# Shared challenges to the control of complex intracellular neglected pathogens

## TL;DR

This paper discusses shared challenges in controlling four complex intracellular pathogens that cause major diseases in low- and middle-income countries.

## Contribution

The paper introduces a cross-pathogen perspective to address biological and social challenges in controlling complex intracellular pathogens.

## Key findings

- The pathogens share similarities in biological and sociodemographic factors affecting their global impact.
- Resource-limited settings hinder research, diagnostics, and treatment access for these diseases.
- An interdisciplinary approach is essential for effective prevention and control strategies.

## Abstract

The complex intracellular pathogens Mycobacterium tuberculosis, Mycobacterium leprae, Leishmania spp., and Burkholderia pseudomallei, which cause tuberculosis, leprosy, leishmaniasis, and melioidosis respectively, represent major health threats with a significant global burden concentrated in low- and middle-income countries. While these diseases vary in their aetiology, pathology and epidemiology, they share key similarities in the biological and sociodemographic factors influencing their incidence and impact worldwide. In particular, their occurrence in resource-limited settings has important implications for research and development, disease prevalence and associated risk factors, as well as access to diagnostics and therapeutics. In accordance with the vision of the VALIDATE (VAccine deveLopment for complex Intracellular neglecteD pAThogeEns) Network, we consider shared challenges to the effective prevention, diagnosis and treatment of these diseases as shaped by both biological and social factors, illustrating the importance of taking an interdisciplinary approach. We further highlight how a cross-pathogen perspective may provide valuable insights for understanding and addressing challenges to the control of all four pathogens.