Who defines the question in neglected tropical disease research?

Neglected tropical diseases (NTDs) are often framed through pathogens, interventions, and elimination targets, but the systems that produce knowledge about them receive less scrutiny. This Viewpoint argues that unequal control of funding, authorship, and publication shapes NTD research questions and can weaken their public-health relevance. Co-design should begin before protocols are fixed and should be supported by proximity to endemic settings, their institutions, and their lived realities. We propose that education, reciprocal mobility, co-supervised training, and durable partnerships among low- and middle-income countries (LMICs) and high-income countries (HICs) be recognised as research infrastructure, and that funders enable researchers in endemic countries to lead such partnerships directly. NTD research should be judged not only by scientific outputs, but also by who defined the question and what relationships made that question possible.