The practical road to elimination of neglected tropical diseases: assessing the past and looking into the future

Abstract Eliminating neglected tropical diseases (NTDs) is critical for reducing poverty, addressing inequality and achieving universal health coverage. As the World Health Organization 2021–2030 Roadmap enters its second half, 2026 represents a pivotal year for translating decades of implementation gains into sustainable elimination outcomes. These have been through expanded access to preventive chemotherapy (PC), strengthened morbidity management and surveillance systems. In Africa, the population requiring PC decreased from 630 million in 2015 to 518.6 million in 2025 with few diseases eliminated in many countries. Sustaining these achievements and accelerating progress towards elimination require updated prevalence mapping, impact assessments, post-treatment surveillance and continuous community engagement while targeting persistent transmission hotspots. However, dwindling external financing threatens program sustainability. Hence, domestic financing, stronger political commitment and country ownership must be prioritized, with continued external technical support for strengthening national capacity and resilient health systems. Collaboration with water, sanitation and hygiene, environmental health and vector-control programs remain critical. Emerging zoonotic threats, demographic changes, import restrictions, fragile supply chains, insecurity and other country-specific challenges must be systematically addressed. The NTD community must move from commitments to measurable impact. Integrating NTD interventions into primary healthcare systems offers a cost-effective and sustainable pathway to elimination.