Neglected Tropical Diseases

Our goal

To eradicate, eliminate, or control eight of the 20 neglected tropical diseases (NTDs) recognized by the WHO and to improve non-NTD health outcomes using the NTD delivery platform.

A health worker tests an elderly woman for human African trypanosomiasis (HAT) during the Democratic Republic of the Congo’s inaugural National Day of HAT in 2018. — A health worker tests a woman for sleeping sickness in the Democratic Republic of the Congo. ©Gates Archive/Diana Zeyned Alhindawi

At a glance

Neglected tropical diseases (NTDs) are infectious diseases that are largely preventable and treatable but continue to affect more than 1 billion people, causing painful disabilities, disfigurement, or death when left unaddressed.
Effective treatment and control methods are available, but more investments are needed to expand access to drug treatments and improve diagnostic, disease mapping, and surveillance tools.
We focus on eight NTDs that present the greatest opportunity for elimination or eradication. We facilitate the use of donated drugs and advance progress by supporting public health surveillance, vector control, and mass administration of drugs that treat multiple NTDs.
We work with governments and other partners to secure more resources to accelerate progress toward our shared goal of a world free from the threat of NTDs.

Our strategy

Addressing neglected tropical diseases is a priority for our foundation.

We work to ensure that our investments complement work being done by governments of affected countries and donor governments, which together provide most of the funding to combat these diseases.

We concentrate on areas where existing funds are scarce, where our support can have a catalytic effect, and where we are better positioned than others to assume risks. To date, we have committed more than US$1.84 billion in grants to organizations that are developing new tools and treatments as well as the innovative delivery methods needed to control, eliminate, or eradicate NTDs. We also advocate for increased international funding to support these efforts.

Many tropical diseases could be considered neglected, but we focus on those that have large-scale and severe impacts, impose significant social and economic burdens in affected countries, and have the greatest likelihood of elimination or eradication through strategic, feasible interventions. We target eight of the 10 diseases specified in the 2012 London Declaration on Neglected Tropical Diseases, tailoring our approach based on the unique challenges of each disease:

Guinea worm disease (dracunculiasis)
Sleeping sickness (human African trypanosomiasis)
Lymphatic filariasis (elephantiasis)
River blindness (onchocerciasis)
Snail fever (schistosomiasis)
Soil-transmitted helminthiases (hookworm, roundworm, whipworm)
Trachoma
Black fever (visceral leishmaniasis)

Global partners celebrate a historic commitment of $777 million to NTD programs at the 2023 Reaching the Last Mile Forum, held at COP28 in Dubai.

[W]ith commitment and funding, we will eliminate the threat of NTDs and save millions of lives. Modeling shows that increasing the coverage of treatments even modestly can have a dramatic impact over the next decade. It’s one of the best buys in global health.

Bill Gates

Co-chair and Trustee

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Areas of focus

Our team focuses on supporting the development of new tools and treatments as well as innovative approaches to improve delivery and mass disease surveillance to achieve significant progress against NTDs.

High-opportunity targets

We support the development and delivery of new drugs, vaccines, diagnostics, and vector-control tools to improve approaches to endemic diseases and support the implementation of country-led programs. These advances have contributed to significant progress in recent years against the eight high-opportunity infectious diseases we target. For example:

Trachoma was eliminated as a public health problem in Ghana in 2018 and has since been eliminated in five other African countries. A disease of the eye that affects nearly 125 million people, mostly in Africa, trachoma is spread by flies and person-to-person contact, particularly in areas with limited sanitation facilities.
River blindness has been eliminated in four countries in South America and in Niger, the first country in Africa to achieve elimination, since the start of mass distribution of the donated drug ivermectin in 2013. The disease is caused by a parasitic worm transmitted to humans from black flies and infects about 21 million people, mostly in Africa.
Lymphatic filariasis has been reduced by 74% globally, thanks to partners that have invested in elimination efforts. The disease, caused by parasitic worms, is transmitted by mosquitoes and affects an estimated 51.4 million people. More than 935 million people have received treatment since 2000. We are working with partners to invest in alternative treatments, tools, and strategies to improve detection and reduce outbreaks.
Guinea worm disease is near eradication, with only 14 human cases globally in 2023. We are working with the Carter Center, in-country partners, and local communities to eradicate the disease, which is transmitted to humans via water sources that are contaminated with the parasitic worm Dracunculus medinensis.

