A laboratory technician prepares a piece of flesh that may contain onchocerciasis worms on January 12, 2022 in Kanga village, Ituri province, northeastern Democratic Republic of Congo. (Photo by ALEXIS HUGUET / AFP)
Neglected tropical diseases (NTDs) affect more than a billion people worldwide. Spread by worms and insects, these preventable diseases blind, disable and disfigure people living in some of the most remote and impoverished corners of the world, perpetuating cycles of disease, stigma and poverty.
Despite their profound effect, neglected tropical diseases have long been left out of budgets and global health priorities. Today, led by African countries and supported by a coalition of partners, this is changing.
The continent’s fight against these diseases has seen significant progress. By 2023, 19 countries in Africa had successfully eliminated at least one such NTD, a remarkable increase from just six countries in 2010. In addition, there are 88 million fewer people in need of interventions against neglected tropical diseases compared to 2013.
Togo, in particular, has made incredible strides, being recognised globally for eliminating four different NTDs.
These gains have been hard-won. But climate change now threatens to reverse them, endangering decades of global health and development progress and leaving vulnerable communities at risk.
Neglected tropical diseases are highly vulnerable to climatic changes and even small fluctuations can trigger a surge in transmission. For instance, changes in temperature and rainfall affect the breeding and survival rates of mosquitoes, which spread diseases such as dengue.
In 2023, dengue cases came close to a historic high, with over 5 million cases globally in regions including Africa. This is just the tip of what could become an unfolding arboviral pandemic.
Added to this is the burden that climate disasters — such as floods, droughts and heatwaves— place on already strained health systems, displacing populations and increasing the risk of disease.
Renewed commitments
Africa accounts for over 40% of the global NTD burden and is the continent most vulnerable to the impacts of climate change. To ensure progress against NTDs is not lost in the face of climate change, we must galvanise the political, technical and financial resources needed to stay the course.
To begin, we need more and better data to inform policymaking and resource allocation. Recent work carried out by the World Health Organisation, with support from Reaching the Last Mile, showed there are gaping holes in our knowledge of how climate change affects many NTDs. Sustained investment to help close these gaps, and shape climate mitigation and adaptation strategies, is a critical concern.
This must also be supported by robust cross-border surveillance systems that can detect and adapt to shifting disease risks. This proactive approach not only curbs the spread of NTDs into new areas but ensures resources can be used to protect vulnerable communities from emerging health threats.
Second, we need sustained funding and country leadership to help accelerate action against NTDs, before climate change causes us to lose ground. This means investing to build equitable and climate-resilient health systems that can respond to endemic communicable diseases, including NTDs, and shield communities against future health and climate shocks.
Unite. Act. Eliminate.
At the Reaching the Last Mile Forum at COP28 in December, African countries joined global partners in pledging over $777 million towards combating NTDs.
This included the expansion of the Reaching the Last Mile Fund from $100 million to a target $500 million, with the ambitious goal of eliminating two NTDs — lymphatic filariasis and onchocerciasis (river blindness) — from the continent of Africa.
This goal builds on the success of the multi-donor fund, which launched in 2017 to pioneer a model for the elimination of these diseases in sub-Saharan Africa.
It has since provided over 100 million treatments and trained 1.3 million health workers, in close partnership with endemic countries. It also played a part in Niger’s journey to eliminate the transmission of river blindness, following decades of country-led investment and effort.
This milestone — once thought to be scientifically impossible in Africa — stands as an example of what can be achieved when countries and partners unite in pursuit of a shared goal.
The next few years represent a tipping point for neglected tropical diseases. The commitments made at the Reaching the Last Mile Forum provide a vital opportunity to unite, act and eliminate NTDs before climate change makes our job even harder.
We must capitalise on this momentum to drive a coordinated global response, safeguarding recent gains made in global health and maintaining progress. We call on both countries and donors to join us in relegating NTDs to the history books. The time for action is now.
Dr Lia Tadesse Gebremedhin is Ethiopia’s health minister, Nassar Al Mubarak is the chief executive of Reaching the Last Mile and Dr Ibrahima Socé Fall is the director of the Global Neglected Tropical Diseases Programme at the World Health Organisation.