USAID is working with countries to advance sustainable approaches to further the elimination of NTDs
Over the past decade, the number of countries responding to neglected tropical diseases (NTDs) has expanded considerably. Many endemic countries’ “NTD programs” are successfully reaching the poorest communities with interventions to control and eliminate diseases that can trap communities in poverty. To address this, countries increasingly need a sustainable, multi-sector government approach to NTDs.
USAID is working with countries to build national NTD programs that are resilient and viable long-term. USAID is supporting country-led efforts to develop sustainability plans, which reinforce national ownership, establish priorities, and strengthen the health system and other sectors to deliver NTD services.
What does sustainability mean?
USAID defines sustainability in the NTD context as:
“The national health system capacity and commitment to maintain the provision of NTD interventions at levels that will continue progression toward control or elimination of diseases in accordance with national NTD goals.”
This definition aligns with the World Health Organization’s (WHO) Sustainability framework for action against neglected tropical diseases, a companion document to the WHO 2030 Road Map for NTDs, which outlines how countries can establish sector specific priorities and decide what actions to take to achieve sustainable NTD services.
Why and how does USAID invest in sustainability?
Many national NTD programs are largely reliant on donor funding. Often NTDs are not included in established national policy, financial, and coordination processes. While this model has driven significant progress towards disease goals, now these investments need to be complemented with approaches that sustain and build on that progress.
Over the decades, USAID has invested in strengthening country leadership and ownership across various development sectors. Consistent with the Agency’s broader development agenda, the USAID NTD Program is now aligning assistance more strategically to advance well-resourced, country-led NTD response. While continuing to support countries in controlling and eliminating five of the most burdensome NTDs, USAID supports countries as they develop sustainability plans, reinforces national governance of NTD programs, and strengthens health systems to better deliver NTD services.
Ultimately, NTD interventions need to be a routine part of national systems and services to preserve the progress made, continue protecting those benefiting from services, and expand services where needed. Securing and maximizing benefits for all sectors requires country leadership to fully incorporate NTD programs into national governance, finance, and planning processes.
National NTD programs have demonstrated, and continue to demonstrate, their role in achieving public health impact, strengthening health services, and contributing towards broad health and development goals. See USAID’s 5 Principles for Supporting Government Sustainability Planning.
Photo Credit: USAID’s Act to End NTDs | West Program
Strategically aligning assistance to advance country-governed, well-resourced NTD programs
Supporting Government-Led Sustainability Plans
USAID supports government-led efforts to review links between national NTD programs and all relevant sectors —such as education and water and sanitation— for gaps as well as opportunities for alignment and coordination. USAID also encourages countries in an “all of government” approach to sustainability plan development which involves obtaining buy-in from leadership across ministries through a co-creation process. This process helps identify where NTD programs need to be strategically incorporated into national governance, financing, planning, delivery, and monitoring systems and processes. USAID is also supportive of governments in establishing country-level mechanisms to monitor government and stakeholder progress against clear benchmarks, time frames, and roles and responsibilities outlined in sustainability plans.
What does this look like practically?
With USAID’s support, Cote d’Ivoire assembled representatives across government sectors, —including health, education, agriculture, and more— to review the current status of NTD services. Through this multi-sector process, the government developed a three-year plan with roles and responsibilities and benchmarks to help guide integration of NTD activities into national policies, strategic planning, health financing, and operations management. The plan was adopted by the government and disseminated to regional and district levels to begin integrating priority NTD sustainability activities into operational plans.
Reinforcing National Governance and Ownership of NTD Programs
Based on nationally identified priorities, USAID technical assistance helps reinforce and complement government efforts to incorporate NTD programs into relevant national policies, planning, and financing processes across sectors and ministries to ensure sustainable resources and planning for NTD programs at all relevant levels.
What does this look like practically?
USAID started providing support for NTDs to the Government of Indonesia in 2012. Within five years, the country completed mapping to identify all districts endemic with lymphatic filariasis (LF) and developed an approach to have districts finance mass drug administration. Indonesia’s government also drafted a strategic plan for NTDs, an exercise which resulted in policy and financing changes at all levels of government and increased domestic funding for LF. As a result of these efforts, the President of Indonesia designated LF elimination as a priority health intervention in 2017. By 2019, 100% of districts were funding mass drug administration from district level budgets.
