Global health initiatives and mycetoma management: the unmet promise

Global health initiatives have undeniably fuelled substantial progress in combating many neglected tropical diseases (NTDs). These efforts have been largely facilitated by international partnerships, collaborative funding and targeted programmes (frequently involving mass drug administration [MDA]) that have brought visibility and resources to diseases that are targeted for elimination like lymphatic filariasis, trachoma and onchocerciasis, with 49 countries having eliminated at least one NTD. Through programmes aligned with the WHO, governments, non-profit and pharmaceutical companies, millions have benefited from prevention and treatment efforts, underscoring the impact of focused health interventions. However, these success stories reveal critical disparities, for example, diseases and conditions amenable to case management such as lymphoedema and hydrocele from lymphatic filariasis and mycetoma. In this article, we focus on the challenges of mycetoma, a debilitating NTD that remains conspicuously underserved. The case of mycetoma underscores significant gaps in the failed commitments of global health and highlights how these initiatives have often fallen short of the stated goals to address all NTDs comprehensively within the framework of Universal Health Coverage and Sustainable Development.