Over one billion people worldwide suffer from neglected tropical diseases (NTDs), a group of 21 viral, bacterial, and parasitic infections identified by the World Health Organization (WHO).5 These diseases disproportionately affect the world’s most marginalized populations, particularly in sub-Saharan Africa, Southeast Asia, and South America, where poverty, inadequate healthcare, and poor sanitation create the perfect conditions for their spread (Figure 1).
Beyond their high mortality rates, many of these diseases cause chronic disability, cognitive impairment, and anemia, reducing a person’s ability to work, support their families, or access education.3 Without proper interventions, NTDs aren’t just a health crisis — they're a poverty trap.
Figure 1. Global Neglected Tropical Diseases (NTDs) Hotspots in 2021.8 The highest incidence of NTDs is concentrated in South and Southeast Asia, sub-Saharan Africa, and parts of South America. Regions in Europe and North America report the lowest incidence.
Impact on Workforce and Productivity
The link between NTD prevalence and poverty is undeniable, with the highest burden falling on regions like sub-Saharan Africa, where socioeconomic and political instability have long hindered progress. For instance, in Kenya, 18 out of the 21 NTDs listed by the WHO are suspected, endemic, or confirmed, painting a stark picture of the challenges faced by these communities.4
The economic toll of NTDs is drastic. Developing countries lose billions of dollars annually due to lost productivity and reduced purchasing power. In addition, NTDs often leave lasting scars even after recovery. Take leprosy, caused by Mycobacterium leprae: it can lead to permanent disfigurement and disability, stripping individuals of their ability to work.4 In economies heavily reliant on agriculture and industry, this translates to a devastating downstream effect. As more people become unable to work, household incomes decrease, pushing families deeper into poverty and placing an even greater strain on national economies.
The burden also extends beyond lost wages. Diseases like dengue hemorrhagic fever require costly intensive care, further straining the already fragile healthcare systems and pushing households into financial debt.4 The cycle is endless: poverty fuels NTDs, and NTDs deepen poverty.
Impact on Education
Education, a powerful weapon to break out of the poverty trap, is another casualty of NTDs. Children in affected regions face a dual threat: malnutrition and cognitive impairments hinder their ability to learn, while activities like swimming or fishing in infested waters expose them to disease. The result is a generation of children missing out on the education they need to break free from the poverty trap.
Yet, there is hope. Preventative measures are proving effective against childhood infections. In Niger, primary school children are receiving praziquantel, a treatment for schistosomiasis, and become better protected from waterborne infections.3 In Kenya, deworming programs have reduced school absenteeism by 25% and serious worm infections by 61%, demonstrating the transformative power of targeted preventions.4
The socioeconomic costs of NTDs are immense, but so too are the opportunities. The World Bank estimates that eliminating NTDs could add $52 billion annually to the global GDP.5 As we work toward the Sustainable Development Goals, achieving “universal healthcare” must be a priority. Addressing NTDs is not just a health crisis; it is an economic and moral one.
What’s Wrong With The Current R&D Landscape for NTDs?
Drug research for NTDs have long been ‘neglected,” historically receiving little attention from the pharmaceutical industry. And the reasons?
Limited financial incentives: Current R&D funding is mostly centered on HIV/AIDS, malaria, and tuberculosis, which affect a larger global population. Since NTDs primarily affect low-income countries, pharmaceutical companies see little return on investment in developing new treatments.1
Political and logistical challenges: Weak healthcare infrastructure and unstable political landscapes in low-income regions create uncertainty about whether treatments will actually reach those in need, discouraging foreign investments.3
Complicated patent landscape: Patents, the monopoly power over a drug for 20 years, allow pharmaceutical companies to set high drug prices, making treatments inaccessible for low-income populations. However, companies themselves may be unwilling to invest in NTD because these low-income populations have a lower ability-to-pay.1
There is also a so-called ‘market failure’ that NTDs suffer from, evident in the lack of new drug development for these conditions. Between 2012 and 2018, only 3% of all newly approved drugs targeted NTDs.4 The R&D pipeline remains heavily focused on high-profile NTDs like dengue and leishmaniasis, leaving many other diseases even further overlooked.1,3 Additionally, NTD treatment often requires complex drug combinations rather than a single vaccine, further driving up development costs and limiting investment in new therapies.
