In early February, the WHO released an Essential Care Package in response to the well documented link between NTDs, poor mental health, and stigma.
An Essential Care Package (ECP) is a practical framework designed to help countries and implementing partners translate global evidence into action at the ground level. Rather than prescribing a single model of care, an ECP brings together a curated set of evidence-based, people-centered interventions that can be delivered across different levels of the health system and adapted to diverse contexts.
The ECP to address mental health and stigma for persons with NTDs was developed in collaboration with academic and research institutions, global NTD networks, people with lived experience and NGOs, including Effect Hope. This broad partnership helped ensure the package is practical for implementation, responsive to context, and rooted in dignity and inclusion.
The unseen impact of NTDs on mental health
There has been growing evidence for quite some time that NTDs affect more than a person’s physical health.
People living with NTDs face a significantly higher risk of psychological distress, depression, anxiety, social isolation, and suicidal thoughts than the general population. These mental health challenges are not incidental. They are deeply shaped by the lived experience of chronic illness, visible symptoms or disability, pain, and the social consequences that often follow.
In some NTDs, such as leprosy, Buruli ulcer (BU), and lymphatic filariasis (LF), depression and anxiety affect a substantial proportion of those living with the disease, adding an often unrecognized layer of disability and suffering. Physical pain, fatigue, and reduced functioning can limit people’s ability to work, care for family members, or participate in community life. Visible signs of disease, such as scarring or swelling, frequently expose people to stigma, discrimination, and social exclusion. Over time, this can lead to isolation, loss of self-esteem, and internalized stigma, where people begin to accept negative beliefs about themselves.
Caregivers and family members are also affected, facing emotional strain, social pressure, and economic stress that increase their own risk of poor mental health.
“When care is delayed, fragmented, or shaped by stigma, the consequences are deeply personal. The social fabric of what holds you up as a human being, falls away from you. For diseases that are in most cases preventable, treatable and curable, this is completely unnecessary.” – Dr. Anna Wickenden, VP, Advocacy & Strategic Partnerships at Effect Hope
Stigma and discrimination intensify these challenges by delaying care seeking, reducing treatment adherence, and limiting participation in community life.
These challenges are often compounded because NTDs are most common in settings with limited health resources, where mental health support is scarce or difficult to access.
A practical roadmap for integrated, person‑centred care
The Essential Care Package (ECP) outlines practical, evidence-based actions that NTD programs can use to support mental wellbeing and address the stigma that too often prevents people from seeking or receiving care. It’s designed to be used, adapted, and implemented locally. It supports national NTD programs, ministries of health, civil society organizations, and community-based partners to integrate mental health and stigma reduction into existing services, rather than treating them as parallel or standalone activities.
Recognizing that health systems vary widely in resources and capacity, the ECP provides guidance that can be tailored to national policies, local disease profiles, available workforces, and community realities. It can be used to inform service design, training, supervision, advocacy, and monitoring, helping ensure that mental health and dignity are embedded within NTD responses rather than addressed only after catastrophic outcomes occur.
In this way, the ECP functions as both a planning resource and a practical roadmap. It helps bridge the gap between evidence and implementation, supporting NTD programs to move beyond disease control alone and toward more holistic, person-centred care.
The Essential Care Package brings together four priority areas for action:
- Mental health promotion and prevention
Mental well‑being exists along a continuum, and people affected by NTDs often live with ongoing distress shaped by illness, stigma, and social exclusion.
The ECP prioritizes early, community‑based approaches such as psychosocial support, mental health education, and action on social and economic factors including poverty and exclusion. These efforts focus on helping people feel supported, strengthening their ability to cope, and ensuring that concerns are addressed early, rather than escalating.
- Identification and assessment of mental health needs
Mental health is treated as an integral part of NTD care, not a separate or specialized concern.
The ECP encourages NTD programs to build routine identification and assessment into everyday services, including recognizing signs of distress, depression, and anxiety, and assessing suicide risk where appropriate. The use of simple, culturally appropriate tools supports earlier engagement with care and helps ensure that people are not overlooked due to stigma, silence, or gaps in referral systems.
- Management of mental health conditions through integrated care
Mental health care is most effective when it is delivered alongside physical care, in ways that are practical, accessible, and rooted in people’s everyday lives.
The ECP promotes a person‑centred, stepped approach to care that is designed to work in resource‑constrained settings. Most mental health support is intended to be delivered close to people’s homes through community‑based and primary health services, supported by task‑sharing and supervision models that equip general health workers to provide compassionate, evidence‑based care.
Clear referral pathways are emphasized for people with more complex needs, ensuring continuity of care.
- Stigma reduction and social inclusion
Stigma and discrimination are not side effects of NTDs. They are core barriers that shape whether people seek care, stay connected to treatment, and can recover. Recommended approaches include education to challenge myths and misinformation, social contact initiatives that centre the voices and leadership of people affected by NTDs, and advocacy to address discriminatory laws and practices.
Peer support, self‑help groups, and livelihoods initiatives are also emphasized as pathways to reduce self‑stigma, strengthen agency, and support fuller participation in community life.
Putting the Essential Care Package into action
At Effect Hope, we’ve recognized from early on that mental health and stigma reduction are essential to achieving NTD elimination and health equity for all. Many of our programs already reflect the principles of the Essential Care Package, grounded in the belief that lasting impact requires a holistic approach to care.
What the ECP sets out in guidance, Effect Hope projects like LivEx and IMAGINE are bringing to life alongside communities.
The LivEx project, launched in 2022 in collaboration with RedAid Nigeria is designed to link NTD treatment with mental health care.
By combining mental health support with self‑care for people affected by leprosy, lymphatic filariasis, and Buruli ulcer, the project responds directly to the distress, stigma, and isolation many people experience. LivEx strengthens local capacity by training healthcare workers and NTD champions to recognize and respond to mental health needs, helping support reach people closer to where they live. Through peer‑led self‑help groups, the project creates spaces for shared support and learning while also reducing stigma and strengthening social connection.
IMAGINE Ghana is testing what it looks like to integrate mental health and NTD care in ways that are practical, participatory, and rooted in local realities.
Working in partnership with communities, health workers, researchers, and government stakeholders, the project is developing and testing a Ghana‑specific version of the Essential Care Package that responds to local realities. By using participatory action research, IMAGINE ensures that people affected by NTDs help shape the solutions, rather than having care models designed without their input. The project focuses on strengthening health systems to better support people living with both physical illness and mental health challenges, especially in underserved areas. In doing so, IMAGINE aims to improve access to holistic, person‑centred care while generating practical tools and evidence that can inform policy and scale‑up in Ghana and beyond.
“The injustice of neglected tropical diseases demands more than disease control alone. When stigma, mental health, and dignity are left unaddressed, people are still left behind. That’s why we invest in programs that explore how NTDs affect mental health and translate that understanding into integrated, people-centered care.” – Maneesh Phillip, VP, International Programs at Effect Hope
Integrated, people-centered approaches that address mental health, stigma, and social inclusion alongside physical care can improve overall wellbeing, strengthen treatment engagement, and support recovery.
Recognizing and responding to the mental health impacts of NTDs is not an added extra. It is essential to delivering effective, dignified care and to supporting people affected by NTDs to live full and meaningful lives.
