In recent years, the literature on neglected tropical diseases (NTDs) has advanced in significant ways: there is a renewed sense of urgency in World Health Organization reports, new specialized journals have been launched, and advocacy groups are leveraging social media to gain attention to the burden of NTDs around the world. But as the literature in this field develops, there is a danger of an important split between work that recognizes the profound geopolitical patterning of NTDs, and focuses accordingly on structural factors that lead NTDs to thrive in some areas of the world and not in others; and, alternatively, work that ‘securitizes’ global health and thereby focuses on the ‘risk’ posed by NTDs to populations in non-endemic countries. This article examines this schism through the example of Chagas disease.