We live in a world of inequalities. On International Women’s Day, we want to address two that intersect: gender inequality and access to healthcare, because, in areas affected by NTDs, women are at a double disadvantage. 

Neglected Tropical Diseases (NTDs) are a group of diseases caused by a variety of pathogens that affect adults and children in the world’s most vulnerable communities. However, what is often overlooked is the disproportionate impact these diseases have on women, making them one of the silent battles in the fight for gender equality and health equity.  

These inequalities are especially significant when considering infections like soil-transmitted helminths (STH), which not only affect a significant portion of the global population but also pose specific threats to women’s reproductive health. It is estimated that 30% of women in sub-Saharan Africa suffer from this infection during pregnancy, potentially leading to premature birth, increased blood loss during childbirth, infertility, and a higher risk of HIV infection. Moreover, research suggests that women living in regions with a high prevalence of STH may have changes in their menstrual cycle and face an elevated risk of contracting the Human Papillomavirus (HPV), further complicating their reproductive health.   

Furthermore, social and cultural factors often compound the impact of NTDs on women. Gender norms and roles may limit women’s access to healthcare and preventive measures, leaving them more vulnerable to infections. Additionally, women frequently bear the primary responsibility for caregiving within families, which can further strain their health and well-being when managing NTD-related disabilities or illnesses. As caregivers, women often spend more time with family members who are infected with NTDs, increasing their exposure and susceptibility to contracting them themselves. Recognizing these dynamics is crucial for implementing interventions that address the unique challenges faced by women in the context of NTDs. 

Economic disparities also play a significant role in perpetuating the gender gap in these diseases. Women in low-income communities often face barriers to accessing healthcare services, including financial constraints, lack of transportation, and limited education. As a result, they may delay seeking treatment or preventive measures, leading to worsened health outcomes and increased disease transmission within their communities. 

Another reason for not seeking treatment is the stigma associated with some NTDs. Issues like social exclusion and difficulties in the workplace or school arise. These, in turn, can lead to a decline in educational attendance due to fear of stigmatization. Typically, these beliefs stem from misconceptions about the etiology of the disease, whether it’s believed to be infectious or linked to poor personal hygiene, as well as from the visible alterations in appearance it may cause. 

Fortunately, treatments are available for these diseases. In the case of soil-transmitted helminths (STH), regular deworming can restore normal menstruation and fertility. Additionally, there are control strategies for STH that involve periodic treatment of populations at risk, primarily children and women of reproductive age. Combining this drug administration with other strategies like water, sanitation, and hygiene (WASH) interventions, hygiene education and community engagement is more likely to bring elimination goals closer to success. Gaining a deeper understanding of the behaviour and significance of STH co-infections within the context of elimination efforts is a crucial intermediate step toward reducing the associated disease burden. 

To effectively mitigate these disparities in NTDs, holistic and gender-sensitive approaches are needed. This entails integrating gender considerations into all aspects of NTD prevention, diagnosis, treatment, and research. Closing the gender gap will require involving governments, healthcare providers, civil society organizations, and communities. By recognizing and addressing the unique challenges faced by women in the prevention and control of NTDs, we can create more inclusive and effective strategies to combat these diseases and promote health equity for all.