In the aftermath of the Covid-19 pandemic, news of the spread of some new infections is a source of serious concern to us all. But it is not always an exaggerated alarm: in our country, and around the world, neglected tropical diseases (NTDs) are on the rise. These are infectious diseases that predominantly affect populations living in rural and remote areas, where poverty, lack of health resources and unsafe sanitary conditions prevail.Despite affecting around 1.6 billion people every year and causing thousands of deaths, NTDs receive little attention and are often ignored by the media. But what exactly are they? They are a heterogeneous group of 21 diseases, including scabies, leprosy, leishmaniasis, echinococcosis, dengue and chikungunya—diseases that in recent years have also affected countries with advanced health systems, such as Italy.
Why are they called ‘neglected’?
Nicola Petrosillo, a lecturer in infectious diseases at UniCamillus University, explains that the term ‘neglected’ does not refer to negligence in treating these diseases, but rather to the fact that they receive little attention from global health institutions. Neglected tropical diseases are forgotten for reasons that go far beyond a simple lack of resources. “The lack of strong international commitment and the absence of effective health systems in the most affected countries do not help. In addition, wealthier countries often do not see these diseases as a priority because they mainly affect the poorest regions of the world”, explains Petrosillo.
In 2024, for example, Italy reported numerous cases of dengue, a tropical disease caused by the virus transmitted by the Aedes mosquito (whose family includes the tiger mosquito), a vector that thrives in environments with higher temperatures and heavy rainfall. “In 2024, we had 693 cases of dengue in our country, 213 of which concerned people who had never travelled, but who may have had a neighbour who had been abroad and who had contracted dengue”, explains Petrosillo. This is a clear sign that globalisation and climate change are facilitating the spread of these diseases, even in countries with advanced health systems.
Climate change and emerging threats
Climate change is playing a crucial role in expanding the geographical areas where tropical diseases—traditionally confined to equatorial and subtropical regions—spread: higher temperatures and changing weather patterns favour the proliferation of disease vectors such as the mosquitoes that transmit dengue and yellow fever. “Continued global warming is leading to the spread of these diseases even in temperate regions. In our country, the tiger mosquito is now proliferating to a significant extent, mainly due to climate changes such as high temperatures and heavy rainfall”, says Petrosillo.
Environmental changes and loss of biodiversity also lead to the transfer of viruses and bacteria between wildlife and humans, increasing the risk of new epidemics. “Wild animals are often carriers of tropical viruses, and if they are transmitted to humans, this becomes a serious problem”, warns the expert. “The risk of viruses being transmitted from animal to human can be significant, leading to a change in the viruses themselves with subsequent cross-species transmission—that’s when a virus can be transmitted from human to human. Basically, this is what we are worried about with bird flu: if there is cross-species transmission, we could be facing a new pandemic”.
The role of epidemiological surveillance
In Italy, the epidemiological surveillance system is well developed: local health authorities actively monitor cases of tropical diseases and there are specialised centres for diagnosis and treatment in case of emergencies. “However, we must not let our guard down”, warns Petrosillo, “because increased international population mobility and climate change could lead to an increase in cases even in countries with a high level of health security”.
So even if our country is not currently in an emergency situation, the increasing incidence of tropical diseases in countries such as Brazil, where yellow fever has re-emerged, must be a cause for concern. Centres of excellence around the world are working to identify and treat NTDs in a timely manner, but many challenges remain.
Prevention strategies and available treatments
Prevention remains one of the most important tools in the fight against neglected tropical diseases. Although it is extremely difficult to eradicate vectors such as mosquitoes, there are effective strategies to limit their spread. “Small interventions in our homes and towns, such as cleaning drains and removing stagnant water from household flower pots, can make a big difference in preventing the spread of mosquitoes and therefore potential vectors of such infections”.
There are also specific treatments for tropical diseases, although access to adequate treatment remains a problem for people in poorer areas. International research is trying to fill this gap by developing new medicines and diagnostic approaches. The biggest challenge, however, is to ensure access to these treatments in the world’s poorest regions.
Eliminating neglected tropical diseases by 2030: is it an ambitious goal?
The World Health Organisation (WHO) has set an ambitious goal: to eliminate or control neglected tropical diseases by 2030. This is at the heart of the global road map, which includes strengthening interventions for prevention, diagnosis and treatment. But Petrosillo stresses that “the situation remains complex, especially in countries most affected by conflict and political instability. The pandemic has had a devastating impact on treatment and prevention programmes, with serious disruption in the distribution of medicines and in the medical services”.
Despite the difficulties, the WHO is implementing targeted strategies to address global challenges, such as adapting to climate change and improving surveillance and data collection systems. But the expert warns that international cooperation is crucial. Without sustained commitment and an effective financing plan, the goal will not be easy to achieve.