World Neglected Tropical Diseases (NTD) Day is observed annually on 30 January to raise awareness about the suffering caused by NTDs and reaffirm the commitment of governments, organizations, and communities to combat these diseases. This year, the global theme is “Unite, Act, and Eliminate NTDs”, emphasizing collective action to improve the health and well-being of over 1.6 billion people affected by NTDs worldwide. The day also serves as a call to action, encouraging support for the ongoing efforts to control, eliminate, and eradicate these diseases.
Neglected tropical diseases are a diverse group of conditions caused by various pathogens, including viruses, bacteria, parasites, fungi, and toxins. These diseases have severe health, social, and economic impacts, disrupting individuals' daily lives and trapping communities in cycles of poverty and inequality. Disabilities and impairments resulting from NTDs often lead to stigma and social exclusion, limiting access to essential care and further deepening the challenges faced by affected individuals.
Global Situation
The Sustainable Development Goal (SDG) target for NTDs is outlined under SDG 3, which aims to ensure healthy lives and well-being for all. Specifically, Target 3.3 focuses on ending the epidemics of communicable diseases, including NTDs, by eliminating or controlling them as public health problems, reducing the morbidity, disability, and mortality they cause, and supporting global and national efforts for integrated and multisectoral action. Progress toward this target is measured through Indicator 3.3.5, which tracks the number of people requiring interventions against NTDs.
In 2021, WHO launched a global road map titled “Ending the Neglect to Attain the Sustainable Development Goals: for Neglected Tropical Diseases 2021–2030.” This strategic document outlines shared goals, disease-specific targets, and smarter investments to strengthen the response to NTDs.
The key global targets include:
- A 90% reduction in people needing treatment for NTDs by 2030.
- A 75% reduction in Disability-Adjusted Life Years (DALYs) related to NTDs.
- At least 100 countries eliminating one NTD and
- Eradication of dracunculiasis and yaws.
The road map emphasizes integrated approaches, multisectoral coordination, universal health coverage, and country ownership. WHO also identifies five core strategies to tackle NTDs: preventive chemotherapy, disease management, vector control, veterinary public health, and water, sanitation, and hygiene (WASH).
To achieve these goals, the road map advocates for:
- Stronger accountability: Focusing on impact indicators, improving scientific understanding, and accelerating programmatic action.
- Intensified cross-cutting approaches: Integrating delivery systems, strengthening country capacity, and mobilizing global resources.
- A cultural shift in operations: Promoting country ownership, clarifying stakeholder roles, and enhancing collaboration to meet 2030 targets.
This framework seeks to mainstream NTDs into national health agendas, ensuring sustained progress and lasting impact.
Situation of NTD in Sri Lanka
Several neglected tropical diseases have historically affected Sri Lanka, with the country achieving significant milestones, such as the elimination of leprosy in 1995 and lymphatic filariasis in 2016. However, challenges remain, as diseases such as dengue, leishmaniasis, and rabies continue to pose significant public health concerns. The Ministry of Health has established national programs for the prevention and management of dengue, leishmaniasis, leprosy, filariasis, and rabies.
Dengue:
Dengue remains a significant challenge for Sri Lanka, with annual outbreaks peaking during the rainy seasons (June–July and October–December). The country has successfully reduced the case fatality rate from 5% in 1996 to 0.07% in 2023. However, rising case numbers continue to be reported, especially in the Western Province, where Colombo, Gampaha, and Kalutara districts recorded the highest detection rates in late 2023.
Leprosy:
Sri Lanka achieved the elimination of leprosy as a public health problem in 1995, defined as a prevalence of fewer than 1 case per 10 000 population. Despite this, approximately 1000 new cases are reported annually, 10% of which involve children. With a fluctuating case detection rate of 7–12 new cases per 100 000 population and a grade 2 disability rate of 6–8%, leprosy remains a priority for targeted interventions. Recognized by WHO as one of 23 global priority countries for leprosy, Sri Lanka is striving for the complete elimination of the disease.
Lymphatic Filariasis:
In 2016, Sri Lanka was declared to have eliminated lymphatic filariasis as a public health problem, meeting WHO's target of reducing the microfilaria rate to below 1%. This achievement followed a successful mass drug administration campaign conducted from 2002 to 2008. Despite this, filariasis remains endemic in eight districts, including Colombo, Kalutara, Gampaha, and Galle.
