In 2002 one of us wrote an editorial in the BMJ entitled “The world's most neglected diseases,” referring to 13 ancient tropical infections of the poor (box).1 These diseases are disabling, disfiguring, and stigmatising; they impair children's physical and cognitive growth; they promote poverty; and many of the drugs used to treat them are toxic, difficult to administer, and are more than 50 years old.2 Five years ago, there was little good news to report. But recently there has been a silent revolution in the attention being paid to these diseases.2 3 We see several reasons for optimism.

Firstly, the long held belief that it is not economically feasible to develop drugs, diagnostic methods, and vaccines specifically for the neglected tropical diseases has now been shattered.4 Although these conditions exclusively affect the world's poorest people, …