PLOS Mental Health Community Case Studies: Mental Health & Neglected Tropical Diseases

In the latest ‘Community Case Studies’ blog from PLOS Mental Health, we speak to Dr. Anil Fastenau, an author on a recent publication in the journal in which psychosocial interventions in individuals with Leprosy are considered. We spoke to Anil to learn more about his work in this community, and what is needed to support the mental health of those in communities with neglected tropical diseases

Please tell us about yourself and how you got into this field of research.

[AF] My journey into global health and research began with a strong foundation in medicine. Originally from Sialkot, Pakistan, I pursued medical studies across several countries, including Pakistan, Kyrgyzstan and Germany. This diverse experience exposed me to the health challenges faced by marginalized communities, sparking my interest in neglected tropical diseases (NTDs), particularly leprosy and Cutaneous leishmaniasis. Over time, I transitioned from clinical practice to focusing on public health strategies and research, aiming to make a meaningful impact on vulnerable populations. My work now revolves around developing strategies for disease elimination, such as the Zero Leprosy Roadmaps, and advocating for integrated approaches that combine medical care with psycho-social support. Seeing the impact of NTDs on the mental health and wellbeing of people affected has really motivated me to do more implementation research.

What are the biggest challenges of working in this field?

[AF] One of the most significant challenges in global health, especially in the context of neglected tropical diseases, is the persistent delay in diagnosis. This leads to severe disability and stigma, particularly in communities with limited healthcare access. Stigma remains a deeply rooted issue, hindering early detection and treatment efforts. Furthermore, this affects the mental health and wellbeing of people affected by NTDs. Mobilizing resources and securing sustainable funding are also ongoing struggles, especially when working in regions with competing health priorities. Lastly, the complexity of implementing global strategies at a local level, where infrastructure and political contexts vary, requires adaptive and culturally sensitive approaches. One of the biggest challenges in the field of NTDs is to design and implement effective interventions to improve the mental health and well-being of people affected by NTDs. Therefore, I would like to put my focus on doing research in this field. However, there is a lot less funding available to conduct and implement research in that particular field.

What have been the most notable changes in your field in the last 5-10 years?

[AF] Over the past decade, we’ve seen considerable advancements in global health, particularly in tackling neglected tropical diseases. The rise of digital health tools for diagnosing conditions like Skin NTDs, alongside more targeted approaches in active case detection, are transforming the field. There has also been a growing focus on integrating psychosocial support into treatment programs, recognizing that health outcomes are not just clinical but social and psychological as well. The development and adoption of country owned NTD Roadmaps have been a major milestone, marking a shift towards more structured and measurable strategies for disease elimination. In addition, there is more awareness now on the mental health issues related to NTDs.

Where do you hope the field goes over the next 10 years?

In the coming decade, I hope to see a world where the stigma associated with leprosy and similar diseases is significantly reduced, allowing for earlier diagnosis and better patient outcomes. I hope that in the future more research is done about effective interventions to improve the mental health and wellbeing of people affected by NTDs. I also envision greater integration of digital technologies in the diagnostic process, making it more accessible and accurate, even in remote areas. My aspiration is that the Zero Leprosy Roadmaps we’ve developed will be fully implemented, leading to sustainable elimination efforts in more countries. Collaboration at all levels—local, national, and international—will be crucial for turning this vision into reality.

What are some of the most important approaches needed to achieve the abovementioned goals?

A key lesson from my work is that involving people affected by NTDs in the design and implementation of NTD control strategies is absolutely essential. Community-driven interventions are most effective when those directly impacted have a seat at the table, helping to shape the solutions that will affect their lives. For instance, in our work in Pakistan, engaging leprosy-affected individuals in planning active case detection initiatives led to higher participation rates and more trust within the community. These individuals bring invaluable insights into local challenges and cultural contexts, which helps tailor interventions to be more effective and sustainable.

Empowering affected communities isn’t just about gathering input; it’s about building leadership and ownership within those communities. Involving them from the outset allows interventions to be more responsive, better suited to real needs, and more likely to succeed in the long term. Moving forward, it’s crucial that NTD programs worldwide adopt this inclusive approach, ensuring that the voices of those most affected are not just heard but actively drive the decision-making process.

Empowering affected communities isn’t just about gathering input; it’s about building leadership and ownership within those communities

***Disclaimer: The opinions expressed in this blog are those of Dr Fastenau and do not necessarily reflect the views of PLOS or PLOS Mental Health