Discussion

The era of the Millennium Development Goals (MDGs) from 2000 to 2015 saw tremendous gains in the reduction and elimination of the neglected tropical diseases (NTDs). According to the Global Burden of Disease Control Study (GBD) 2013, there was a 30-40% reduction in the prevalence of lymphatic filariasis (LF), onchocerciasis, ascariasis, and trachoma, in addition to significant yaws reductions, gains partly achieved through integrated mass drug administration using a “rapid impact package” launched in 2005. In addition we are progressing towards the elimination of Gambian African trypanosomiasis and eradication of Guinea worm. In contrast and according to GBD 2013, so far little progress has been made so far towards the global elimination of hookworm, schistosomiasis, and intestinal protozoan infections such as cryptosporidiosis and amoebiasis, while there have been dramatic increases in some vector borne NTDs including leishmaniasis, Chagas disease, and arbovirus infections. With the launch of the Sustainable Development Goals (SDGs) this year we have seen some new and important trends, including the rise of NTDs among the poor living in wealthier G20 countries &hypen; a concept known as blue marble health. In addition vector-borne NTDs and schistosomiasis are on the rise in areas at the confluence of extreme poverty, human migrations stemming from conflict, and climate change, especially in the Middle East and North Africa, Southern Europe, and the Americas. There is a need for a two-pronged approach to advance NTD elimination, including expansion of the rapid impact package to reach all of the world’s poor requiring treatment, in addition to developing new and improved control tools such as drugs, diagnostics, insecticides, and vaccines. But we need innovative financing mechanisms for such technologies, as well as programs of international science diplomacy.