Preventive Chemotherapy at Crossroads: Progress, the Funding Crisis, and Strategic Priorities for Achieving the 2030 WHO Neglected Tropical Diseases Road Map

Global investments in preventive chemotherapy (PC) programmes have substantially reduced the burden of neglected tropical diseases (NTDs), with more than 31 billion donated treatments delivered to over one billion people at risk since 2011. Recent reductions and terminations in United States/USAID support, occurring within a broader contraction in global health financing, now threaten to reverse these hard-won gains by disrupting mass drug administration, disease surveillance, health workforce capacity, and community-based delivery systems. This perspective advocates for renewed and sustained investment in PC programmes by highlighting the critical contributions of medicine donation initiatives to the global NTD elimination agenda, the implications of the current funding crisis for achieving the 2030 targets, and strategic investment priorities to sustain programme gains, strengthen health systems, and accelerate progress toward the elimination of NTDs by 2030.