Ending Neglected Diseases? One West African Country Has Done This Four Times.

No one could have predicted that in less than 12 years one country in the world would be recognized by the World Health Organization for eliminating four neglected tropical diseases (NTDs). That country is Togo.

“Togo has taken to heart the fight against neglected tropical diseases… .”

— Moustafa Mijiyawa, Minister of Health, Togo

NTDs are a diverse group of ancient diseases that cause illness and lifelong disabilities for more than a billion people worldwide. Many people living with NTDs are stigmatized, and unable to participate fully in school or unable to find work — which can put them at greater risk of poverty.

Fortunately, safe, effective treatments exist to prevent and treat many NTDs, making it possible for countries to ultimately eliminate some of the diseases as public health problems outright. While many countries have eliminated an NTD in the last decade, none has come close to Togo’s record.

Twelve years ago, four (now eliminated) NTDs were endemic within Togo’s borders: lymphatic filariasis, trachoma, Guinea worm, and African sleeping sickness. These diseases cause a variety of health problems — lymphatic filariasis can cause disability from extremely swollen limbs; trachoma can cause blindness; Guinea worm and African sleeping sickness cause pain and distress, and the latter is deadly when not treated.

“When we eliminate an NTD, this is always a good thing for the country.”
— Tchalim Maweke, Planning Coordinator for the NTDP, Ministry of Health, Togo

The Government of Togo, through the Ministry of Health, Public Hygiene and Universal Access to Care, has fought NTDs using proven interventions — administering treatments to communities at-risk, consolidating health services to improve efficiencies, establishing national expert advisory committees, and conducting evaluations to produce data that guides decision-making. Using this concentrated approach, combined with more than two decades of sustained political commitment by Togo’s government and community leaders, the country was able to eliminate four NTDs in a short time span: guinea worm (2011), lymphatic filariasis (2017), sleeping sickness (2020) and most recently, trachoma (2022).

“If our population is unscathed by these diseases, … we are in good health and [are] able to work towards improving the quality of life for everyone.”

— Tchalim Maweke, Planning Coordinator for the NTDP, Ministry of Health, Togo

When it comes to a disease-free future for Togo, the country has a bright trajectory. In late 2021, the country adopted a first-of-its-kind strategic plan designed with multiple government sectors to ensure health services for persons at-risk of or living with NTDs are available long-term. The newly validated sustainability plan details the government’s key priorities, strategies, and benchmarks to move towards a sustainably resourced strategy that will enable them to reach NTD goals.

USAID has worked alongside the Ministry of Health and Public Hygiene in Togo to fight five of the most common NTDs: trachoma, lymphatic filariasis, river blindness, schistosomiasis, and intestinal worms. USAID began NTD work with Togo in 2009 and continues to support the country as it works to control and eliminate three additional NTDs. There are 20 internationally recognized NTDs.

Since 2006, USAID’s NTD Program has worked with more than 30 countries to control and eliminate five of the most common and burdensome NTDs. To date, the program has leveraged more than $28.6 billion in donated medicines and provided more than 3 billion treatments. As a result of this program, more than 341 million people live in communities no longer requiring treatment for lymphatic filariasis and 172 million people live in communities no longer requiring treatment for blinding trachoma.

Learn more about USAID’s work at neglecteddiseases.gov.

About the Authors

Dr. Anders Seim is the Executive Director of HDI and Dr. Piham Gnossike is the National NTD Coordinator for the Togo Ministry of Health, Public Hygiene and Universal Access to Care.