Neglected tropical disease elimination is a relay race – let's not drop the baton

The timelines for eliminating neglected tropical diseases (NTDs) are relatively short in comparison to the millennia that these diseases have plagued communities, yet within our lifetime, several countries have successfully eliminated diseases through focused and concerted public health campaigns. As in a relay race, the winning team is not necessarily the fastest, but the one that runs consistently from start to finish without dropping the baton. In the race to eliminate NTDs there are certain moments when the baton needs to be passed, particularly when donor funding ends or when countries transition to new phases in the elimination framework, such as transitioning from mass drug administration (MDA) campaigns to a period of post-treatment surveillance. Regardless of how effectively and efficiently an individual runs his/her leg of the relay, the baton eventually needs to be passed to the next recipient. The challenge is maintaining momentum. National programmes that are successful in eliminating NTDs will be so because they have become efficient in the transition (handovers), although some disruptions may test even the most efficient and committed team. The coronavirus disease 2019 (COVID-19) pandemic is just one example, but civil unrest, natural disasters, climate events and political instability are other well-defined impediments to successful public health campaigns.