By Frank Okello
Against decreasing donor funding in the health sector, experts have called for increasing domestic financing and local ownership to eliminate neglected tropical diseases (NTDs).
Speaking during a webinar hosted by AMREF Health Africa titled “Escape the Neglect, Eliminating NTDs in a changing world,” Dr. Githinji Gitahi, AMREF Health Africa’s CEO, noted that NTDs disproportionately affect poor rural communities, especially in the Global South. “There is a direct link between poverty and NTDs; the poorer you are, the higher the burden,” he said.
He contrasted Africa with Global North countries like Germany, where GDP per capita exceeds USD 50,000, noting that NTDs are virtually absent due to robust health systems, while in sub-Saharan Africa, where many countries average under USD 2,000 per capita, these diseases persist as both a symptom and a driver of poverty.
Dr. Gitahi underscored that in contrast to diseases backed by profitable pharmaceutical markets, NTDs yield limited economic incentives, leaving their control largely dependent on donor funds and philanthropy.
According to Kenya’s Ministry of Health Senior Deputy Director, Dr. Sultani Matenderecho, the shift in financing will affect NTDs more, as most of the interventions are donor-driven.
Calling for government ownership and increased domestic financing to eliminate NTDs, he said, “It is not possible for countries to develop economically when they are heavily infested with NTDs.”
Dr. Matendechero noted that Kenya has cut the number of people needing NTD interventions from 21.8 million in 2010 to 8.7 million in 2022. This is notable progress in reducing NTD cases, but the achievements remain fragile.
“A KSh 72.5 billion funding gap still overshadows the country’s elimination plan, raising fears that gains could stall or even be reversed if adequate support is not secured,” he said.
Across the border, Tanzania is charting a different course. Dr. Clara Jones, NTD Program Director at Tanzania’s Ministry of Health, noted that her government is reducing reliance on foreign aid by prioritizing domestic resource mobilization.
Since 2021, councils have been asked to shoulder NTD financing, with a target of 60% domestic coverage by 2026. “It is not easy, but ownership is the only way to guarantee sustainability,” she said, noting 130 councils ran drug campaigns without donor funds in 2024.
Still in Tanzania, efforts to fight NTDs are increasingly being driven from the ground up. The government is rolling out advocacy campaigns in schools and supporting grassroots youth groups with small grants to champion awareness and interventions.
Central to this strategy is the Community-Driven Training and Advocacy (CDTA) approach, which places local voices at the heart of outreach and ensures that the fight against NTDs truly reaches the people most affected.
Dr. Jones cautioned that integrating NTD programs into national health systems comes with challenges, often weighed down by staff shortages, rigid funding rules, and everyday logistical headaches.
Onome Dibosa Osadolor, UNICEF’s Senior Immunization Specialist for East and Southern Africa, cautioned that underfunding and shrinking staff capacity have compromised responses to health crises.
“Governments are increasingly taking ownership of their programs, reducing dependency on donors. Domestic resourcing is on the rise,” She said, but noted that NTDs are still not included in essential health care packages, leaving millions outside guaranteed treatment.
Dr. Solomon Zewdu, CEO of the END Fund, defended philanthropy as a “catalytic investment” to bridge funding gaps. “Domestic resources alone will not solve our problems. We need to optimize partnerships, mobilize global resources, and involve high-net-worth individuals who are willing to help,” he said.
Dr. Zewdu also pinpointed digital opportunities such as AI for health data collection and cross-border surveillance, but admitted that investment in NTD research remains rare because it offers no clear financial returns.
Panelists also underscored the need for countries to learn from one another. Tanzania, for example, uses a practical guide known as Kikondi to help program managers benchmark their NTD efforts. Regional initiatives like Expanded Special Project for the Elimination of Neglected Tropical Diseases (ESPEN), a WHO-backed platform, are also creating spaces for peer learning and collaboration.
One message stood out clearly: NTDs may be neglected by markets, but they cannot be ignored by governments. Speakers stressed that without sustained investment, stronger integration into health systems, and active involvement of communities at the grassroots, the cycle of poverty and disease will remain unbroken. As Dr. Zewdu summed it up: “Integration should not only appear in moments of crisis. It must be part of our day-to-day programming if we are to win this fight.
