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Africa Can Lead in Ending Neglected Tropical Diseases

Op-ed by Cynthia Mwase

More than 600 million people across Africa – nearly half the population of the entire continent – are impacted by a group of more than 21 life-altering diseases that many people around the world have never heard of. These diseases – known as neglected tropical diseases, or NTDs – are impairing physical and cognitive development, and when left untreated, causing permanent disability, blindness or even death. Many of those impacted are young children who miss school when they are infected and women who can face higher maternal health risks, stalling progress towards gender equity.

There is hope, however, for a future free of NTDs, which are largely preventable and treatable. In fact, in recent decades, there’s been extraordinary progress: on World NTD Day this year, we celebrated the elimination of at least one NTD in 50 countries, nearly half of which are in Africa.

Africa is leading efforts to reduce the burden of these diseases – and can help the world meet an ambitious but achievable target of seeing at least one NTD eliminated in 100 countries around the world by 2030. To make this a reality, we – global partners, donors and national governments – must unite to invest in proven strategies that will allow us to secure a safer and healthier future.  

One of the key drivers of progress has been innovation. Continued investment in research and development by the pharmaceutical industry, academic institutions, non-profits and other partners has yielded safer and more effective tools to treat and prevent NTDs. 

In the case of sleeping sickness, a parasitic pathogen that is fatal without treatment, a combination of new drugs helped simplify treatments for patients and reduce the burden on health systems, contributing to a 97 percent reduction in cases since the late 1990s. In 2023, Ghana became the seventh country in Africa to eliminate the disease and the total number of people infected has remained under 1,000 since 2018, putting Africa – and the world – closer than ever to ending it for good. 

Today, through work by the Drugs for Neglected Diseases initiative (DNDi) and other partners, a single-dose oral drug is in development and could one day help national programs achieve global elimination goals. 

However, these innovations are only effective if they reach the communities that need them. National governments, local organizations and implementing partners have driven major public health gains against NTDs by supporting expansion of disease surveillance, mass drug administration and health systems strengthening measures to deliver medicines to the right places at the right times.  

Take the elimination of trachoma, the world’s leading cause of infectious blindness, in Benin last year. It was only made possible following years of effort from the government and its partners to deliver treatments, train surgeons and enable operations for advanced cases. Now, 3.4 million people in the country are no longer at risk of losing their sight to the disease. Just last year, three countries eliminated trachoma – a testament to the feasibility of trachoma-free world. 

Collaborative investments, centering the needs of communities, have been paramount to these achievements. That’s why it was encouraging to see global and regional level partners come together to pledge over $780 million in support of NTD programs at the Reaching the Last Mile (RLM) Forum last December.   

This included an expansion of the Reaching the Last Mile Fund (RLMF), which was launched in 2017 by the President of the United Arab Emirates, with support from the Bill & Melinda Gates Foundation, The Children Investment Fund Foundation (CIFF), and Helmsley Charitable Trust, among others. The expansion will increase the Fund’s reach from seven countries to 39, with the goal of supporting the elimination of two diseases – river blindness and lymphatic filariasis – across Africa, helping to improve the lives of 350 million people. 

Mechanisms like the RLMF can only achieve their goals when they are supported and led by the communities where the need is the most acute. At the Forum, the governments of Sierra Leone and Tanzania joined with global partners in making additional financial pledges to the RLMF and committing to take country- and community-level actions to stop these two diseases. 

We know that NTD interventions work, and they can significantly improve the livelihoods of millions of people, restore equity and dignity, and provide an opportunity for healthy and productive lives for Africans affected by these diseases. African governments have already driven major progress on NTDs. Now is the time to keep up this momentum through sustained investment and political commitment at all levels, from global organizations to local partners.  

As a community, we must come together to invest in proven solutions and implement programs like the RLMF that are making bold commitments to disease elimination. When we do, more Africans will enjoy the healthier futures they deserve.

Cynthia Mwase is the Director Health, Africa, at the Bill & Melinda Gates Foundation.