Successes Of The Past: What Have We Learnt?
When it comes to fighting NTDs, public–private partnerships (PPP) have become crucial, bridging gaps in drug development and access. PPPs have been suggested to play a role in addressing the ‘policy and market failure’ for NTDs.3 We believe these partnerships offer significant benefits by pooling resources to drive innovation. In the long run, they enhance the impact of publicly funded research for academia while also strengthening public relations and credibility for pharmaceutical companies. These partnerships take two primary forms: access PPPs and product development partnerships (PDPs). While each approach has its unique strengths, together they create a robust framework to accelerate progress against NTDs.
Access PPPs focus on improving the availability and affordability of existing treatments. They bring together governments, non-profits, pharmaceutical companies, and other stakeholders to address systemic barriers such as pricing, supply chain inefficiencies, and regulatory hurdles.1 Some standout examples include:
Merck's Mectizan Donation Program: In 1987, Merck & Co. committed to donating ivermectin (Mectizan®) for the treatment of onchocerciasis, known as river blindness. This initiative is the longest-running, disease-specific drug donation program of its kind. The program has approved the distribution of over 5 billion treatments across affected regions, significantly contributing to the control and elimination of the disease.4
The Global Program to Eliminate Lymphatic Filariasis: In 2000, WHO launched this initiative with the goal of eradicating lymphatic filariasis (LF). Building on its previous success with ivermectin, Merck & Co. donated the same drug for LF in 1998. GlaxoSmithKline also donated albendazole, an antiparasitic medication. Since this program started, the number of LF infections has been reduced by 74% globally.3
On the other hand, PDPs are nonprofit organizations that drive innovation by coordinating research for new NTD treatments. They facilitate clinical trials in endemic regions and secure funding from both public and private sources.6 An example is the Drugs for Neglected Diseases Initiative (DNDi), a collaborative, patient-focused, non-profit organization that has been instrumental in developing treatments for Chagas disease.6 By repurposing existing drugs like fexinidazole and fostering research networks in Latin America, DNDi has brought hope to millions of patients who were previously neglected by traditional drug development pipelines.6
Beyond these models, alternative approaches like consortiums are gaining traction, particularly in Europe. The Innovative Medicines Initiative (IMI), a joint effort between the European Commission and the European Federation of Pharmaceutical Industries and Associations, has secured €5 billion in funding for public health initiatives between 2008 and 2024.1 What sets IMI apart is its matching contribution model: public funds are allocated to SMEs, academia, and patient groups, while the private sector provides in-kind resources like talent, proprietary technologies, and research facilities.2 This collaborative approach addresses resource challenges that would be insurmountable for private companies alone, paving the way for groundbreaking innovations.
How Can Non-Profit Organizations Join The Fight?
This is not just a fight for academia and industry, non-profit organizations (NPOs) can play a role too. There are a few ways NPOs can help:
Helping to develop advocacy programs with partners
Mobilizing funding and technical assistance to support local government-led research.2
Helping partners develop new delivery models to be scaled-up.2
Working with local government authorities to fast-track the approval of NTD treatments.
Supporting the local healthcare systems with supply chain and mobilizing medical supplies resources to supporting healthcare professionals in endemic regions.2
Here are some NPOs that are actively working to fight NTDs.
United to Combat NTDs: A global advocacy organization dedicated to ending NTDs by mobilizing resources in support of the World Health Organization's NTD road map and the Sustainable Development Goals.3
The END Fund: The organization collaborates with various stakeholders to deliver treatments for the five most prevalent NTDs, having treated over 180 million people in 2023 alone.3
The Carter Center: Founded by former U.S. President Jimmy Carter and his wife Rosalynn, the center has been instrumental in near-eradication efforts of Guinea worm disease, reducing cases from 3.5 million in 1986 to just 14 in 2023.4
Bill & Melinda Gates Foundation: Through its Global Health Program, the foundation aims to eradicate, eliminate, or control eight of the 20 NTDs recognized by the WHO, improving health outcomes in affected regions.
