Forging a Future Free from Neglected Tropical Diseases

World Neglected Tropical Diseases Day (“World NTD Day”), established by the World Health Organization and observed every January 30th, raises awareness and mobilizes action against neglected tropical diseases (NTDs), affecting over 1.6 billion people worldwide.^1,2 In recent years, we have witnessed advances in the development of tools to control, prevent, and eliminate at least one NTD in many countries. One such example is the vaccine for Dengue, now becoming available in epidemic areas, such as in Brazil. Also, new drugs have reached the market. However, future action plans must consider the challenges posed by record high temperatures, biodiversity loss, poverty, social inequalities, and reduced investment in fighting these diseases, particularly in the global South.

The year 2023 was marked as the hottest year on record due to climate change, affecting the natural habitats of pathogens and facilitating their survival and ability to infect hosts, including humans. This is particularly crucial for mosquito-borne diseases. Additionally, deforestation impacts wildlife habitats, leading to closer human–wildlife contact and potentially increasing the occurrence of pathogen spillover and zoonotic diseases. These environmental changes are not only ecological concerns but also public health issues that disproportionately affect impoverished communities in the global South.

Combatting poverty and increasing inequalities, especially in lower and middle-income countries (LMICs) in the global South, is imperative, as these regions are most affected by NTDs. Limited access to healthcare, clean water, and sanitation in these areas heightens infection risks. For instance, in Brazil, 26 million people lack direct access to clean water, and around 105 million lack fully improved sanitation services.³ The impacts of climate change, including severe flooding and droughts, further exacerbate public health challenges in the poorest areas of the country.

These environmental and socio-economic factors raise the need for drug discovery against NTDs. While there has been progress in drug approvals for NTDs, such as fexinidazole for human African trypanosomiasis and moxidectin for onchocerciasis, the development of new clinical candidates remains limited. Furthermore, the growing issue of antimicrobial resistance, exemplified by leprosy resistance to rifampicin, dapsone, and ofloxacin, and the general lack of investment in drug discovery in LMICs hinder progress.

Drug discovery for NTDs is primarily supported through investments from international organizations and public–private partnerships. In LMICs, drug discovery efforts are limited, with insufficient leadership to drive innovation toward public health needs. However, promising initiatives driven out of academic institutions like the University of Cape Town Holistic Drug Discovery and Development (H3D) Centre in South Africa are working to increase capacities in drug discovery and foster scientific leadership.⁴ Yet, increased investment by local governments in both academic and industrial sectors is crucial.

ACS Medicinal Chemistry Letters is committed to enhancing the visibility of science in the field of NTDs, particularly by providing a platform for research groups in LMICs to disseminate their work.⁵ This would increase the diverse and inclusive character of the research in the area of NTDs, as seen in recent publications.⁶⁻⁹

To effectively prevent and combat NTDs, a multifaceted approach integrating environmental management, public health policies, and socio-economic disparity mitigation is essential, alongside robust drug discovery and development efforts. Aligning these strategies with the United Nations’ Sustainable Development Goals and the Paris Agreement on Climate Change is crucial.

In conclusion, World NTD Day is not only a day for awareness but also a call to action across multiple fronts. By adopting a holistic approach that combines environmental, social, policy, and scientific strategies, and by enhancing the drug discovery capabilities in LMICs for researchers in these regions to contribute to a pipeline of innovative therapeutics, we can make significant strides in eradicating these diseases and improving global health outcomes. The fight against NTDs is a testament to our commitment to a more equitable and healthier world.

Views expressed in this editorial are those of the authors and not necessarily the views of the ACS.