
also proposes strategies for attaining
will support global efforts to control,
eliminate and eradicate neglected
these targets over the next decade. The tropical diseases:
document is intended to succeed the
first road map, published in 2012.1 Pillar 1
Accelerate programmatic action
The new road map was drafted through
an extensive global consultation that
Pillar 2
began in 2018 and culminated in the
Intensify cross-cutting approaches
document’s endorsement by Member
States at the Seventy-third World Health Pillar 3
Assembly in November 2020. Change operating models and culture
to facilitate country ownership
© WHO/Eduardo Soteras Jalil ccelerating work to overcome the global impact of neglected tropical diseases. Geneva: World Health Organization; 2012
A
1
(https://apps.who.int/iris/handle/10665/70809).
Driving progress Renewing momentum
Since 2010, significant progress has
been made. Today, 600 million people
no longer require interventions
against several NTDs and 42 countries,
territories and areas have eliminated
at least one disease. Dracunculiasis
is on the verge of eradication, with
54 human cases reported in four
countries in 2019; lymphatic filariasis
© WHO/Yoshi Shimizu © WHO/Yoshi Shimizu
and trachoma have been eliminated as
a public health problem in 17 and 10
countries, respectively; onchocerciasis Addressing NTDs has contributed to Even though substantial progress Concerted action across multiple
has been eliminated in four countries in alleviating the human and economic has been made, some of the targets dimensions and an agile response
the Region of the Americas; the annual burden they impose on the world’s set for 2020 in the earlier road map to challenges will be necessary to
number of cases of human African poorest communities. It also were not achieved. The new road map achieve the targets. The recognition,
trypanosomiasis has fallen from more demonstrates the impact of aligning identifies critical gaps and the actions for example, of Dracunculus medinensis
than 7000 in 2012 to fewer than 1000 the work of Member States with that required to reach the 2030 targets. infection in mammals other than
in 2019, eclipsing the original target of of diverse partners, which during the Experience from the past decade shows human beings shows how challenges
2000 cases by 2020; and the number of past nine years has demonstrated two that further multisectoral action is can manifest in the last stages – the
new leprosy cases reported globally has important facts: (i) NTD interventions required across the whole gamut of “last mile” – of eradication. Unforeseen
continued to decline since 2010 at on are one of the best buys in global public 20 diseases and disease groups and circumstances such as pandemics, local
average 1% per year after most endemic health and yield an estimated net along particular dimensions such as epidemics, political instability, migration,
countries reached elimination as a benefit to affected individuals of about diagnostics, monitoring and evaluation, consequences of climate change and
public health problem, defined as less US$ 25 per dollar invested in preventive access to and logistics for medicines antimicrobial resistance can complicate
than one case on treatment per chemotherapy2; and (ii) NTDs serve and medical products, capacity existing programmatic complexity and
10 000 population. as an important tracer in identifying strengthening, advocacy and funding. At will require additional mitigating action.
disparities in progress towards both this critical juncture on the road towards
universal health coverage and equitable elimination of NTDs, the stakes remain
access to high-quality health services. high. Ambitious, impact-oriented targets
are needed to guide efforts towards the
Sustainable Development Goals and
accelerate control and elimination.
2
itzpatrick C, Nwankwo U, Lenk E, de Vlas SJ, Bundy DAP. An investment case for ending neglected tropical diseases. In: Holmes KK, Bertozzi S,
F
Bloom BR, Jha P, editors. Major infectious diseases, 3rd edition. Washington, DC: The International Bank for Reconstruction and Development/
The World Bank; 2017. doi:10.1596/978-1-4648-0524-0/ch17.
Integrating and mainstreaming approaches Delivering results, achieving impact
Countries are both the drivers and the Given the shift to cross-cutting
beneficiaries of progress towards the approaches, structures and ways of
2030 targets for NTDs. National and working may need to be adapted
local governments must therefore lead accordingly, for example by making
work to define agendas and realize funding streams and reporting
their objectives, financed partly or fully structures more flexible.
through domestic funds. Countries
Looking ahead to the next decade,
must integrate and prioritize prevention
clearly much work needs to be done to
and control of endemic NTDs in
© WHO/Anuradha Sarup address NTDs, as their burden remains
national health plans and dedicate a
heavy among the most vulnerable and
corresponding line item in national
Continued programmatic action is The road map aims to renew marginalized populations of the world.
health budgets. Multisectoral action
called for, particularly in targeted areas momentum by proposing concrete Yet, perhaps equally clearly, the need
must be fostered and planned well
where critical gaps exist across multiple actions focused on integrated platforms to overcome these diseases of poverty
in advance in order to build the
diseases. Adequately structured for delivery of interventions, and is compelling in order to attain the
high-level political will required to
investigations of operations and thereby improve programme cost– Sustainable Development Goals and
support NTD plans.
implementation, including community- effectiveness and coverage. ensure universal health coverage.
based and applied research, are also As countries define their national NTD
Capacity strengthening within national The road map sets out global targets for
essential for building a solid foundation plans, the support of partners will
health systems will deliver interventions stakeholders to align their efforts and
on which effective NTD interventions remain essential for filling critical gaps,
through existing infrastructures, re-focus action over the next decade.
can be designed and delivered. strengthening capacity and enabling
improve the sustainability and efficiency It encourages all parties to reevaluate
programmatic targets to be achieved.
