INTERVIEW: Leprosy in the context of the NTD roadmap

Activity area:

At the end of January, the WHO published its new road map for neglected tropical diseases (NTDs). The road map targets 20 diseases, including leprosy, and features cross-cutting targets aligned with the Sustainable Development Goals (SDGs). In February, the Leprosy Bulletin interviewed Dr. Ren Minghui, who has been the WHO’s Assistant-Director General for Universal Health Coverage/Communicable and Noncommunicable Diseases since 2017.

LB (Leprosy Bulletin): What should people know about neglected tropical diseases? 

RM (Ren Minghui): Neglected tropical diseases (NTDs) are a diverse group of conditions of bacterial, viral, parasitic, fungal and non-communicable origin. Despite their diversity, they share a common geographical and social context and their burden is predominantly located in tropical areas across the globe. Many are vector-borne, have animal reservoirs, and are associated with complex life cycles, making their public-health control quite challenging.

More than 1 billion people are affected by these diseases and an estimated 1.7 billion people require treatment for at least one NTD every year. Although they do not kill in large numbers, several NTDs debilitate and cause life-long suffering to affected populations, depriving them of their livelihood. 

They mainly affect poor communities and their correlation with poverty is so close that they are often referred to as diseases of neglected populations. Their entrenchment among disadvantaged population groups with little public voice contributes largely to their neglect.

LB: Please tell us about the NTD road map for 2021-2030.

RM: The WHO’s Ending the neglect to attain the Sustainable Development Goals: A road map for neglected tropical diseases 2021-2030 sets out global targets for 2030 and impact indicators to prevent, control, eliminate, or eradicate 20 diseases and disease groups. Although we made substantial progress over the last decade by prioritizing the public health needs of poor and marginalized populations, many of the targets set in the first road map for 2012-2020 were not met. 

The new road map identifies critical gaps and the actions required to reach the new targets. These include working with local governments, local partners and communities and fostering their active engagement in NTD programs. 

The 2030 global targets are:

  • To reduce by 90% the number of people requiring treatment for NTDs
  • Get at least 100 countries to have eliminated at least one NTD
  • To work with everyone to eradicate two diseases (dracunculiasis and yaws); and
  • To reduce by 75% the disability-adjusted life years (DALYs) related to NTDs

In addition to the targets for 2030, we have set impact indicators for 2023 and 2025 for each NTD. The impact indicators selected reflect the public health goals set for each disease: eradication, elimination (interruption of transmission), elimination as a public health problem (major decrease in transmission and/or elimination of morbidity), and control. 

Experience from the past decade shows that further multisectoral action is required in areas such as diagnostics, monitoring and evaluation, access to and logistics for medicines and medical products, capacity strengthening, advocacy, and funding. The road map aims to renew momentum by proposing concrete actions focused on integrated platforms for delivery of interventions and thereby improve program cost-effectiveness, efficiency and coverage. 

It also calls for closer coordination and action within and beyond the health sector—encompassing education and disability, for instance—in order to maximize synergies.

LB: Are there approaches used for other NTDs that can benefit leprosy, and vice-versa?

RM: An approach that can benefit leprosy is involving community health care workers during mass drug administration (MDA) campaigns to detect and refer suspected cases of leprosy, promote contact tracing, health education and social mobilization. Another opportunity is including leprosy detection and diagnosis in the skin-NTDs approach. 

One of the advantages that leprosy can bring is in the field of human rights, stigma, discrimination and gender where advocacy is particularly strong as compared with other NTDs. Leprosy models can also be used to promote self-care and community-based disability care interventions and the promotion of assistive devices (such as footwear for patients with lymphatic filariasis and mycetoma) or corrective surgery interventions extended to people affected by Buruli ulcer.

Other areas where approaches used for leprosy can help other NTDs include active case detection and contact tracing, community involvement, involvement of affected people in decision-making, and e-learning modules.

LB: Are you hopeful that the global objectives will be met? 

RM: The road map aims to free the next generation from NTDs. We need to work together to be able to achieve this and turn challenges into strengths as we have so well demonstrated during this current COVID-19 pandemic. Solidarity and innovation should motivate us to move forward in the face of adversity. 

The road map calls for the full engagement of local governments, youth, and communities as we want to work horizontally—away from disease-specific programs and across sectors to accelerate work by involving everyone. 

We also want to work with communities and partners to prevent NTDs promote full access to basic water supply, sanitation, and hygiene in areas endemic for NTDs and achieve greater improvement in collecting and reporting NTD data disaggregated by gender.

But challenges will always surface, particularly in the field of disease elimination and eradication. We need to monitor the situation and be ready to adapt programs to unforeseen circumstances. Such events may include pandemics, local epidemics, political instability, migration, consequences of climate change, and antimicrobial resistance—all can complicate existing programmatic complexity. Concerted action and agile responses to challenges will be necessary to achieve the 2030 targets. 

What gives us hope is the determination to succeed. The road map is perfectly within the framework of the SDGs and its targets are fully aligned with the renewed emphasis on universal health coverage of the global public health community. We believe in the shared vision of this road map and are optimistic that by working together we can achieve the targets set for 2030.

Dr. Ren Minghui
Assistant Director-General
Universal Health Coverage/Communicable and Noncommunicable Diseases
World Health Organization (WHO)
Dr. Ren’s profile on the WHO’s website:


NO. 102 MARCH 2021