Integrated efforts

We support efforts to develop coordinated and integrated strategies to address multiple infectious diseases at the same time, focusing on three main areas:

Mass drug administration. We support efforts in regions with a prevalence of several infectious diseases that can be treated with the same drugs or a similar schedule of treatments. Our work includes obtaining pharmaceutical donations to support large-scale drug administration programs. Five of our target NTDs can be controlled in this way: river blindness, lymphatic filariasis, soil-transmitted helminthiases, snail fever, and trachoma.
Public health surveillance. Good data is crucial—including data showing where a disease is prevalent in humans and where it’s found in mosquitoes, flies, worms, or other vectors. This data is lacking for many NTDs, so we look for shared approaches to sample collection and processing and support data aggregation and the design of surveillance systems and precision mapping to pinpoint populations that are at risk. Two of our target NTDs—sleeping sickness and black fever—can be controlled by screening at-risk populations and treating infected individuals.
Vector control. Most NTDs are caused or spread by insects or worms, which are costly and difficult to control. However, control measures are similar for all of these vectors, creating the opportunity to coordinate across multiple efforts. To improve coverage, we support the development of a framework for cross-disease coordination, including integrating NTD and non-NTD tools. For instance, the same diagnostic test could be used for sleeping sickness and malaria.

Why focus on neglected tropical diseases?

NTDs affect around one in five people globally, often in the lowest-income and remotest communities.

This often keeps a prosperous life out of reach, results in children missing school, and deprives millions of their most productive years of life. It can plunge communities into an endless cycle of poverty, costing countries billions of dollars annually in lost income and direct health costs.

Eliminating NTDs can improve lives, expand educational opportunities, spur economic development, and ensure greater social stability.

Growing resolve within the public and private sectors has accelerated progress on NTDs. In 2020, 600 million fewer people needed NTD interventions than in 2010. These gains can be largely attributed to the leadership of endemic countries and strong global partnerships that support the goals of NTD programs.

In 2012, our foundation joined governments, pharmaceutical companies, and other philanthropies and organizations to launch the London Declaration on Neglected Tropical Diseases, catalyzing the political will needed to control, eliminate, or eradicate 10 NTDs.

In 2022, leaders came together again to launch the Kigali Declaration on NTDs, which built on the commitments made in London and galvanized financial commitment and endorsement from 62 signatories to help achieve the goals in the World Health Organization’s 2021–2030 NTD roadmap.

Since 2012:

50 countries have eliminated at least one NTD.
Pharmaceutical companies have donated 17 billion tablets to prevent and treat NTDs.

Through this kind of resolve, the world can beat NTDs once and for all.

Safi Boubacar, 40 years old with her son Manssour Boubacar, 3 years in the village of Toumandey, Dosso region, Niger on April 23, 2017. Manssour has just received the polio vaccination Biopolio B1/3, albendazole, a medication used for the treatment of a variety of parasitic worm infestations and a vitamin A oral liquid preparation. — A mother and son in the village of Toumandey, Niger.

Strategy leadership

Our partners

Uniting to Combat NTDs

Uniting to Combat NTDs is a coalition of organizations that provides funding, expertise, and resources to support the control and elimination of NTDs.

View partner website

The END Fund

The END Fund is a nonprofit organization dedicated to ending NTDs through programs including its Accelerate Resilient, Innovative, and Sustainable Elimination of NTDs (ARISE) Fund.

View partner website

The Carter Center

We support the Carter Center’s international campaign to eradicate Guinea worm disease in humans and animals by the end of 2030.

View partner website

Sightsavers

We support the Sightsavers Accelerate program, which works to eliminate trachoma, the world’s leading infectious cause of blindness, from Africa.

View partner website

DNDi

We provide support for DNDi’s research on onchocerciasis and sleeping sickness and its efforts to develop better, low-cost treatments for these diseases.

View partner website

Global Institute for the Elimination of Infectious Diseases (GLIDE)

GLIDE works to advance policies to combat infectious diseases in the Middle East, neighboring countries, and globally and advocates for universal access to routine immunization for children.

View partner website

Speak Up Africa

We provide strategic advocacy support to Speak Up Africa to accelerate progress on the control and elimination of malaria and NTDs, improved sanitation, and health R&D in West Africa.