The African region is accelerating the implementation of the global roadmap for neglected tropical diseases (NTDs), and 10 countries have eliminated at least one NTD since 2021, Dr Matshidiso Moeti, World Health Organization (WHO) regional director for Africa told the body’s executive board last week.

Togo eliminated four NTD, while Egypt eliminated lymphatic filariasis and trachoma has ceased to be a public health problem in Morocco. Moreover, 42 countries in the region will also be certified free of guinea worm disease before 2025, said Moeti.

The countries were guided both by the WHO global framework and using the Africa region’s Framework for the Integrated Control, Elimination and Eradication of Tropical and Vector-borne Diseases in the African Region  for 2022 to 2030.

“The strides made by the WHO African region and other WHO regions result from strong country leadership and effective partnerships,” said Moeti. 

She emphasised the role of the expanded special project for the elimination of neglected tropical diseases (ESPEN), which enabled countries to pool resources and work closely with the global NTDs community. She urged the board to sustain ESPEN’s funding in order to expand its successes as the region moves to the last miles of NTD elimination. 

“We must maintain and accelerate our progress by sustaining political commitment, enhancing multisectoral actions through effective partnerships and mobilising additional domestic and international funding to achieve the NTD roadmap goals,” Moeti concluded.

The roadmap sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups as well as cross-cutting targets aligned with the Sustainable Development Goals. It is based on three foundational pillars: accelerated programmatic action, intensified cross-cutting approaches, and changing operating models and culture to facilitate country ownership.

Appeal for flexible funds

Senegal expressed its commitment to align with the roadmap “to speed up efforts in prevention, control, and elimination of NTDs”, and urged the WHO to increase flexible funding for NTDs within Universal Health Coverage (UHC) efforts, emphasising the need for collaboration and domestic funding.

Cameroon, aligning with previous statements, praised the WHO’s roadmap and emphasised its commitment to national plans for NTDs. The country outlined specific goals for 2024-2028, including the interruption of Guinea worm disease and leprosy transmission. Cameroon highlighted the need for cross-sectoral collaboration, calling for mobilisation of human resources and domestic financing.

Meanwhile, Germany reiterated its dedication to the fight against NTDs, emphasising the Kigali Declaration on NTDs. Germany dwelt on improving access to quality health services, expanding water, sanitation, and hygiene initiatives, and investing in social security. 

The United States called for internal reforms within WHO to strengthen NTD programs and ensure accountability, transparency, and equity.

Non-state actor the Global Health Council (GHC) called for improved access to new drugs for NTD and better diagnosis ,as central to accelerating progress and meeting the goals of the roadmap.

“We call on member states to sustain and expand investments to accelerate R&D of safe and affordable treatments for NTDs and improved diagnostics, particularly for NTDs with specific unmet needs for use in primary healthcare settings,” the GHC said.

To accelerate market access for diagnostics, it recommended the exploration of regulatory and manufacturing pathways by the WHO and member states, to facilitate simultaneous or aligned prequalification and regulatory approval processes.

While highlighting the inextricable link of NTDs to poverty and inequality, it noted that the increased attention in recent years has brought new resources to the fight against NTDs and fuelled research breakthroughs.

“Yet very significant gaps remain in the arsenal of tools needed to control and eliminate these diseases, underscoring the need for research and development (R&D) of new tools,” it noted. 

Injecting new urgency into the fight against AMR

Member States also discussed antimicrobial resistance (AMR), which they framed as a growing and existential threat that hasn’t seen the sustained political attention it demands. 

The need for new actions is further supported by the WHO’s global action plan on antimicrobial resistance which is coming to an end in 2025.

Germany expressed its support for the WHO’s global AMR initiative and emphasised collaboration with academia, the private sector, and civil society. They asked that attention be on increasing investment and innovation in quality-assured, priority,  new and improved antimicrobials, novel compounds, diagnostics, vaccines, and other health technologies to fight AMR.

Morocco, speaking on behalf of the Eastern Mediterranean region, emphasised the diverse challenges faced by countries in the region. The representative stressed the importance of adapting responses to the varied contexts, emphasising the need for a coordinated, cross-cutting approach. They advocated for strengthening health systems, particularly in vulnerable and conflict-affected areas, and urged action beyond hospitals to include primary care, emergency, and public health programs.

“We believe that in our region, we have a very diverse picture. Therefore, in our response to AMR, we have to ensure that it is adapted to these different contexts if it is to be effective,” said the Moroccan representative.

Second UN high-level meeting on AMR

The US supported the continuation of AMR as a priority for the WHO, especially as the world prepares for the second UN General Assembly high-level meeting on AMR in September.

“We urge WHO to be fully inclusive of all partners, including Taiwan, and support Taiwan’s participation as an observer to the World Health Assembly, truly embodying the meaning of health for all,” said the U.S. representative.

Japan emphasised the importance of political momentum in addressing AMR and called for strategic allocation of resources at the national level. The Japanese representative highlighted the need for international collaboration, citing the example of Taiwan’s significant public health achievements. Japan pledged support for the implementation of National Action Plans on AMR in collaboration with the WHO and member states.

“In the September second UN high-level meeting on AMR, we have a good opportunity to increase the political momentum for countermeasures. The Government of Japan would like to contribute to promoting the implementation of the National Action Plan on AMR,” stated the Japanese representative.

Rwanda, speaking on behalf of the WHO Africa region, emphasised the urgent need to accelerate the implementation of national action plans on AMR and acknowledged progress made by member states in developing these plans.

“We take note of the report and call for effective implementation of all strategic and operational priorities by all members and stakeholders,” said the African region representative.

Problems with national AMR plans

According to the WHO DG’s report on AMR, while 178 countries had developed multi-sectoral national action plans on AMR as at November 2023, only 27% of countries reported implementing their national action plans effectively and only 11% had allocated national budgets to do so. He also fragmented implementation of national action plans in the human health sector, which he observed is often limited to hospitals, despite the vast majority of antibiotic use being outside hospitals. 

“Capacity to prevent, diagnose and treat bacterial infections and drug resistance, and the evidence base for policy development, are very limited in low- and middle-income countries. The integration of antimicrobial resistance interventions in health systems, and inter-dependencies with other health systems capacities and priorities, are often not recognized in strategies for universal health coverage or health emergencies,” the DG reported.

He proposed three urgent strategic priorities for a comprehensive public health response to antimicrobial resistance in the human health sector, notably surveillance of both antimicrobial resistance and antimicrobial consumption; the development of new vaccines, diagnostics and antimicrobial agents; and measures to make these accessible and affordable.