Limited political visibility. Heavy donor dependency. Inadequately trained health workers. Fragile water and sanitation systems. Weak surveillance. These are not just technical shortcomings; they are the factors threatening to reverse years of hard-won progress in the fight against Neglected Tropical Diseases (NTDs).

“This progress remains fragile and is now threatened by declining international funding and persistent structural weaknesses in national health systems,” warned Dr Maria Rebollo Polo, a leading World Health Organization expert, during the opening session of the REMAPSEN Media Forum, held via webinar.

While much of the global narrative has focused on success stories, Dr Rebollo made it clear that beneath the optimism lies a foundation that could easily crumble without sustained political and financial commitment. “Neglected Tropical Diseases continue to suffer from limited political visibility, heavy donor dependency and weak integration into national health systems, which puts long-term sustainability at risk,” she noted.

Neglected Tropical Diseases still affect more than one billion people worldwide and accounted for 119,000 deaths in 2021 alone. Beyond fatalities, they continue to drain communities of productivity and dignity, accounting for more than 14 million disability-adjusted life years in a single year. “These diseases do not only cause illness and death; they undermine education, productivity and economic development, trapping affected communities in cycles of poverty,” Dr Rebollo explained.

These are not distant statistics. They represent children missing school because of preventable infections, farmers unable to work due to disfiguring disease, and families pushed deeper into poverty by chronic illness. Against this backdrop, the progress made over the past decade is remarkable. Since 2010, 695 million fewer people now require intervention for NTDs, with 239 million reached between 2020 and 2023 alone.

In 2024, more than 1.4 billion preventive treatments were administered globally, protecting 864.6 million people from at least one NTD. The World Health Organization has also validated 58 countries for eliminating at least one of these diseases, with nine nations achieving elimination targets in 2025 alone, including Senegal, Kenya, Egypt, Niger and Guinea.

“Since 2010, nearly 700 million fewer people require intervention for neglected tropical diseases, largely due to mass chemoprevention campaigns and coordinated global efforts,” Dr Rebollo said. Yet she cautioned that these gains are now under serious threat.

International funding dedicated to NTDs has dropped sharply, from $531 million in 2018 to just $260 million in 2023. The impact is already being felt across Africa, where the burden of these diseases is highest. The reduction or shutdown of major donor programmes, including USAID’s Act to End NTDs initiative, has slowed mass drug administration campaigns and weakened national response systems in several countries.

“The sharp decline in international financing is already slowing mass drug administration campaigns and weakening national capacities, particularly in countries with the highest disease burden,” she warned.

In response to shrinking resources, some African countries are rethinking how they deliver care. Ethiopia, Kenya and Uganda are integrating NTD services into their primary healthcare systems. Madagascar is combining NTD treatment with vaccination campaigns. Tanzania is linking its NTD response to nutrition programmes. Rwanda and Togo are adopting multisectoral approaches that connect health with education, water and sanitation.

“Integrating NTD interventions into primary healthcare systems and existing platforms such as immunisation, nutrition and school-based programmes is becoming essential as resources decline,” Dr Rebollo explained.

However, she stressed that innovation alone will not succeed without political will. To sustain elimination, NTDs must be fully integrated into national development policies, supported by dedicated budget lines, stronger supply chains, improved disease surveillance and digital reporting systems. Countries must also develop transition plans to gradually reduce reliance on donor funding while empowering communities to take ownership of local interventions.

“Strong national leadership, dedicated domestic financing and full integration of NTDs into national policies are critical to sustaining elimination gains,” she said.

In her presentation, Dr Rebollo emphasised that the fight against Neglected Tropical Diseases is not just about health. “Combating neglected tropical diseases is not only a health intervention; it is an investment in equity, education, productivity and national sovereignty,” she stated. When a community is freed from lifelong disability, it gains not only better health but also the power to learn, work and thrive.

As donor fatigue grows and global priorities shift, the future of millions hinges on whether national governments and international partners will protect the gains already made or allow preventable diseases to reclaim lost ground. “The future of the fight against neglected tropical diseases depends on reducing reliance on external funding while strengthening country ownership, surveillance systems and community engagement,” Dr Rebollo warned.

For families who depend on a single annual treatment to stay healthy, the battle against Neglected Tropical Diseases is not a policy debate. It is a daily fight for survival—and one the world cannot afford to abandon.