Beyond incremental modifications to of interventions and enable patients their approaches and consider how
Deliberate efforts are needed to engage
programmatic action, a more radical to access equitably all aspects of the efficiency and effectiveness of their
the community, especially young people,
change is needed to integrate and treatment, care and support. commitments and contributions can
in processes that support national NTD
mainstream approaches within national be improved. Finally, it seeks to foster
programme implementation, follow-up
Close coordination and multisectoral greater collaboration and openness in
health systems and coordinate action and review.
action within and beyond the health lessening and removing the profound
across sectors. These cross-cutting
sector, encompassing not only vector global burden of NTDs.
concepts are not new; they are outlined
control, water and sanitation, human,
in various existing NTD plans, but their
animal and environmental health and
operationalization has been problematic
health awareness but also, for instance,
in some instances.
education and disability, will maximize
synergies.
Road map targets, milestones and indicators1
© WHO/Andy Craggs © WHO/Fid Thompson
Overarching global targets for 20302
90% 75% 100 2
3
Percentage reduction Percentage reduction in Number of countries having Number of neglected
in people requiring disability-adjusted life eliminated at least one tropical diseases eradicated
interventions against years related to neglected neglected tropical disease
neglected tropical diseases tropical diseases
Cross-cutting targets for 2030
Integrated Multisectoral Universal Country
approaches coordination health coverage ownership
75% 100% 90% 90%
Integrated treatment coverage index Access to at least basic water supply, Share of countries including neglected Share of countries reporting on all
for preventive chemotherapy sanitation and hygiene in areas tropical disease interventions in their relevant endemic neglected tropical
endemic for neglected tropical diseases package of essential services and diseases
40 – to achieve targets 6.1 and 6.2 of budgeting for them
Sustainable Development Goal 6 90%
90%
Number of countries that adopt and
90%
implement integrated skin neglected Share of countries collecting and
tropical disease strategies Share of countries with guidelines for reporting data on neglected tropical
Share of the population at risk management of neglected tropical diseases disaggregated by gender
75% 4 protected against catastrophic out-
of-pocket health expenditure due to
disease-related disabilities within
national health systems
Percentage reduction in number of
deaths from vector-borne neglected neglected tropical diseases – to achieve
tropical diseases (relative to 2016) – to target 3.8 of Sustainable Development
achieve WHO’s global vector control Goal 3
90%
response goal
Share of countries with neglected
tropical diseases integrated in national
health strategies/plans
1
Source: Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030. Geneva: World Health Organization; 2020.
2
The baseline year for the overall percentage reduction is 2020 except for 3 and 4.
3
Compared with the baseline in 2010.
4
Compared with the baseline in 2016.
Impact of integrated approaches on disease-specific targets
Disease Indicator 2020 2023 2025 2030
TARGETED FOR ERADICATION
Dracunculiasis Number of countries certified free of transmission 187 (96%) 189 (97%) 191 (98%) 194 (100%)
Yaws Number of countries certified free of transmission 1 (1%) 97 (50%) 136 (70%) 194 (100%)
TARGETED FOR ELIMINATION (INTERRUPTION OF TRANSMISSION)
Human African trypanosomiasis Number of countries verified for interruption of transmission 0 0 5 (21%) 15 (62%)
(gambiense)
Leprosy Number of countries with zero new autochthonous leprosy cases 50 (26%) 75 (39%) 95 (49%) 120 (62%)
Onchocerciasis Number of countries verified for interruption of transmission 4 (12%) 5 (13%) 8 (21%) 12 (31%)
TARGETED FOR ELIMINATION AS A PUBLIC HEALTH PROBLEM
Chagas disease Number of countries achieving interruption of transmission through the four transmission 0 4 (10%) 10 (24%) 15 (37%)
routes (vectoral, transfusion, transplantation and congenital), with 75% antiparasitic
treatment coverage of the eligible population
Human African trypanosomiasis Number of countries validated for elimination as a public health problem (defined asEnding the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030. Overview This document is an update of a brochure published in 2020 under WHO/UCN/NTD/2020.01. ISBN 978-92-4-001879-2 (electronic version) ISBN 978-92-4-001880-8 (print version) © World Health Organization 2021. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence.
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