# Inclusion in Neglected Tropical Disease Programmes: A Review of Inclusive Approaches for Control and Elimination

## TL;DR

This paper reviews how to better include marginalized groups in programs targeting neglected tropical diseases by addressing social and structural barriers.

## Contribution

The paper introduces a working definition of inclusion in NTD programming that emphasizes integrating underserved groups at all levels.

## Key findings

- Structural inequalities like poverty and racism significantly hinder equitable healthcare access for NTDs.
- Community-driven approaches and peer support are critical for empowering marginalized populations.
- Inclusive NTD programming must align with global equity goals like the Sustainable Development Goals.

## Abstract

Neglected Tropical Diseases (NTDs) disproportionately affect the world’s most marginalised populations, yet programmes aiming to control and eliminate NTDs often fail to fully address the structural, social, and political dimensions of exclusion. This narrative review examines the concept of inclusion within NTD programming, with a particular focus on intersecting forms of marginalisation, including poverty, gender, disability, and displacement. Drawing on studies from 2010 to 2025, from various databases such as google scholar, PubMed and PLOS, this review synthesises evidence on barriers to equitable healthcare access, the role of community-driven approaches, and the integration of inclusive strategies within NTD programming and broader health systems. Key themes include the impact of structural inequalities such as racism and poverty, the need for gender-responsive services, the marginalisation of displaced communities, and the critical role of community empowerment through mechanisms like peer support and community drug distribution of NTD medicines. The review proposes a working definition of inclusion in NTDs as the intentional integration of underserved groups into all levels of programming, policy, and service delivery. It highlights the urgency of reframing NTDs not just as biomedical challenges but as deeply embedded social justice issues. By embedding inclusion into programme design, implementation, and evaluation, stakeholders can better align NTD responses with global equity goals and the Sustainable Development Goals.