Dar es Salaam, Tanzania — Neglected tropical diseases (NTDs) don’t make the news often, but they affect more than 1.7 billion people worldwide. The diseases caused by parasites, bacteria, viruses, and toxins do more than just make people sick. They can lead to blindness, intense pain, and keep families stuck in poverty. Africa bears one of the heaviest burdens, with over 600 million people still waiting on treatment, despite major progress in reducing their spread.
The diseases are labeled “neglected” because they mainly affect the poorest and most vulnerable communities. Often, these diseases thrive in places without clean water, sanitation, or quality healthcare. Poverty and social stigma are perpetuated by this situation. However, the past decade has seen considerable progress. Millions have received treatment, and prevention efforts are spreading in areas where these diseases are common. At least 56 countries have eliminated at least one NTD, while the global goal is to reach 100 by 2030.
Despite a global roadmap targeting the elimination of many NTDs by 2030, progress is threatened. Geopolitical shifts, such as the abrupt halt of the United States Agency for International Development’s (USAID) funds and broader reductions in global aid, have left a severe funding gap. These disruptions, combined with regional variations in disease transmission, threaten to stall or reverse hard-won gains.
The impact is especially severe in countries like Tanzania, where the disease burden is significant and the need for solutions is pressing.
“In Tanzania, 15 of the 21 neglected tropical diseases classified by the World Health Organization are present, posing significant health challenges,” said Dr. Clarer Jones Mwansasu, the NTDs Programme Manager from the Ministry of Health.
Diseases such as lymphatic filariasis, schistosomiasis, and soil-transmitted helminths take a heavy toll due to limited access to clean water and healthcare. However, Tanzania refuses to be defined by ‘neglect’ and is making bold moves to tackle these preventable diseases. The reality on the ground shows just how steep the task ahead remains.
A strategic focus on five
Rather than spread resources thin across all 15 diseases present in the country, Mwansasu explained that the NTD program focuses on five preventable, chemotherapy-targeted diseases: lymphatic filariasis, onchocerciasis (river blindness), schistosomiasis (bilharzia), soil-transmitted helminths (intestinal worms), and trachoma. “These diseases can be effectively managed through preventive or curative care,” she said.
This focus doesn’t mean other diseases are ignored. Other NTDs are managed through different programs – dengue falls under the epidemiology section, while leprosy is handled by the TB and Leprosy program.
Before the formal establishment of the NTDs programme in 2009, interventions existed, but they were implemented with different programs addressing different types of NTDs. To improve efficiency and resource utilization, Mwansasu said, Tanzania adopted an integrated approach guided by WHO guidelines, with mass drug administration (MDA) serving as the main intervention.
Beyond medicine
The program goes beyond simply distributing medication. Dr. Eligreta Mnzava said tackling misinformation and fears about neglected tropical diseases requires strong community engagement. The NTD program collaborates with leaders at various levels – district, government, regional, and village – to reassure communities that the program aims to improve their health.
“We want communities to understand where they can go, whether to hospitals or community health workers, to register when there are activities concerning NTDs,” Mnzava explained. To counter misinformation, fears, and local beliefs that might influence medical-seeking behavior, she pointed out the importance of widespread health education and the role of media platforms, such as local radio and television.
Dr. Mwansasu added another layer to this community-focused approach: “We train staff at the call center before any mass drug administration (MDA) intervention so they can handle community questions. These pre-MDA interventions address misconceptions before they arise.”
The program also emphasizes advocacy and behavioral changes, particularly because these diseases require consistent preventive practices. Maintaining progress after mass drug administration depends on continued behavioral change and community sensitization, Mwansasu noted.
The partnership web
While Tanzania is making strides to reduce its burden of NTDs, the government cannot do it alone. Several NTD programs rely heavily on donor funding, creating a complex web of international partnerships that has been crucial to Tanzania’s success.
Peter Kivumbi, NTD Programme Manager at Sightsavers, explained how his organization works closely with the government and the Ministry of Health, focusing on trachoma by building capacity, providing training, and supplying equipment. “This approach makes sure that the benefits last even after Sightsavers’ programs end,” he said.
