; and (B) maintaining sufficient funding to ensure that progress is sustained. (5) NTDs have an enormous impact in terms of disease burden and quality of life. NTDs cause the loss of up to 185,000 lives and up to 2,500,000,000 disability-adjusted life years each year. NTDs surpass both malaria and tuberculosis in causing greater loss of life-years to disability and premature death. Many NTDs cause disfigurement and disability, in addition to significant morbidity and mortality, leading to stigma, social discrimination, and societal marginalization. (6) NTDs create an economic burden of billions of dollars through the loss of productivity and high costs of health care required for treatment. People afflicted by NTDs are less productive than their healthy counterparts. NTDs jeopardize the ability of people to attend work and school, or to produce at full capacity. For example, controlling 1 NTD (hookworm) in children can result in a 43 percent increase in future wage earnings. (7) The social, economic, and health burden of NTDs falls primarily on low- and middle-income countries, where access to safe water, sanitation, and health care is limited. At least 100 countries face 2 endemic NTD burdens, and 30 countries carry six or more endemic NTDs. All low-income countries are affected by at least 5 NTDs, and 149 countries and territories are affected by at least 1 NTD. (8) NTDs are not confined to the developing world. Several NTDs have been reported in the United States and other developed countries. In the United States, NTDs disproportionately affect communities of color and the poor, with up to 2,850,000 African Americans suffering from toxocariasis and at least 300,000 people, who are mostly Hispanic Americans, are afflicted with Chagas disease. (9) Many NTDs can be controlled, prevented, and even eliminated using low-cost, effective, and feasible solutions. Understanding the economic burden of NTDs on productivity and health care costs can help to assure governments and donors that the resources directed toward