The Need for Investments in NTDs
Why should we invest in NTDs? Investing in the eradication of NTDs is not just a moral imperative — it is a strategic decision with far-reaching benefits.
By addressing NTDs, we can unlock significant economic and social gains, particularly in the world’s most vulnerable regions. Eliminating these diseases would lead to improved productivity and workforce participation, as healthier individuals are better able to contribute to their economies. For example, studies have shown that treating soil-transmitted helminths in children can increase future earnings by up to 30%, bringing about an estimated net benefit of $25 per $1 invested to affected individuals.7
Enhanced educational outcomes and human capital development would follow, as children free from the burden of NTDs can attend school regularly and achieve their full potential. Programs like Kenya’s school-based deworming initiative, which reduced absenteeism by 25%, has estimated to add 14 years of education per child for every $100 spent.4,7 This program has scaled-up to cover schools in Kenya, Ethiopia, and India, which reaches over 190 million children to date, thus demonstrating the transformative power of such investments.4
Beyond productivity and education, eliminating NTDs would significantly reduce healthcare costs and improve financial stability for households. Families would no longer face the crippling expenses of treating diseases, and this financial relief would allow households to invest in their futures, breaking the cycle of poverty. For instance, the World Bank estimates that every dollar spent on NTD interventions yields a return of up to $30 in economic benefits, making it one of the most cost-effective global health investments.7
The Path Forward: A Collective Responsibility
The WHO has set out a roadmap to ending NTDs by 2030, but we are nowhere near our goal. More than 1 billion people worldwide still suffer from NTDs.3 Therefore to achieve greater health benefits, a multi-pronged approach is essential. Governments and international organizations must increase funding for NTD programs, ensuring that resources reach the communities that need them most. Strengthening healthcare infrastructure in endemic regions is equally critical, as robust systems are needed to deliver treatments and monitor progress. PPPs also play a key role, uniting academia, industry, governments, and nonprofit organizations to drive drug development.
International cooperation is the cornerstone of this effort. Initiatives like the Global Fund and the London Declaration on NTDs have shown what is possible when the world comes together, but more must be done to ensure no one is left behind.7 By investing in NTD elimination, we are not only improving health outcomes but also building a foundation for economic growth, social equity, and global stability.
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References
1. Aerts, C., Sunyoto, T., Tediosi, F. and Sicuri, E. “Are public-private partnerships the solution to tackle neglected tropical diseases? A systematic review of the literature.” Health Policy. 121:745–754. (2017).
2. Bush, S. “Presidential address: The role of non-governmental organisations in neglected tropical disease programmes.” Transactions of the Royal Society of Tropical Medicine and Hygiene. 117: 675–677 (2023)..
3. Miguel, E., Hicks, J.H., Kremer, M., Baird, S., Ozier, O., Jukes, M., Mbiti, I., Duhon, M., Walker, M., Ochieng, E. and Fernald, L. “School-Based Deworming'.‘ | IPA. poverty-action.org. (n.d.).
4. Ochola, E.A., Karanja, D.M.S. and Elliott, S.J. “The impact of Neglected Tropical Diseases (NTDs) on health and wellbeing in sub-Saharan Africa (SSA): A case study of Kenya.” PLOS Neglected Tropical Diseases. 1: e0009131(2021).
5. Shuaibu Abdullahi Hudu, Abdulgafar Olayiwola Jimoh, Kehinde Ahmad Adeshina, Edith Ginika Otalike, Tahir, A. and Abdelmonem Awad Hegazy. “An Insight into the Success, Challenges, and Future Perspectives of Eliminating Neglected Tropical Disease.” Scientific African. e02165–e02165 (2024).
6. Sunyoto, T. “Partnerships for better neglected disease drug discovery and development: how have we fared?’ Expert Opinion on Drug Discovery. 15: 531–537 (2020)..
7. ‘Invest in neglected tropical diseases.” Uniting to Combat NTDs. 2015.
8. “R&D funding flows for neglected diseases by disease, year and funding category.” World Health Organization. Accessed 3 Mar. 2025.