The scale of international support is vast. USAID has been a major donor since 2009, contributing to various projects. Sightsavers UK has supported trachoma programs and environmental improvement initiatives through multiple implementing partners. The END Fund backed the RLM Expansion Project to fight lymphatic filariasis and onchocerciasis. The Bill and Melinda Gates Foundation assisted with NTDs through its supply chain technical support mechanism. The United Kingdom provided significant help through programs like DFID, SCEND, and Arise NTDs, which were active between 2021 and 2022.
Additional partnerships include the International Trachoma Initiative providing Zithromax to combat trachoma, the Mectizan Donation Program supplying Ivermectin to treat intestinal strongyloidiasis and onchocerciasis, and the World Health Organization supporting coordination, technical guidance, and medicine provision.
These collaborations have greatly helped Tanzania’s integrated NTD control programs, which include mass drug administration, morbidity management, and improved surveillance.
Building financial independence
The coordinated effort to control neglected tropical diseases in Tanzania shows the government’s commitment to developing the health sector. The country’s NTD activities follow the Master Plan and the Sustainability Plan (2021-2026), which support the National Health Policy Strategy Plan and call for increasing domestic funding to meet high-priority needs.
Financial sustainability is crucial.
Financial sustainability is crucial, and Mwansasu is clear about the goals: “The Sustainability Plan aims to raise domestic financing for interventions to 6% by 2026. True ownership means financial independence and the ability to make decisions regardless of funding source.”
Tanzania has already made significant progress in this area.
Domestic financing for NTD programs has improved from 0.6% to 25%, with some councils reaching 60% domestic financing for NTD interventions. Local governments now set aside funds for NTD interventions through the Council Comprehensive Health Plan (CCHP), guaranteeing continuity even when donor support fluctuates.
“Tanzania is keen on accelerating the domestic financing strategy to ensure the sustainability of interventions,” Mwansasu said. “We are happy that we developed a domestic resource mobilization strategy, which, though not yet finalized, has already begun being implemented.”
The country is also pursuing innovative funding approaches. Tanzania is part of a seven-country initiative under Uniting to Combat NTDs, submitting a joint proposal to AUDA-NEPAD to strengthen regional collaboration. “We believe that once our proposal is accepted, it will solve a lot of financial gaps,” Dr. Mwansasu said.
Additionally, Tanzania is working with the Ministry of Finance to include NTDs as a priority in the International Development Association (IDA21) submission to the World Bank. “We are not taking loans for NTD,” she said, indicating a commitment to grant-based funding rather than debt.
Climate crisis – a growing threat
The climate crisis is becoming a significant threat to the fight against NTDs, and Tanzania is experiencing this firsthand. Hope Rusibamayila, the National Trachoma Elimination Focal Person, explained how the climate emergency greatly affects the spread of NTDs and response efforts, especially in the Arusha and Manyara regions where the pastoral Maasai community lives.
The Maasai’s seasonal migration patterns, tied to grazing availability and water sources, create challenges for intervention programs. “When MDAs are conducted, communities may have moved, making it difficult to measure progress during follow-up surveys,” Rusibamayila said. Reduced water supply in these areas increases infection risk, while seasonal migration requires targeted interventions across both dry and wet seasons.
Dr. Mwansasu pointed to specific examples of climate impact: “Diseases such as lymphatic filariasis, transmitted by mosquitoes, and river blindness, transmitted by black flies, are affected by changes in climate.” She noted that infections are being introduced into areas that were not previously endemic. “Njombe District was traditionally considered too cold for blackflies to survive. However, climate change has led to the discovery of new vectors in that area, and new infections have been reported due to rising temperatures.”
The implications are serious: “Njombe, which was once non-endemic, has now become endemic, and interventions have had to start there,” Mwansasu said.
Addressing gender and social barriers
Tanzania’s NTD programme has had to confront gender barriers in access to treatment. Rusibamayila explained that men are often missed during interventions because of work patterns, while some women are excluded because of cultural norms requiring spousal approval.
“These diseases do not have gender. They affect everyone.”
