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6 THIRD WHO REPORT ON NEGLECTED TROPICAL DISEASES
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1.3 Confronting challenges
There is an urgent need to address the shortfall in long-term funding for various programmes.
In April 2014, NTD partners published Delivering on promises and driving progress, which
estimated that an additional US$ 1.4 billion, or US$ 200 million per year, would be needed
to meet the 2020 Roadmap targets (5). These requirements include implementation costs for
some but not all NTD interventions; they do not include, for example, vector control or the
broader preventive chemotherapy agenda, such as post preventive chemotherapy surveillance
and morbidity management and disability prevention. They also do not cover innovations, new
tools or costs associated with improved strategies to achieve the Roadmap’s targets for 2020,
much less the UHC targets for 2030.
National control programmes must be strengthened, maintained and mandated with
clearly defined responsibilities in order to coordinate essential functions such as situation
analysis, strategic planning, budgeting, prevention, diagnosis, treatment, surveillance, capacity
development, timely distribution of medicines and supervision of operations at all levels of the
national system.
Although significant progress has been made against vector-borne diseases, dengue and
chikungunya continue to spread at an alarming pace. Challenges also include the shortage
of trained health-care personnel, the absence of integrated vector control programmes and
the degree of readiness in some countries to implement WHO-recommended integrated
programmes comprehensively.
Emerging challenges in Chad and insecurity in Mali and South Sudan have hindered
dracunculiasis eradication and may compromise WHO’s target of interrupting transmission of
the disease by the end of 2015.
Some critical interventions go beyond the scope of health. Unpredictable epidemics such as
the current Ebola virus disease crisis in West Africa and their potential to expand can divert
resources away from NTDs and adversely affect national control programmes. Long-term
political commitment, sustained strengthening of health systems, maintenance of technical
capacities, and effective monitoring and evaluation of interventions are crucial to achieving
the Roadmap’s targets.
More State-level engagement, sustainable and innovative financing and greater coordination
are required to bring game-changing treatments and diagnostics to patients. Increased domestic
resources, including funding and intersectoral collaboration, must be enhanced to support
implementation of programmes to achieve universal coverage against NTDs. 1 The concept of
universal coverage against NTDs is more fully developed in Chapter 2.
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1
Universal coverage against NTDs (in particular) applies the principles of universal health coverage (in general) to an essential
package of interventions for low-income and rural populations, and other disadvantaged groups.