Compared with the study carried out by Yang et al. in 2014 [18], the NTDs mapping presented here, using DALYs instead of absolute numbers of those affected, provides a more comprehensive assessment. This mapping aligns with global health goals, such as those outlined by the WHO. It would not only aid the efficient allocation of resources for NTDs control and elimination but also allow a more accurate understanding of the impact of the NTDs on society in a specific geographical region. In addition, it promotes evidence-based decision-making by considering the severity of different disabilities and the duration of time individuals are affected. Indeed, precision mapping for national NTD control programmes could assist in comparing the relative impact of different NTDs and guide resource allocation more correctly than otherwise. By prioritizing diseases with higher DALY values, limited resources can be correctly allocated and achieve better impacts. For instance, Fig. 2A demonstrates a low co-presence of 3–4 NTDs in the Xizang Zizhiqu, while Fig. 2B shows a high disease burden of 178,318.99 DALYs due to taeniasis/cysticercosis. Mapping NTDs by DALYs allows for better coordination and evaluation of progress towards these goals at the global level.

Our research found that dengue fever has continuously increased in recent years. There are several reasons why dengue cases have increased and expanded northward into China. With climate change, warmer temperatures and increased precipitation in previously cool regions have created suitable conditions for the mosquito species Aedes aegypti and Ae. albopictus that transmit the dengue virus. Globalization has facilitated the movement of infected individuals and vector mosquitoes. Rapid urbanization and infrastructure development, particularly in southern China, have created more conducive environments for mosquito breeding. It is now essential to strengthen the surveillance-response system to minimize the public health impact of this emerging/re-emerging disease. An integrated vector control approach should be implemented with relevant stakeholders, including local government, environmental agencies, and community organizations.

Echinococcosis is mainly distributed in pastoral areas with poor sanitation and economic conditions (such as the Xizang Zizhiqu, Qinghai, and Gansu provinces). It is common for Xizang nomads to feed the internal organs of slaughtered cattle and sheep to their dogs. This practice, along with weak preventive awareness, poor local sanitation conditions, and wild sources of infection (through stray dogs, wolves, and foxes), pose a severe challenge to preventing and controlling echinococcosis. It is shown that there has been an increasing trend in the number of echinococcosis cases over the years with focus in Qinghai and Sichuan provinces. It may be related to the intensive screening for echinococcosis after release of national-level control plans. Additionally, the transmission of echinococcus is influenced by various environmental factors that can be affected by natural events, including global warming. This suggests that environmental, biological, and socioeconomic factors should be considered in disease management. This is essential for the development of effective control and preventive measures to prevent the spread of echinococcosis in affected areas.

Food-borne NTDs include FBTs and taeniasis. In 2015, the disease burden of important FBTs in China accounted for 26.50% of the total NTDs in this study, suggesting that increased attention is warranted. According to the "2015 National Survey on the Status of Key Human Parasitic Diseases" [19], a total of 18 PLADs prevailed with Clonorchis sinensis with 3.46 million estimated infections mainly in southern and northeastern China. The disease burden of taeniasis in 2015 was estimated to be 305,320.57 DALYs, mainly in the southwestern Xizang Zizhiqu and Sichuan province. In order to promote the prevention and control of food-borne NTDs and explore control strategies under the new settings, since 2019, a total of 10 clonorchiasis intervention pilots have been established in six PLADs, namely Jilin, Heilongjiang, Hunan, Guangdong, Guizhou and Guangxi Zhuang Zizhiqu, and one pilot for taeniasis intervention in Xizang Zizhiqu [22].

The First National Epidemiological White Paper on Snakebite [23], published in 2023, provides an overview of the snakebite epidemiology in China (Fig. 5). The white paper presents comprehensive data on the incidence and distribution of snakebite cases in 12 PLADs. It analyses geographical variations, seasonal patterns, demographic characteristics of snakebite victims, snake species and venom profiles, healthcare access and response. Snakebite incidents in Yunnan, Guangdong, Hainan, Guizhou, and Fujian provinces are primarily attributed to Trimeresurus stejnegeri. Hubei, Hunan, and Jiangxi provinces, snakebites mainly involve Agkistrodon halys. Protobothrops mucrosquamatus snake is the primary culprit in Sichuan province and Chongqing Municipality. In Guangxi Zhuang Zizhiqu, Naja atra is the predominant species. The white paper discusses existing prevention and control measures implemented in China and highlights the importance of future key research areas. These include prioritizing advancements in the production, accessibility, and efficacy of antivenom to enhance the treatment of snakebite cases. Additionally, there is a need for ongoing monitoring snakebite incidents to comprehensively understand the evolving patterns and risk factors associated with snakebites across diverse regions. Furthermore, it emphasizes the necessity of fortifying healthcare systems to ensure prompt response and efficient access to effective treatment options.

