Reflections on the World Health Day 2025 theme “Healthy Beginnings, Hopeful Futures”
By Alison Krentel, PhD, Chair of the Canadian Network for NTDs
April is a busy month in public health around the world! Last week was World Health Worker Week, yesterday was World Health Day, April 14th will be World Chagas Day, and at the end of the month, it will be World Immunization Week. These moments provide opportunities to collaborate, to raise awareness and to generate new ideas. As I contemplated the theme for World Health Day on maternal and newborn health, “Healthy beginnings, hopeful futures,” I wondered into what sort of world the next generation of babies would be born. As a mother, I asked myself what needed to be done to ensure that these children have hopeful and healthy futures. And as an academic researcher, I wanted to explore how this year’s theme could be envisioned through the lens of neglected tropical diseases (NTDs).
NTDs are a group of 21 infectious diseases and conditions that affect 1.5 billion people (1 billion of whom are children) living on our planet. These ancient diseases disable, maim, and can even result in death if not treated in time. NTDs are diseases that affect people often living in ‘last mile’ communities, in places where health care is hard to deliver. Women and children are often disproportionally at risk for NTDs. For example, infection with soil transmitted helminths or schistosomiasis in children, impacts their growth and development and risks poorer health outcomes in the future. These infections increase rates of anemia in pregnant women and put healthy pregnancy outcomes at risk. Eliminating, even eradicating some NTDs are part of the World Health Organization’s goals towards reaching SDG 3.0: to ensure healthy lives and promote well-being for all at all ages. Given their prevalence globally, addressing NTDs contributes to healthier pregnancies, deliveries, babies, and children.
Over the last few months, there have been major cuts and reductions announced for global public health and development aid from some of the world’s biggest bilateral donors – the USA, UK, Germany, France, Denmark. In Canada, we await the federal election at the end of this month to know what direction Canada might take. In the meantime, civil society and academics across the health and development sector are advocating for Canada to maintain and even increase its overseas development aid in recognition of our deep history with international cooperation and growing global needs.
While the cuts to USAID have been felt acutely given their seemingly indiscriminate and abrupt nature, we must acknowledge the wider global movement away from global health, humanitarian aid and international cooperation towards more inward-facing nationally focused budgets. For certain, the systems and processes that have been established over the last few decades have now either changed or are under serious, existential threat. As a global public health community, we have a responsibility to find solutions, to identify new opportunities, and to leverage existing platforms to ensure that we reach our goals. When we think of that next generation of children, we must persist and adapt in this current fluid context.
Let me draw on two initiatives that the NTD community has been nurturing in recent years: one focused on localization, and one on integration. Recently, I have been encouraged to hear that countries that have relied on external funding for their NTD programs are ready to integrate NTDs into their health systems and national health budgets. In some countries, the drive towards sustainability was initiated under USAID, where identifying pathways towards domestic resource allocation was a priority. In countries affected by funding cuts, a more localized approach to funding will take time to fit within national annual budget cycles. Dedicated advocates will be needed to support advocacy for increased domestic NTD funding. Some countries have already integrated NTD programmatic activities into their district and national budgets. These countries have established a localized approach to NTD programs that can serve as an example for other countries to learn from and follow. A more localized approach to NTDs means that efforts started through externally funded programs can be sustained within the national health care system, including the distribution of donated treatments and provisions for NTD morbidity management and disability prevention through primary health care budgets. Sustainability of NTD programs within health systems contributes to healthier futures for everyone- women, men, girls, and boys.
The second initiative is an acceleration of integration. Globally, we have recognized that we need to be more efficient in the delivery of our global public health care programs, including NTDs. Fragmentation brought on by vertical programs has sometimes hindered health system strengthening and created parallel systems for reporting, financing, supervision, and program delivery. For example, a community health worker (CHW), the backbone of many community-based programs, may visit a community for childhood vaccination campaigns, for supervision of bed net use, and for NTD mass drug administration. Consolidated trainings, supportive supervision and more efficiency in reporting would allow CHWs to maximize their community interactions and leverage existing platforms like child and maternal health days or immunization campaigns to include NTD prevention, diagnosis, and treatment.
Another example for much-needed integration is the persistent neglect of female genital schistosomiasis (FGS). A disease of importance for up to an estimated 56 million women and girls in Africa, FGS requires an integrated approach within sexual and reproductive healthcare (including HIV/AIDS), cervical cancer screening and maternal health programs. Without integration, the prevention, diagnosis, and treatment of FGS fall between women’s health and infectious diseases, resulting in lost opportunities to optimize women’s health and wellbeing. A hopeful, healthy future for women of reproductive health age should include the integration of FGS and other NTDs into as many points of care as possible over her life course. This can also include presumptive treatment of soil transmitted helminths and schistosomiasis during antenatal care visits beyond the first trimester.
Bringing together disease control initiatives, like NTDs, into routine health care delivery and into the health system provides a stable and sustainable platform for the elimination goals outlined in the WHO 2030 NTD Roadmap and in regional agendas like PAHO’s Elimination Initiative. In a more localized approach to global public health issues like NTDs and maternal and newborn health, countries can determine where and how integration can occur and in a manner that will strengthen their health systems. Thinking about global public health issues in a siloed manner is no longer a viable option. We need to identify synergies and new ways of working together.
So in a month of important days and weeks of global public health, I’d encourage us to think beyond one specific issue and look towards new ways of working. After all, maternal, newborn and child health goals cannot be achieved globally without addressing NTDs. The opportunities for synergy are endless.
