1. Neglected Tropical Diseases Hidden and silent : Key problems
Complacency, lack of information and commitment
The poor, with little political voice, suffer most
Not perceived as a threat to western society
Incapacitating more than killing
Low profile in public health priorities
Negative image, complicated names and complex strategies

2. Global distribution: the burden divides the world in two.
Approximately 1 billion people are affected by more than one of NTDs

3. Large scale interventions
Lymphatic filariasis
Leprosy
Onchocerciasis
Schistosomiasis
Helminthiasis
Trachoma
Yaws
Rapid Impact Interventions
Improving access
Case management and development of new tools
Human African trypanosomiasis
Chagas diseases
Buruli ulcer
Leishmaniasis
Focused interventions
Improving innovation

4. The importance of the Right to health for the control of NTDs
Advocacy: Participation of Paul Hunt in two international meetings on NTDs, and several meetings in WHO. Goodwill Ambassador Mr Sasakawa
Help scientific community to focus thinking on strategies adapted to the local reality: Berlin and Bangalore
Assessment at country level...Mission report in Uganda
Specific recommendations to Governments, private sector, NGOs and international community
If integrated into policies, programmes and projects, the right to health helps to ensure that they are evidence-based, robust, sustainable, equitable and meaningful to those living in poverty.
Key role of the civil society, NGOs and people affected by NTDs

5. The case of Leprosy
Leprosy is considered shameful and people hid their symptoms for fear of ostracism despite free and effective multidrug treatment.
This chronic infectious disease usually affects the skin and peripheral nerves but has a wide range of possible clinical manifestations.
Women in leprosy-endemic areas of the world, with few exceptions, suffer from marked economic and social dependency and inferiority which can only be heightened by the social stigma associated with leprosy. Nevertheless, they bear an enormous responsibility for the health of their families, often as head of the household, and they often possess a unique capacity to influence community opinion.
Drugs used for multidrug therapy (MDT), are donated by Novartis and made available free to all affected countries through WHO. Since 1985, more than 15 million patients have been cured of leprosy through the use of MDT.

6. World Health Organization
Leprosy situation in 2008
8 April 2019
Between 1985 and 2008, more than 15 million cases have been cured with MDT. The number of persons registered for treatment fell from 5.4 million in 1985 to in 2008.
Global case detection continues to fall every year
Only 3 countries remain with prevalence rates above 1 per 10,000 population (1985: 122 countries): Brazil, Nepal and Timor Leste)

7. World Health Organization
Registered prevalence by WHO Region
in 2007 and 2008, and % change*
8 April 2019
Region
Prevalence at beginning of 2007
Prevalence at beginning of 2008
% change from 2007 to 2008
Africa
29 548
30 055
+1.71%
Americas
64 715
49 388
-23.68%
East Mediterranean
3 986
4 240
+6.37%
South East Asia
+3.69%
Western Pacific
9 805
8 152
-16.86%
World
-5.30%
* Patients registered for treatment, excluding Europe

8. New case detection by WHO Region in 2006 and 2007, and % change*
World Health Organization
New case detection by WHO Region in 2006 and 2007, and % change*
8 April 2019
Region
Cases detected during 2006
Cases detected during 2007
% change from 2006 to 2007
Africa
34 480
31 037
- 9.99%
Americas
47 612
41 978 %
East Mediterranean
3 261
4 091 %
South East Asia
- 1.47%
Western Pacific
6 190
5 867
- 4.20%
World
- 4.19%
* excluding Europe

9. Milestones in MDT treatment
World Health Organization
Milestones in MDT treatment
8 April 2019
Multidrug therapy (MDT) recommended as a standard treatment for leprosy by WHO in 1982, contains rifampicin, clofazimine and dapsone
1986: only 5% of registered patients on MDT
1991: World Health Assembly resolution to eliminate leprosy as a public health problem
1995: WHO started global supply of high quality MDT free of cost
1998 onwards : 100% of registered cases on MDT

10. MDT changes the face of leprosy
World Health Organization
MDT changes the face of leprosy
8 April 2019
Highly effective - cures patients in 6 – 12 months
Single MDT dose renders patient non-infectious
Best way to prevent disabilities through early cure
Treatment is safe with few side effects
No drug resistance following MDT has yet been reported
The numbers of relapses after treatment remains very low, at less than one case per 1,000 patients per year.

11. But still a long way to go
World Health Organization
8 April 2019
Stigma and discrimination are still present in developed and developing countries
An estimated one million persons live with severe disabilities and are highly vulnerable
Despite the medical progress and information, a significant number of countries have regulations aiming at isolating, limiting access to work, public transport, international travel, divorce 11

12. Key features of a right to health approach to neglected diseases
Community participation
Fighting stigma and discrimination
Research and development
An integrated health system that is responsive to local priorities
Monitoring and accountability: monitor and hold to account national and international actors in the public and private sectors. The guiding question should be: have all duty-bearers done all they reasonably can to promote and protect the right to health of those suffering from, or vulnerable to, neglected diseases?