Neglected tropical diseases (NTDs) are a diverse group of conditions1 that still affect 1 billion people, mainly vulnerable populations in underserved regions of the world. Nevertheless, they are preventable, treatable and can be eliminated. As of May 2025, 56 countries have successfully eliminated at least one NTD – demonstrating significant progress towards WHO's global target of 100 countries reaching elimination by 2030.
This hard-won progress is now at risk. The dismantling of official development assistance (ODA) for global health, and particularly for NTD programmes, threatens to stall or reverse gains and negatively impact lives of vulnerable communities.
Threat to NTD gains
The recent withdrawal of funding by the United States from NTD projects jeopardizes the success of 19 years of investment in the global effort to eliminate NTDs.
Early reports shared with the World Health Organization (WHO) indicate that the immediate impact of the funding withdrawal has delayed 47 campaigns in which mass treatment was warranted to free 143 million people from the burden of NTDs. In 2020, WHO Member States set targets for 2030 by endorsing the Road map for neglected tropical diseases 2021–2030 through World Health Assembly decision WHA73(33). Missing the planned campaigns and impact surveys in 2025 will postpone the achievement of targets in at least 10 additional countries. The abrupt cuts also halted critical research to validate new treatments, diagnostics and surveillance platforms to ensure these diseases no longer pose a threat globally.
On 10 April 2025, WHO issued a warning on the impact caused by sudden suspensions and reductions in ODA for health, indicating that health service disruptions had been reported by over 70% of its surveyed country offices and that NTD programmes were among the most severely affected. In some settings, the nature and scale of service disruptions are comparable to those observed during the peak periods of the COVID-19 pandemic.
Critical shortages in medicines and health products are leaving one third of responding countries without essential commodities for major health services. At the same time, the suspension of funding has triggered job losses among health and care workers in over half of those countries.
Furthermore, if alternative mechanisms for service delivery are not urgently secured, suspensions and reductions in ODA for health could lead to expiration of over 55 million NTD tablets by the end of 2025, in Africa alone. In response, countries are working to identify local opportunities to sustain treatment activities, including integrated campaigns within broader health initiatives and mobilization of national resources to protect people's health, prevent medicine wastage and sustain progress.
Incredible past achievements at risk
Over the past two decades, the Government of the United States of America, through USAID, supported the delivery of 3.3 billion treatments to more than 1.7 billion people in 26 countries, clearing infections, stopping transmission and reducing the burden of lymphatic filariasis, onchocerciasis (river blindness), schistosomiasis, soil-transmitted helminthiases (intestinal worm infections) and trachoma in several areas. This cumulative support of US$ 1.4 billion significantly advanced public health outcomes and enabled 14 countries (Bangladesh, Benin, Cambodia, Colombia, Ecuador, Ghana, Guatemala, Lao People's Democratic Republic, Mali, Mexico, Nepal, Niger, Togo and Viet Nam) to achieve elimination of at least one NTD.
NTD programmes have continued delivering impressive results despite fierce challenges: in 2023 alone, more than 860 million people received treatment for NTDs through mass drug administration or individual case management; and between January 2023 and May 2025, 17 countries were officially acknowledged by WHO for eliminating one NTD. Today, the halt in drug distribution and the layoff of frontline health workers threaten to reverse this progress – raising serious concerns about the resurgence of NTDs in the most affected regions.
Funding challenges and implications for NTDs
The withdrawal of United States funding to NTD programmes is not an isolated event. The last few years have witnessed a deprioritization of financial investments in support of NTDs, which accelerated during the years of the COVID-19 pandemic. For example, in 2021, another key stakeholder, the Government of the United Kingdom of Great Britain and Northern Ireland, ended its flagship NTD initiative, the Ascend programme. Nevertheless, recent pledges such as those made in December 2023 during the Reaching the Last Mile (RLM) Forum had raised hopes of reversing this trend.
Decreased funding places a heavy strain on NTD programmes at a time when they are called to face unprecedented challenges, including the impact of climate change on vector-borne diseases. Notably, WHO declared dengue a grade 3 emergency in 2024, when over 14 million cases and 10 000 deaths were reported in 107 countries. The current global risk of dengue is assessed as high, and the disease remains a global health threat, while lack of resources continues to hamper prevention and control efforts, and the disease has spread to newer areas and countries in recent years.
NTD programmes are recognized among the most cost-effective initiatives in global health, also thanks to effective public-private partnerships. Generous donations from pharmaceutical companies including Bayer AG, Chemo Group, Eisai Co. Ltd, EMS SA Pharma, Gilead Sciences, Inc., GSK, Johnson & Johnson, Merck KGaA, Merck Sharp & Dohme (MSD), Novartis, Pfizer and Sanofi – cumulatively valued at over US$ 12 billion between 2011 and today –make life-changing treatments available to those in need at minimal cost.
Defunding NTD programmes threatens a proven public health success, potentially reversing hard-earned progress, exacerbating the cycle of disease and poverty, leaving vulnerable populations further marginalized and deepening inequality.
Moving forward
During the most recent Seventy-eighth World Health Assembly, NTDs were centre-stage , with a number of events held on the margins of the Assembly. Notably, two NTD-related resolutions , on eradication of dracunculiasis (Guinea-worm disease) and on skin diseases, were unanimously adopted by Member States.
At this critical juncture, it is imperative to build on such renewed consensus and strengthen the global commitment to eliminating NTDs. This requires fostering nationally owned, sustainable programmes complemented by catalytic external support. Together, we must work towards the complete elimination of NTDs and release communities from the heavy burden of suffering these diseases cause.
Notes
- Buruli ulcer; Chagas disease; dengue and chikungunya; dracunculiasis; echinococcosis; foodborne trematodiases; human African trypanosomiasis; leishmaniasis; leprosy; lymphatic filariasis; mycetoma, chromoblastomycosis and other deep mycoses; noma; onchocerciasis; rabies; scabies and other ectoparasitoses; schistosomiasis; snakebite envenoming; soil-transmitted helminthiases; taeniasis and cysticercosis; trachoma; yaws.
