The changing neglected tropical disease landscape in Africa: implications for policy, practice, and strengthening health systems

Introduction Mass drug administration (MDA) has reached up to 1 billion people annually to combat neglected tropical diseases (NTDs). This study explores the evolving NTD landscape in Africa amid shifting disease patterns, funding cuts, and universal health coverage goals. Methods We analyzed data from ESPEN and Sightsavers databases to assess historical trends and forecast future treatment needs. Results By 2027, few or no MDAs for lymphatic filariasis and trachoma will be required and MDAs for onchocerciasis dropped sharply after 2024. In contrast, schistosomiasis and soil-transmitted helminths continue to require widespread MDA. Conclusion To secure elimination gains, remaining MDAs must be completed and broader health systems approaches adopted.