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Neglected tropical diseases (NTDs) affect over one billion of the world’s poorest people. Over 150,000 people per year die from NTDs, and many more are impacted by blindness, disability, disfigurement, cognitive impairment, and stunted growth. People with NTDs are stigmatized. Children become too sick to attend school. Adults lose the ability to work. And yet, NTDs are entirely treatable and preventable. Moreover, the annual cost of treatment is incredibly low. In most cases, it is around fifty cents per person.

On one hand, the solutions are simple: deliver medication to people who need it and establish local infrastructure offering treatment and education. On the other hand, solutions are complex: navigating local and national politics, engaging major pharmaceutical companies, and coordinating international non-governmental organizations, billions of dollars, drugs with limited shelf lives, thousands of health workers, and millions of citizens.

Ultimately, NTD stories begin and end with people, from car-washers in Lake Victoria to surgeons on motorbikes, from  local NGOs to Big Pharma. Under the Big Tree comprises stories of people from all facets of the NTD world, illuminating the scope of the problem and the impact of its solution. The collaborative model for NTDs is a valuable case study applicable to other global issues that require a comprehensive, systems approach.

Through interviews, research, and frontline experience, Ellen Agler, with award-winning writer Mojie Crigler, explains and examines the science, medicine, history, funding, and what it means to live with—or live free of—these diseases.