Snake bites prevalence and main types involved in surveillance provincial-level administrative divisions in China. This figure maps out the prevalence of snake bites across China's provincial-level administrative divisions. It further details the primary types of venomous snake species responsible for these bites. Map approval number: GS(2024)3052

One Health is a collaborative, multi-disciplinary approach that recognizes the interconnectedness of human, animal, and environmental health. Applying the One Health theory allows for a holistic and interdisciplinary approach to addressing zoonotic diseases [24]. It emphasizes the collaboration and coordination of experts from various fields, such as medicine, veterinary sciences, ecology, environmental sciences, and public health. By integrating knowledge and expertise from these disciplines, it becomes possible to understand the complex interactions between humans, animals, and the environment and develop cost-effective strategies for prevention and control of NTDs.

A successful One Health case in China is the control of schistosomiasis. Implementing the National Schistosomiasis Control Program in China has involved collaboration between health, agriculture, water resources, environmental protection, and health education sectors. This comprehensive approach has included snail control programs, sanitation and safe water supply improvements, health education, and regular medical treatments. These efforts with One Health approach have significantly reduced the burden of schistosomiasis in China. The disease has been eliminated as a public health problem with prevalence less than 1% by 2015 [25] and now the Chinese government has set a target to achieve the ultimate goal of complete elimination by 2030 [2].

The "Action Plan for the Prevention and Control of Echinococcosis (2010–2015)" [26] was a comprehensive initiative launched by the Chinese government to address the prevention and control of echinococcosis. Subsequently, the "National Key Parasitic Disease Prevention and Control Plan (2006–2015)" [26] and the "Healthy China Action Plan (2019–2030)" [27] were successively introduced to anti-echinococcosis. China aims to achieve the interim goal of transmission control of echinococcosis by 2025 and the goal of transmission interruption by 2030. The key components of these action plans included: (1) surveillance and monitoring of echinococcosis in both humans and animals; (2) implementation of preventive measures, such as health education and deworming programs for dogs; (3) improved diagnosis and treatment of echinococcosis in humans; and (4) coordination and collaboration among various sectors, including health, agriculture, and environmental protection, another good example reflecting One Health approach. It is believed that China will make more significant achievements in global health governance and provide other countries with Chinese solutions in the future. At the same time, considering Chinese large geographical scale and significant ecological diversity, the allocation and management of resources in the country are facing more complex challenges, and it is hoped that relevant international policies will be more inclined to support China and provide more resources.

Our research contributes valuable insights that can inform a more comprehensive and effective response to the challenges posed by NTDs, ultimately fostering shared health and sustainable development for humans, animals, and environment. In this study, we presented aggregated multiple diseases burden mapping, which allows for a comprehensive understanding of their distribution and overlaps. This information can help prioritize and allocate resources effectively and correctly by identifying common transmission pathways. Implementing intervention with One Health approach that target same host responsible for transmitting multiple diseases can be a cost-effective approach akin to a "one stone, two birds" strategy. Similarly, treating multiple NTDs with a single drug can also have a synergistic effect. This indicates that we can improve the efficiency of medical resource utilization by treating multiple diseases with a single drug. For instance, dogs serve as the primary transmission hosts for four types of NTDs, including rabies, echinococcosis, leishmaniasis, and clonorchiasis. Praziquantel can be used to against cysticercosis, echinococcosis, schistosomiasis, and the FBTs (such as clonorchiasis and paragonimiasis). Different diseases control groups/programmes focusing on the same target host or same drug chemotherapy should work together to effectively interrupt the transmission of these NTDs. Health education and targeted awareness campaigns should be conducted to educate key populations about the risks and harms associated with NTDs transmitted by same host and treated by same drug.

This study has several limitations. Firstly, the reliance on reported cases and deaths from national databases may result in underreporting or misreporting, leading to potential inaccuracies in the disease burden estimates. Secondly, the use of disability weights from global sources may not fully capture the local context and specific impacts of NTDs in China. Furthermore, the burden of mental health/disability [28] is not considered in this study, which may lead to an underestimation of the actual disease burden. Additionally, the data on NTDs were obtained from various sources, and the quality and completeness of the data may vary, potentially affecting the accuracy of our estimates.