A Road Map for Neglected Tropical Diseases 2021–2030
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Buruli ulcer Chagas disease Dengue and chikungunya Ending the neglect to Dracunculiasis attain the Sustainable Echinococcosis Development Goals Foodborne trematodiases A road map for neglected Human African trypanosomiasis tropical diseases 2021–2030 Leishmaniasis Leprosy Lymphatic filariasis Mycetoma, chromoblastomycosis and other deep mycoses Onchocerciasis Rabies Scabies and other ectoparasitoses Schistosomiasis Soil-transmitted helminthiases Snakebite envenoming Taeniasis and cysticercosis Trachoma Yaws SECTION 01: CONTEXT AND PURPOSE OF THE ROAD MAP 01 Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030 ISBN 978-92-4-001035-2 (electronic version) ISBN 978-92-4-001036-9 (print version) © World Health Organization 2020 Some rights reserved. 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However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. © WHO/Shobhan Singh Design and layout by Big Mouth Gets. The definitive version of the road map can be found in the official records of the Seventy-third World Health Assembly (document WHA73/2020/REC/1, Annex 8). 02 A ROAD MAP FOR NEGLECTED TROPICAL DISEASES 2021–2030 Neglected tropical diseases 01. Context and purpose (NTDs) are ancient diseases of the road map of poverty that impose a 02. devastating human, social 2030 targets and economic burden on and milestones more than 1 billion people 03. Accelerate programmatic worldwide, predominantly in action tropical and subtropical areas among the most vulnerable, 04. Intensify cross-cutting marginalized populations. approaches 05. Change operating models and culture to facilitate country ownership 06. Conclusions Fig. 1. Geographical spread of the NTD burden, by DALY and gross domestic product 3 Fig. 2. Interactions among interventions against NTDs and the SDGs 5 Fig. 3. Progress against NTDs 6 Fig. 4. Shifts in approaches to addressing NTDs 9 Fig. 5. Areas that require concerted action 20 Fig. 6. Dimensions for assessing disease-specific actions 25 Fig. 7. Gap assessment for each NTD 26 Fig. 8. The role of diagnostics 28 Fig. 9. Assessment of diagnostic gaps and priorities 30 Fig. 10. Current challenges along the NTD supply chain 35 Fig. 11. Current status of commitments to donations of medicines 38 Fig. 12. Critical actions for each disease and disease group to reach the 2030 targets 40 Fig. 13. Four categories of cross-cutting themes 47 Fig. 14. Integrated approaches to the management of skin NTDs 48 Fig. 15. Disease groupings for which joint interventions may be applicable 50 Fig. 16. Mainstreaming NTDs into national health systems 55 Fig. 17. Considerations for balancing disease-specific and integrated approaches 55 Fig. 18. Coordination with health ministries and other ministries and authorities 57 Fig. 19. Relevance of coordination for each NTD 58 Fig. 20. Examples of coordination with other disciplines and sectors 60 Fig. 21. WASH and NTDs: activities and mechanisms for coordination 62 Fig. 22. Global vector control response: activities and mechanisms for coordination 63 Fig. 23. One Health approach and NTDs: activities and mechanisms for coordination 64 Fig. 24. Roles of stakeholders at all levels and in all sectors 69 Fig. 25. Shifts in organizational structures in countries 71 Fig. 26. Examples of steps in designing a national NTD plan 74 ii A ROAD MAP FOR NEGLECTED TROPICAL DISEASES 2021–2030 CONTENTS Foreword iv Acknowledgements vii 01. Glossary viii Context and purpose of the road map Executive summary x 1. Context and purpose of the road map 2 2. 2030 targets and milestones 12 02. 3. Accelerate programmatic action 24 2030 targets and milestones 3.1 Diagnostics and other key innovations 28 3.2 Monitoring and evaluation 32 3.3 Access and logistics 34 03. Accelerate programmatic 3.4 Advocacy and funding 36 action 4. Intensify cross-cutting approaches 46 4.1 Integrate approaches across diseases 48 04. 4.2 Mainstream delivery platforms within national health systems 54 Intensify cross-cutting 4.3 Coordinate efforts across sectors 56 approaches 5. Change operating models and culture to facilitate country ownership 68 6. Conclusions 78 05. References 79 Change operating models and culture to facilitate Annex: Disease summaries 82 country ownership 06. Conclusions A ROAD MAP FOR NEGLECTED TROPICAL DISEASES 2021–2030 iii FOREWORD Nine years have elapsed since the World Health In the same spirit, the road map highlights the need for Organization (WHO) published its first road map for innovative approaches to achieve maximum efficiency neglected tropical diseases, which set targets for 2020. and scalability through enhanced capacity, increased With exemplary country leadership and the continued country commitment including domestic funding, and support of industry and partners, we have been able to external resource mobilization. In short, this road map push back many of these diseases, bringing some close places people and communities at the centre of efforts to elimination and eradication. to improve their health and welfare. However, despite substantial progress in reducing the This new road map is our collective vision and was overall burden, many of the targets set for 2020 were developed over the past two years through extensive not achieved. consultations. WHO is committed to working with every country and partner to better deliver interventions This road map builds on past lessons and experiences in a coordinated manner and improve the cost– so we can better understand emerging challenges. Over effectiveness and coverage of programmes that will the next decade, we will move from a disease-specific to guarantee that the poorest have enhanced access an integrated approach that cuts across all 20 diseases to quality-assured, effective and safe medicines and and disease groups, to ensure country ownership and diagnostics. leadership, to work even more closely with countries and partners, and to promote the development of new As we demonstrated during the COVID-19 pandemic, tools for prevention, diagnosis and treatment. working across sectors in unity and solidarity is not just a concept but a powerful force. This road map We will also work with other programmes and sectors unites us all to work together to free those afflicted by to optimize our strategy to achieve the targets: by 2030, neglected tropical diseases from unnecessary suffering, we aim to free more than 1 billion people who currently stigmatization