USAID works alongside countries to distribute safe, effective medicines to communities at risk of NTDs
Neglected tropical diseases (NTDs) are a group of parasitic, bacterial, and viral diseases that disproportionately affect poor and marginalized populations. Many of these diseases are often debilitating, stigmatizing, and can cause life-long disability. But they are also preventable and treatable with safe and effective interventions that can control, and in some cases, eliminate the disease.
Since 2006, the U.S. government, through USAID, has worked with more than 30 countries to end the effects of five of the most common NTDs. Most countries still impacted by NTDs have fought them for many years, and many have made significant progress, but there is still more that needs to be done to control and, ultimately, eliminate NTDs.
Why does USAID fight NTDs?
NTDs cause considerable human suffering. They can cause lifelong disability, and can have significant economic and social impact on affected individuals, communities, and countries. According to the World Health Organization (WHO), NTDs affect more than 1 billion people globally. As a proportion, NTDs affect more people than HIV/AIDS, malaria, and tuberculosis combined, but only receive a fraction of the support for implementation, research, and primary care. Communities and countries are affected, as acute symptoms and chronic, long-term health problems make it more difficult for people living with NTDs to engage in school and work. When NTDs are not addressed, people, families, and communities are unable to reach their full potential and poverty persists.
USAID focuses on five of the most burdensome NTDs. Efforts to control and eliminate these NTDs are considered a “global health best buy.” Interventions such as drug treatments are highly effective and are relatively inexpensive. Every $1 invested by the U.S. government leverages $26 in donated NTD medicines, offsetting billions of dollars in the costs of medicine. Read more about the generous donation of medicines from pharmaceutical partners. USAID’s work contributes to global health and development goals, such as the WHO’s Road Map for NTDs: “Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030.”
What does control or elimination of NTDs mean?
For the five NTDs that USAID targets, the medicines that are used suppress disease transmission, and may reduce the most severe effects of the diseases (morbidities) in individuals. As these morbidities decline in a geographic area the disease is said to be “controlled”, but continued interventions are still needed. Once the morbidities are no longer present and no new morbidities are occurring (or the cause [i.e. bacterium, parasite, etc.] no longer exists), the disease is said to be “eliminated”. Specialized surveys developed by the WHO can be conducted to determine if a specific area or region within a country has achieved elimination. Once elimination occurs, then the use of medicine is likely no longer required and treatments can stop. Once a whole country has determined that it can safely stop treatment everywhere they may do a systematic review to determine if the number of people who test positive for the disease is under a specified amount. The results of this review are sent to the WHO and, if approved, a country may formally be confirmed as having “eliminated” the disease. See the countries USAID has worked with to successfully eliminate an NTD.
How does USAID work to control and eliminate NTDs?
USAID works with countries to use a wide variety of tools, strategies, and medicines to reduce the burden of NTDs and eliminate them where feasible. Because NTDs most often affect poor, marginalized, and isolated populations, conducting mapping surveys helps to identify where people are at-risk of infection and treatment is needed. Large scale treatment of these populations requires established supply chains, trained health workers and volunteers, effective distribution of medicines, and monitoring for their safe, effective use.
Confirmation by WHO requires the use of sensitive diagnostic tools and survey methods to confidently measure the presence or absence of disease. As more countries get closer to their control and elimination targets, the understanding of these diseases grows. New challenges may be identified that require novel tools or strategies to be developed to ensure the goals can be achieved. Finally, countries that receive confirmation from WHO need robust, sustainable systems to monitor to ensure that the diseases do not return.
Photo: Children take a dose of medication during a mass drug administration for the elimination of lymphatic filariasis in South Sumatra, Indonesia. Credit: RTI International / Muhammad Fadli
USAID uses proven strategies to assist countries as they map, treat, evaluate, and ultimately control and eliminate NTDs
Mapping
Mapping is a relatively quick and inexpensive way to classify a geographic area as “endemic” and requiring treatment, or “non endemic” and not requiring it. Mapping is conducted most often at the district level, using survey methods and diagnostics endorsed by the WHO. Most of the areas where USAID currently works are now effectively mapped; and much of this mapping work was supported by USAID over the last decade.