“In the past three years, we have introduced gender equity and social inclusion interventions. We go into communities to discuss who is being left out and why, so that everyone is included,” she said. “These diseases do not have gender – they affect everyone.”
Education plays a central role in sustaining progress. “For trachoma, sustainable behavior change requires children to grow up knowing proper WASH practices. That is why we have school-based interventions, and why we’ve worked with the Ministry of Education to integrate NTD awareness into the curriculum,” Rusibamayila explained.
The programme has also developed training modules for integration into pre-service health courses, ensuring new health workers enter the system with knowledge of NTDs, which will strengthen long-term sustainability.
Preventing resurgence
The global NTD community provides over a billion treatments each year, but concern remains that progress on controlling and eliminating NTDs may be undone without sustained attention and resources. Dr. Faraja Lyamuya, an epidemiologist and focal person for lymphatic filariasis elimination, explained the ongoing challenges.
“We are working closely with the lymphatic filariasis and vector control programmes to make sure the disease does not resurge in areas where it had previously been controlled,” she said. After COVID-19, ongoing surveillance and follow-up were supposed to continue, but these efforts have been irregular due to challenges with testing kits and limited information. Despite these challenges, they have used available data to monitor the situation through hospital administration.
Rusibamayila emphasized the importance of WASH interventions for trachoma prevention: “When communities have access to water, it improves hygiene and reduces the risk of reinfection in areas where prevalence has already been lowered.”
The government collaborates with multiple ministries, including Water, Education, and the President’s Office, to sustain WASH interventions. Bi-annual national WASH forum meetings help different sectors coordinate interventions and track progress. “We are also strengthening the health system by integrating trachoma indicators into the district health information system,” Rusibamayila said. “This helps us track patients and quickly detect any resurgence, allowing us to enhance interventions where needed.”
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Leading by example
Tanzania has developed approaches that are attracting international attention. The country has created a systematic approach to documenting geographic coverage for trachoma, meeting WHO criteria for elimination validation. Kivumbi noted that the program tracks every stage through a patient-centered data system.
“Tanzania is among the first countries leading in this effort. We have properly documented the entire process, from case finding and training to management protocols, and this has already been established at the national level through collaboration between the Ministry of Health and multiple partners,” Kivumbi said. “This approach has attracted international interest, with countries seeking to learn from our experience.”
Progress toward 2030
The “Road to 2030” for neglected tropical diseases follows the World Health Organization’s roadmap launched in 2021, with the bold goal of eliminating 20 NTDs by 2030. The main goals include reducing by 90% the number of people who need treatment for NTDs, decreasing by 75% the illness and disability they cause, helping at least 100 countries eliminate one NTD, and completely eradicating Guinea worm disease and yaws worldwide.
As of May 2025, 56 countries have successfully eliminated at least one NTD, putting the world more than halfway toward the 2030 goal of 100 countries. This milestone reflects Africa’s united front against NTDs, with six African countries recently signing an agreement to eliminate visceral leishmaniasis in a landmark deal.
Tanzania has made significant progress toward its NTD targets. The transmission of lymphatic filariasis has been interrupted in 119 out of 184 councils, leaving only five councils that still need MDA. Trachoma transmission has stopped in 69 councils, with seven remaining.
“This is a major achievement,” said Dr. Mwansasu. WHO targets aim to reduce the number of people requiring chemotherapy by 90% by 2030; Tanzania has already achieved 76%, equating to about 39.4 million fewer people requiring treatment. Much of this success has come from interventions against lymphatic filariasis and trachoma.
Despite these achievements, challenges remain. Dr. Mwansasu acknowledged financial constraints and competing health priorities, especially following shifts in donor funding, and called on the global community for support.
“We want the global community to support us in those initiatives. But we also want the flexibility of funding. We want to work together with the government at the national and subnational levels,” she said.
“Tanzania is on track for a healthier future and the elimination of NTDs with continued integration, community engagement, and domestic commitment.”
Chironda was in Tanzania as part of a workshop and field visits hosted by Sightsavers and Tanzania’s Ministry of Health, in collaboration with other partners, including Uniting to Combat Neglected Tropical Diseases, a global advocacy organisation that exists to end NTDs by mobilising resources.
