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Neglected tropical diseases (NTDs) are a diverse group of 20 disease and disease groups that are typified by their prevalence in low-income countries or in the poorest populations of middle- to high-income countries and are caused by a variety of pathogens such as viruses, bacteria, protozoa and parasitic worms. Relative to the "big three" infectious diseases (HIV, tuberculosis, and malaria), NTDs receive comparatively less treatment and research funding, despite studies suggesting their economic burden being comparable to malaria and tuberculosis combined. This neglect has been attributed to their lower mortality rates compared to the "big three", and because they mainly effect the poorest within society. NTD treatment development is generally not commercial and therefore patents and profit do not generally drive treatment innovation. Indeed, one study found that there was a 13-fold greater chance of a drug entering the market if it targeted a central nervous system disorder or cancer than for an NTD.
Patients with NTDs often find themselves stigmatised by their communities, often due to physical deformity caused by the disease. This can lead to denial of marriage, community rejection, or inability to work, all of which are potentially detrimental to the patients’ well-being. In some cases, this stigma can also make treatment more complex as disease-control is made more difficult by a decrease of help-seeking and treatment adherence.
For more than 20 years, the World Health Organisation has tasked itself with controlling, eliminating and eventually eradicating NTDs, with WHO convening the first meeting of global partners in 2007 to devise roadmaps to tackle NTDs. Research has shown that in fact a large number of them can be tackled by overarching, simple, and relatively inexpensive, interventions such as policies related to water, sanitation and hygiene, or health policy. However, research is beginning to suggest that tackling inequalities at a societal level may have a positive knock-on effect on NTD treatment and prevention.
In collaboration with WHO, our projects seeks to understand how societal inequalities hinder effective NTD research and treatment, and in turn how they can be addressed and overcome. To do this, we will focus on how gender, human rights and healthcare inequality manifest within NTD patient demographics, disease research, NTD treatment and monitoring procedures. This will be considered at the level of each individual NTD and also from a bird’s-eye perspective of all or sub-groups of NTDs. This research will then inform cross-cutting policy proposals that have the potential to be implemented in effected regions.