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When patients are faced with disability, mental ill-health or diseases of poverty, the impact of illness can be far reaching, causing low self-esteem, stigma, discrimination or exclusion.

Often, these patients can live among communities with poor understanding or inaccurate beliefs about their condition.

Healthcare providers can lack the communication tools to reach out to communities effectively, engage patients or share important healthcare messages.

At Acting for Health, we use the power of our unique theatre activities and methodology based on several years' work in the areas of disability and mental health, so that patients can rapidly improve their self confidence, communities can absorb fresh information as well as strengthen the relationships with patients and healthcare professionals (as well as NGOs, government ministries, pharmaceutical companies...) can consolidate their professional communication skills.

We currently focus on:

• blindness & deaf-blindness

• mental health

• disability

• neglected tropical diseases & diseases of poverty

• behaviour change

NTDs & Stigma: when disease leads to social exclusion

What are Neglected Tropical Disease & how to they impact patients?

Neglected Tropical Diseases (or NTDs) are a group of very diverse diseases affecting more than 1 in 7 people worldwide. The majority of NTD patients are vulnerable people, often the poorest of the poor. NTDs include parasitic diseases (such as intestinal worms and sleeping sickness), bacterial diseases (leprosy, Buruli Ulcer...) and diseases caused by viruses (such as dengue fever).  Although many NTDs are not immediately fatal, they place a severe burden on their patients whether in terms of disability & disfigurement, impact on economic activity, social exclusion, stigma from their communities... The impact of NTDs on mental health worldwide is severely under-reported. 

Stigma: what is it?

Stigma is “a social process, experienced or anticipated, characterized by exclusion, rejection, blame or devaluation, that results from experience, perception, or reasonable anticipation of an adverse social judgment about a person or group” (Weiss & Ramakrishna). Prejudice, negative attitudes and discrimination are part of stigma.

Why is it relevant to NTDs?

Stigma and discrimination, and its mental health consequences affect many NTDs. The prejudice, stigmatization and discrimination that people experience can be more limiting than the condition itself. It may have social, psychological and health-related consequences. Social exclusion is a common consequence, including reduced education and work opportunities, which in turn lead to or may aggravate poverty and may reduce marriage prospects. Psychological consequences may affect mental health and include low self-esteem, depression and even suicide.


For which NTDs is this relevant?

Stigma, discrimination and mental health are associated with 10 of the 18 NTDs, particularly Buruli ulcer, leishmaniasis, leprosy, lymphatic filariasis, onchocerciasis, certain forms of schistosomiasis, Chagas disease and podoconiosis.

What are the opportunities for use across NTDs?

Although the reasons why certain NTDs are stigmatized may differ across cultures and religions, the manifestations and consequences of stigma are very similar across NTDs and cultures. Also interventions that have been shown to be effective can be used across NTDs. This is true for interventions aimed at reducing NTD-related stigma and discrimination in society (including e.g. health services) and for interventions seeking to prevent or ameliorate negative psychological and social effects in persons affected and their families. Instruments to measure stigma and its effects are available and have been used for studies on several NTDs. They can easily be adapted for use with other NTDs also.


Read more information and view relevant publications on stigma and discrimination and mental health.

Related resource(s): 


    The stigma of disease and disability. Understanding causes and overcoming injustices.

    Corrigan PW. 2014; 319.


    Stigma and the social burden of neglected tropical diseases.

    Weiss MG. PLoS neglected tropical diseases. 2008; 2(5):e237.

    Stigma: the stealth weapon of the NTD.

    Hotez PJ. PLoS neglected tropical diseases. 2008; 2(4):e230.


    Neglected tropical diseases and mental health: a perspective on comorbidity.

    Litt E, Baker MC, Molyneux D. Trends in parasitology. 2012; 28(5):195-201.

NTD information from the World Health Organisation

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