Neglected Tropical Diseases (NTDs) remain a stark marker of global health inequity, affecting over 1.5 billion of the world’s poorest and most marginalized people. The Global Report on Neglected Tropical Diseases 2025 by the World Health Organization (WHO) charts two decades of concerted action, revealing significant victories alongside persistent and emerging challenges.
As the world commemorates World NTD Day, the focus sharpens not only on eliminating transmission but also on addressing the profound, often invisible, suffering caused by stigma and untreated mental health conditions among those living with these debilitating diseases.
A Legacy of Progress: Two Decades of Action
Established in 2005, the WHO Global NTD Programme has spearheaded a remarkable collective effort. The results are tangible: the number of people requiring interventions against NTDs has fallen by almost one-third since 2010, from over 2 billion to 1.495 billion in 2023. This decline occurred even as the global population grew, meaning the share of the global population at risk dropped from 31.2% to 18.5%.
A cornerstone of this success has been mass drug administration (MDA). Nearly 30 billion tablets and vials of donated medicines have been delivered since 2011, with 1.8 billion in 2024 alone. This has propelled countries toward elimination milestones. By the end of 2024, 54 countries had eliminated at least one NTD, with 7 new countries acknowledged in that year alone (including Brazil and Timor-Leste for lymphatic filariasis, and Jordan, the first globally, for leprosy).
Disease burden, measured in Disability-Adjusted Life Years (DALYs), fell from 17.2 million in 2015 to 14.1 million in 2021. Notable successes include a 59.7% reduction in DALYs from human African trypanosomiasis and a 97.4% drop in reported cases since 2000. Lymphatic filariasis treatment coverage rebounded to pre-COVID-19 levels in 2023, treating 412 million people.
The Unseen Burden: Stigma and Mental Health
Beyond the physical toll, the 2025 report and World NTD Day spotlight a critical, neglected dimension: mental health. People living with chronic, disabling, or disfiguring NTDs face significantly higher rates of depression, anxiety, and suicidal behavior than the general population. Discrimination and social stigma isolate individuals, hindering healthcare access, economic participation, and social inclusion.
In a landmark move, WHO launched its first global guide on an Essential Care Package for addressing mental health and stigma for people affected by NTDs. This underscores a paradigm shift toward holistic, person-centered care that treats the whole individual, not just the pathogen.
Persistent Challenges and Data Gaps
Despite progress, the path to the 2030 road map targets is fraught with obstacles:
- Uneven Progress and New Threats: Climate change is expanding the range of vector-borne NTDs like dengue, which WHO classified as a Grade 3 emergency in 2024. Geopolitical conflicts and humanitarian crises disrupt services and access.
- The Financing Cliff: Official Development Assistance (ODA) for NTDs fell by 41% between 2018 and 2023, threatening sustainability and gains.
- The Data Deficit: A lack of high-quality, timely data remains a major impediment. Many NTDs are under-recognized, with weak surveillance systems and reporting fragmented across multiple platforms. Diseases like mycetoma, chromoblastomycosis, and noma (added to the NTD list in 2023) suffer from severe information gaps, obscuring their true burden.
- Inequities in Access: Access to basic Water, Sanitation, and Hygiene (WASH) remains low among populations requiring NTD interventions (56.9% in 2022), perpetuating transmission cycles. Furthermore, populations at risk of NTDs are more vulnerable to being impoverished by out-of-pocket health expenses, even if these costs don’t meet the threshold for “catastrophic” spending.
Spotlight on the Eastern Mediterranean Region: A Microcosm of the Struggle
The Eastern Mediterranean Region (EMR) illustrates the complex interplay of progress and persistent hardship. In 2023, 78 million people in the region required NTD interventions. Of these, 20.4 million (26.2%) were treated via preventive chemotherapy.
The region has celebrated major successes, with 10 countries eliminating at least one NTD. Oman was the first country globally to eliminate trachoma in 2012, and Jordan followed as the first global verifier of leprosy elimination in 2024. Countries like Pakistan, Somalia, and Sudan are rolling out integrated approaches to combat skin-related NTDs.
However, the EMR faces acute challenges:
- Incomplete disease mapping and hard-to-reach populations limit MDA coverage.
- Weak supply chains lead to shortages of diagnostics and medicines.
- Ongoing conflicts and emergencies in several high-burden countries severely disrupt health services.
- Under-reporting, especially from the private sector, weakens surveillance.
- Insufficient government commitment and resource allocation for NTDs slow progress.
WHO’s Strategic Response: Integration and Investment
In response to these global and regional challenges, WHO is undergoing strategic restructuring, merging the Global Malaria and NTD Programmes to enhance efficiency. The strategy focuses on:
- Accelerating Programmatic Action: This includes technical innovation (6 new medicine formulations prequalified in 2024), normative work (50+ publications), and operational support through mechanisms like the new Global Coordination and Stewardship Committee for donated medicines.
- Intensifying Cross-Cutting Approaches: Promoting integration of NTD services (e.g., the skin NTD framework), strengthening gender, equity, and human rights (GER) approaches, and mainstreaming NTD interventions into national health systems and essential service packages.
- Fostering Country Ownership: Supporting countries to develop sustainability plans and mobilize domestic resources.
Specifically for regions like the EMR, WHO has prioritized two flagship initiatives:
- Expanding access to quality medical products by reducing import reliance, enhancing local production, and strengthening regulatory systems.
- Investing in a resilient health workforce through expansion, retention, and skill-building.
The Way Forward
The next five years are critical. While the “golden age of disease elimination” has yielded extraordinary results, the final stretch to the 2030 targets is the most difficult. Success requires:
- Sustained and Smart Financing: Bridging the ODA gap and increasing domestic investment.
- Integrated, People-Centered Health Systems: Moving from vertical programs to services integrated into primary healthcare, including mental health and disability support.
- Robust Data Systems: Harmonizing and strengthening surveillance to guide action and ensure accountability.
- Addressing the Social Determinants: Combating stigma and investing in WASH, education, and poverty alleviation.
The fight against NTDs is a litmus test for global health equity. Ending the neglect means not only eliminating diseases but also restoring dignity, hope, and opportunity to billions. As the 2025 report concludes, with focused effort, integration, and unwavering commitment, a future free from the burden of NTDs is not just aspirational—it is achievable.
