Authors

Discussion

Introduction

Neglected tropical diseases (NTD) affect over 1.7 billion people globally. Of the 20 recognized NTDs, 6 are antibiotic-treated infectious diseases: Buruli ulcer, leishmaniasis, leprosy, onchocerciasis, trachoma, and yaws.

Context and Aim

The WHO 2021-2030 NTD roadmap recommends antibiotic use for mass drug administration (MDA) and/or case management for these 6 diseases. We aim to generate evidence on antibiotic use and resistance to justify NTD elimination as an antibiotic stewardship strategy.

Method

We carried out a comprehensive review of countries’ NTD plans and WHO standard practice guidance to identify the antibiotics used, along with a literature review to measure resistance in NTDs and other diseases.

Findings

Rising antibiotic resistance poses a threat to NTD elimination and basic standards of care. Of the 6 antibiotic-treated NTDs, 4 demonstrate resistance. Further, of the 14 antibiotics used, 6 show resistance for both the corresponding NTD and one or more infectious diseases such as tuberculosis, gonorrhea, and pneumonia.

Innovative contribution to policy, practice and/or research

Global progress in NTD elimination is evident. However, there remains a paucity of data for policy makers to prioritize NTD elimination as an antibiotic stewardship strategy. Presenting evidence for decreasing resistance development through reducing antibiotic use, particularly through MDAs, is a valuable political and economic argument for strengthening NTD efforts.