The road map for neglected tropical diseases 2021-2030 is built on three foundational pillars that will support global efforts to control, eliminate and eradicate neglected tropical diseases.

Pillar 3 refers to changing operating models and culture to facilitate country ownership.

Meeting the targets set in the road map will require shifts in organizational structures, ways of working and thinking. Roles and responsibilities must be clear at each level and sector of the global NTD community to define the appropriate operating model.

• Countries are both the drivers and the beneficiaries of progress towards the road map targets for 2030, and country ownership is essential for meeting the 2030 NTD targets with the support of regional and global stakeholders. Local governments (at municipality and district levels) are also essential for successful implementation of interventions and coordination of multisectoral action.
• Regional stakeholders occupy an important position as the interface between global and local levels, providing guidance to countries in translating global targets and in sharing best practices.
• Global development of norms, guidance and tools and technical advances will remain vital. WHO’s collaborating centres for NTDs constitute a global network of expertise in activities such as target product profiles for new NTD products and diagnostics.

Partners play a pivotal role at all levels but particularly in countries. Clear delineation of responsibilities among partners will ensure geographical coverage, avoid duplication and ensure that no community is overlooked. The coordination of this extensive, diverse network will be supported by WHO, which will work with all stakeholder groups.

Country ownership of NTDs is not confined to one national entity; rather, it is relevant at all levels of government, especially in countries where health systems are becoming decentralized. It is envisaged that national and local governments will also take a proactive approach in defining and carrying out an NTD agenda, financed in part or fully from domestic funds. Additionally, involvement of patient groups and people living with NTDs in designing NTD programmes can empower them and ensure that interventions adequately cater to patient needs. Mainstreaming the participation of young people across all NTD activities will also be important for the attainment of the goals of the road map. Youth engagement is key to influence positive change and harness energy, values-based motivation and social connectedness, in order to spread information, generate innovative solutions and change communal behaviours and norms in favour of national NTD programmes.