Rabies:
Rabies continues to cause 20–30 deaths annually, primarily due to delayed post-exposure treatment following bites from infected dogs. Timely treatment, including wound care, anti-rabies serum, and vaccine administration—freely available at government hospitals—can prevent fatalities. Strengthening awareness and timely access to treatment remain crucial to addressing this issue.
These ongoing efforts highlight Sri Lanka's commitment to combating NTDs while addressing persistent challenges.
Current NTD programmes supported by WHO
In 2024, Sri Lanka conducted its first integrated vector-borne diseases review mission, becoming the second country in the WHO South-East Asia Region to do so. A team of national and international experts, WHO staff, and external consultants reviewed vector control programs across 13 districts in six provinces. They engaged with health officials, field officers, and affected communities, and conducted consultations at various levels of the healthcare system.
Key findings and recommendations were presented, emphasizing the following actions:
- Strengthening surveillance systems by improving case detection and reporting in public and private sectors.
- Enhancing healthcare worker capacities at sub-national levels for effective vector control.
- Digitalizing and analyzing data for evidence-based decision-making.
- Improving governance, coordination, resource allocation, and accountability.
- Boosting advocacy, risk communication, and community engagement.
- Fostering cross-border collaboration and implementing real-time data monitoring.
These recommendations aim to strengthen Sri Lanka's vector control programs, align them with global strategies like the Global Vector Control Response (GVCR), and support both national and global health objectives.
In July 2024, in collaboration with the National Dengue Control Unit (NDCU) and Sri Lanka Medical Association (SLMA), National institute of Infectious Diseases (NIID) hosted its first international training on dengue case management for healthcare workers from Bangladesh. The seven-day intensive training was a structured training of trainers on dengue case management. Following its success, similar programs were conducted for participants from Bhutan and Myanmar. These sessions employed diverse modalities, including lectures, hands-on clinical training, field visits, and interactive discussions, alongside a symposium involving top health officials and experts. The training exemplified the value of cross-country collaboration in building technical and practical capacities to address public health challenges. It has empowered participants to strengthen their own health systems, contributing to the well-being of the region. Institutions such as the SLMA, NDCU, NIID, and WHO collaborate at the country level, demonstrating how cross-organizational partnerships can effectively promote activities for the greater benefit.
The WHO has continued its support for Sri Lanka's National Dengue Control Programme by enhancing preparedness, surveillance, and disease control efforts. Assistance was provided for the National Dengue Control Programme Review and the end-term evaluation of the previous National Strategic Plan (NSP). Additionally, WHO contributed to the development of the Dengue National Strategic Plan 2024–2028. To improve clinical management of dengue cases, WHO collaborated with the National Institute for Infectious Diseases to train medical officers and nurses from high-burden hospitals across the country. Furthermore, WHO is supporting a dengue modeling and prediction initiative aimed at forecasting and estimating case burdens to strengthen prevention and response efforts.
To enhance the efforts of the Anti-Leprosy Campaign, WHO supported the development of guidelines to adapt and implement the leprosy elimination road map at national and sub-national levels in Sri Lanka. This initiative, conducted with inputs from international experts and WHO staff specializing in leprosy elimination, focuses on achieving leprosy elimination by 2035. WHO also worked to improve the quality of leprosy services delivered by healthcare staff and facilitated the establishment of a surveillance system to monitor antimicrobial resistance in leprosy drugs within the country. WHO additionally supported the Ministry of Health to conduct Adverse Drug Reaction (ADR) survey for the Multi-Drug Treatment ( MDT) used for leprosy in Sri Lanka.
WHO assisted the National Anti-Filariasis Campaign in its efforts to combat lymphatic filariasis by facilitating monthly review meetings with Regional Medical Officers and technical staff throughout 2024. Further, WHO promoted the identification and sharing of best practices through district-level reviews and field visits to high-performing Regional Anti-Filariasis Units, with findings communicated to the advisory body for informed decision-making. WHO also assisted in the publication of the National Strategic Plan on Lymphatic Filariasis 2023–2027 to guide the campaign's efforts.
Leishmaniasis control efforts were supported through capacity-building initiatives for Medical Officers, Medical Officers of Health (MOH), and Public Health Inspectors (PHIs) in five districts.
Moving forward, WHO Sri Lanka aims to continue supporting the country by mainstreaming the priority NTDs in the national health agendas for stronger preparedness, surveillance, and control, to deliver on the 2030 global targets for NTD control.