Strengthening Cross-Cutting Health Systems to Deliver NTD Services
USAID’s support assists government-led efforts to incorporate NTD services and functions into existing national programs and cross-cutting systems such as supply chain management, information systems, and workforce utilization.
What does this look like practically?
In 2019, the Department of Health in the Philippines issued an administrative order establishing guidelines for integrated elimination hubs for malaria and LF at the sub-national level. This important policy change ensures people have access to quality health products and laboratory services at all levels of care. Field laboratory technicians are cross-trained in a variety of active and passive infectious disease surveillance laboratory and clinical methods. The elimination hubs have created a framework for sustainability and accountability in areas co-endemic with malaria and LF so they can continue surveillance to ensure elimination efforts remain on target and in full effect for the impacted communities.
Supporting sustainable country-led programs to accelerate progress on ending NTDs
Sustainability in Action
- 12 USAID-supported countries have developed or are developing NTD sustainability plans
- 10 of those USAID-supported country governments have publicly validated an NTD sustainability plan
- Côte d’Ivoire (2020), Senegal (2021), Uganda (2021), Togo (2021), Ghana (2021), Tanzania (2022), Ethiopia (2022), Niger (2022), Mali (2023), Sierra Leone (2024)
Stories
- Sierra Leone: MoH in Sierra Leone Praises NTD Sustainability plan for prioritizing locally driven solutions and equitable health services
- Mali: Mali’s MoH Validates NTD Sustainability Plan During Period of Major Progress
- Niger: U.S. Congratulates Government of Niger for Commitment to End Neglected Diseases
- Ethiopia: Ethiopia Launches Third National NTD Strategic Plan and Sustainability Plan for NTDs
- Tanzania: Tanzania Launches New Master Plan And Sustainability Plan For Neglected Tropical Diseases
- Côte d’Ivoire: Government of Côte d’Ivoire Backs National Neglected Tropical Diseases Sustainability Plan
- Senegal: Government of Senegal Validates NTD Sustainability Plan
- Uganda: Ugandan Government Launches a National Sustainability Plan for Neglected Tropical Diseases
- Togo: “Health is Everyone’s Business”: How Togo is Tackling Sustainable Neglected Tropical Disease Services
- Ghana: Ghana High-level Multisectoral Stakeholder Engagement Seeks to Mobilize Political Commitment for the Neglected Tropical Diseases Sustainability Agenda
- Indonesia: Setting a Sustainable Course to Fight NTDs in Indonesia
- Philippines: A Mighty Force – One woman sets her sights on the health of Filipino children
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
Fact Sheet: USAID – Expanding Government Partnerships to Sustainably Eliminate NTDs (French Version)
Webinar: USAID – Fresh Takes: A conversation about doing business differently to secure sustainable NTD programs (French Version)
WHO’s Sustainability Framework for Action (French Version)
Key Learnings from Health Systems Strengthening for the NTD Community
NTD Sustainability Analysis and Planning Consultation Guide
Domestic Resource Mobilization for NTDs: Three-Country synthesis; Case studies from Colombia, Guatemala, Philippines
Key Aspects to Effective Program Sustainability: Briefs on Strengthening Ownership and Collaboration, Adaptive Technical Assistance, and Multisectoral Coordination
USAID’s 5 Principles for Supporting Government Sustainability Planning
Policy and Advocacy Resources
Considerations for a Sustainability Framework for Neglected Tropical Diseases Programming
Making Sustainability a Reality in NTD Programs: A Conversation with Richard Killian
Video: Journey to End NTDs: The road to elimination
USAID Programs
Act to End NTDs | East (Act | East)
Act to End NTDs | West (Act | West)
Ending Neglected Diseases through Operational Research (ENDOR)
Onchocerciasis Elimination Program for the Americas (OEPA)
Achieve Onchocerciasis Elimination in the Americas (Achieve OEA)