Treating
Providing treatments and measuring the effect of those treatments through monitoring and evaluation is the largest part of USAID’s NTD work. For most of the diseases targeted, treatment usually involves planning and distribution of medicines for at least 3-5 years. This is called “mass drug administration” or MDA. Regular assessments follow MDA to measure the drug distribution effectiveness and the prevalence of disease or infection.
MDA includes regular, large-scale distribution of medicines to entire at-risk populations, usually once or twice a year, regardless of infection status. By treating entire populations, the transmission of disease is suppressed to the point that it is either no longer a public health problem or spread of the disease is no longer possible. USAID uses an integrated treatment approach, often treating multiple NTDs at one time, improving both impact and efficiency. Treatments are typically given during a “campaign,” which is a planned, time-limited effort to give medicines to a community at-risk for a disease. The medicines used are safe and effective, and they can be given by trained volunteers.
Pharmaceutical companies donate medicines to countries to treat NTDs through a yearly application process. Prior to USAID’s NTD Program, some of the global NTD drug donation programs were underutilized, as many countries lacked the resources to measure disease or distribute treatments. In this regard, USAID’s support has been crucial in expanding the global distribution of donated medicines to fight NTDs. To date, USAID has supported countries to distribute billions of treatments. See more results.
Monitoring and Evaluating
USAID supports countries to monitor program quality and effectiveness through regular monitoring of MDA coverage, surveys to measure progress in reducing disease, and evaluations to determine if specified targets were achieved so that treatments can be safely stopped. Consistent monitoring of programs ensures adherence to guidelines developed to help achieve control and elimination goals. Evaluation of the impact of interventions on disease allows programs to determine progress, adapt to challenges, and allow countries to move toward confirmation by WHO. Ensuring that monitoring and evaluation is done effectively and accurately is critical in both progressing toward and achieving NTD programmatic goals.
Because of USAID’s support, more than half a billion people no longer require treatment for three of the most burdensome NTDs
Results*
- 3.3 billion treatments delivered
- 1.7 billion people treated
- $31.3 billion leveraged in donated drugs
- 8.2 million individuals trained, strengthening the expertise and capacity of country partners
- 13** USAID-supported countries have eliminated at least one NTD as a public health problem
- People no longer requiring treatment for lymphatic filariasis: 455.2 million
- People no longer requiring treatment for trachoma: 196.6 million
- People no longer requiring treatment for onchocerciasis: 16.2 million
Learn more about these results.
*Cumulative results from 2006 to 2023. **As of August 2024.
Stories
- Meet Surni and Mabinty, women living with the long-term effects of lymphatic filariasis, but living in communities that will eliminate the disease in the future
- See how preventing an overlooked disease called schistosomiasis can help children grow and learn
- Learn how Ghana and Nepal defeated trachoma, the leading infectious cause of blindness
See more news and stories.
As a part of the global NTD community, USAID abides by and contributes to global guidance, research, and best practices
Technical Resources
World Health Organization | Neglected Tropical Diseases (WHO)
Expanded Special Project for the Elimination of NTDs (ESPEN)
USAID’s Neglected Tropical Disease Program COVID-19 Resources
Policy and Advocacy Resources
Video: The Journey to End NTDs – How it works
Global Schistosomiasis Alliance (GSA)
Global Alliance to Eliminate Lymphatic Filariasis (GAELF)
International Coalition for Trachoma Control (ICTC)
International Trachoma Initiative (ITI)
Mectizan Donation Program (MDP)
Soil-Transmitted Helminths Advisory Committee
USAID Programs and Partnerships
Act to End NTDs | East (Act | East)
Act to End NTDs | West (Act | West)
Coalition for Operational Research on NTDs (COR-NTD)
Onchocerciasis Elimination Program for the Americas (OEPA)
Achieve Onchocerciasis Elimination in the Americas (Achieve OEA)