What Togo teaches other countries about tackling neglected diseases

If Africa is searching for proof that eliminating multiple Neglected Tropical Diseases (NTDs) is not just possible but achievable within a generation, it needs look no further than Togo, a country within the continent.

In a region where NTDs have long been accepted as diseases heavily linked to poverty, Togo chose to disrupt that narrative—and it succeeded.

The World Health Organization defines a Neglected Tropical Disease (NTD) as a group of 21 diseases that “mainly affect poor and vulnerable populations” and thrive in conditions of poverty, poor sanitation, and limited access to healthcare.

They are described as “neglected” because they have historically received less attention and funding compared to other major diseases, despite affecting around 1.5 billion people globally.

Togo bears the torch

In 2022, the West African nation became the first country in Africa and among only four in the world to eliminate four Neglected Tropical Diseases as public health threats: Dracunculiasis (Guinea worm disease), lymphatic filariasis, human African trypanosomiasis (sleeping sickness) and trachoma.

But what makes Togo remarkable is not only that it has eliminated the diseases. Even after reaching a milestone that many countries are still chasing, it has not paused. Instead, it has set its sights on eliminating more diseases by 2030, including onchocerciasis, schistosomiasis, leprosy and yaws.

In January this year, Togo announced it would reject the complacency that often follows success and will “demonstrate leadership” in the fight against diseases.

Togo’s Health Ministry, in a statement, expressed determination to “eliminate diseases including onchocerciasis, schistosomiasis, leprosy and yaws, stressing these illnesses have a “lasting impact on productivity, schooling and household income, particularly in rural areas.”

Dr. Mamadou Nouhou, the World Health Organization’s representative in Togo, during World NTD Day celebrations this year, also said the West African country was determined to “leave no one behind.”

Dr Elizabeth Juma, Team Lead for the Expanded Special Project for Elimination of NTDs (ESPEN)—a WHO-led partnership programme—points out Togo’s success story is offering the continent something more valuable than inspiration—a blueprint.

“It is not just the voice… It’s action, it’s about leadership. Togo worked with global partners—but on its own terms. The government laid down the strategy, insisting this is what we want to do,” Juma tells TRT Afrika.

Uneven progress

As of early 2026, 22 African countries have eliminated at least one Neglected Tropical Disease. Experts say Africa is not failing in its fight against NTDs; in many respects, it is building momentum.

“Unfortunately, we are not on target to achieve the (UN’s) goals that were set for 2030,” Dr Juma says.

That shortfall is not due to a lack of knowledge or even commitment. It is rooted in structural fragilities that have long defined public health across much of the continent. Chief among them is dependence—particularly on external funding.

The gradual withdrawal of overseas development assistance after the COVID-19 pandemic exposed just how precarious many national programmes had become. When major donors reduced support, interventions slowed, timelines slipped, and in some cases, programmes risked stalling altogether.

“If funding fell out, then it meant that we dropped everything,” Dr Juma explains. “We risk losing all that significant investment that has been made.”

Experts say the danger is that Neglected Tropical Diseases are unforgiving because if treatment campaigns or surveillance are interrupted, they will return—and could spread faster than they were driven out. Years of progress can unravel quickly, dragging communities back into cycles of disability, stigma and poverty.

This is where Togo’s example becomes more instructive than exceptional.

Its success was not built on extraordinary funding or favourable conditions. It was built on choices. Political leadership that moved beyond rhetoric and embedded NTD elimination into national policy.

Government officials framed the ambition in broader terms, emphasising that eliminating these diseases is not just a health issue but a crucial step towards breaking the cycle of poverty and achieving “health equity.”

“The strategy relies on expanding prevention and free treatment campaigns. It also aims to strengthen community awareness programs, train medical personnel, and improve access to health services in rural and remote areas,” a government statement announced in January.

Lessons for the continent

That sense of ownership—of setting priorities, mobilising resources and insisting on continuity—may be the most important lesson Togo offers.

For too long, many African health programmes have been shaped externally, leaving them vulnerable when priorities shift or funding declines. Togo inverted that relationship. It defined its goals first and invited partners to align with them.

“Togo did not allow partners to dictate what was to be done. It is the government that has laid down the strategy and says, 'This is what we want to do.’ ‘This is where we want to go.’ ‘This is what we are putting in.’ ‘What can you put in to help us get to this goal?’ They have done very well in leading,” Juma says.

Experts have also called for homegrown research institutions and build our capacity of whether it's the universities or standalone health research institutions, to conduct research.

“Global government cuts have had a huge impact already on research,” Deputy Director, South African National Bioinformatics Institute Professor Nicki Tiffin tells TRT Afrika. “It’s institutional knowledge that gets lost. Loss of deep knowledge. We lose experienced people from the health innovation workspace.”

Nigerian pharmaceutical microbiologist Professor Iruka Okeke echoes these concerns, drawing on her interactions with emerging researchers across Nigeria.

“In Nigeria, the scientific community has been losing talent at an alarming rate. Young scientists we recruit explicitly state that they intend to leave even at the start of their training because they cannot envisage a productive scientific career here”, Okeke tells TRT Afrika.

The good news is that several African countries are beginning to adapt and learn, according to Juma.

“Many African states ministries of health said, we are going to have integrated delivery of programmes. At the end of the day, we will have far less disruption than would have been expected.”

In places like Tanzania, Uganda and Madagascar, health systems have reorganised themselves, merging programmes, sharing resources and prioritising efficiency.

Juma believes it is here, perhaps, that the real test for Africa lies. Not in whether it can replicate Togo’s technical strategies, but in whether it can replicate its mindset: a refusal to outsource responsibility and a commitment to continuity.