Neglected tropical diseases
Last updated October 2025
2024 Global Report on neglected tropical diseases 1
Summary
Globally programmes to fight neglected tropical diseases (NTDs) are making significant progress towards the 2030 targets set in Ending the neglect to attain Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030 2.
The WHO 2024 Global report on neglected tropical diseases describes a wide range of activities, accomplishments and challenges, presenting epidemiological and programmatic data for 2022, gathered, compiled and analysed in 2023. The purpose of the document is to guide monitoring and evaluation of NTD programmes to improve their quality and effectiveness in alignment with NTD road map targets.
Status of the global NTD road map indicators
Quantitative information is provided on the NTD road map indicators: four overarching, ten cross-cutting, and fifty five disease-specific indicators. Information is also included on the number of people treated for NTDs in 2022.
Overarching NTD indicators
1 Reduction in people requiring interventions against NTDs. 2030 target is 90%.
Achieved 26% in 2022 (reported as insufficient to reach the 2030 target).
2 Reduction in NTD-related disability-adjusted life years (DALYS). 2030 target is 75. Achieved 11% in 2022.
3 Countries achieving elimination of at least one NTD. 2030 target is 100 countries. Achieved 50 countries in 2022.
4 Eradicating two NTDs. The 2030 target is the eradication of yaws and dracunculiasis
Cross-cutting NTD indicators
Integrated approaches
1 Reduce deaths from vector-borne diseases. 2030 target is 75%. Increased by 22%
in 2022 compared with 2016.
2 Integrated treatment coverage index for preventive chemotherapy. 2030 target is 75%. Global index achieved 46% in 2022.
3 Countries implementing integrated skin NTD strategies. 2030 target is 40 countries. Achieved 11 countries in 2022.
Multisectoral coordination
4 Ensuring access to basic water supply, sanitation and hygiene (WASH) in NTD- endemic countries. 2030 target is 100%. Achieved 63% among the population requiring interventions against NTDs in 2022.
5 Countries integrating NTDs in their national health strategies/plans. 2030 target is 90%. Achieved 15.2% in 2022 in countries endemic for at least one NTD.
6 Protecting against catastrophic out-of-pocket health expenditure due to NTDs.
2030 target is 90%. Achieved 87.4% in 2021 for the population at risk of NTDs.
Universal health coverage
7 Countries including NTD interventions in their essential health services and budgeting for them. 2030 target is 90%. Achieved 3.3% in 2022.
8 Countries having guidelines for the management of NTD-related disabilities within their national health systems. 2030 target is 90%. Achieved, see page 14 of report.
Country ownership
9 Countries reporting on all relevant endemic NTDs. 2030 target is 90%. Achieved 17.4% in 2022.
10 Countries collecting and reporting NTD data disaggregated (separated) by gender. 2030 target is 90%. Achieved 9.2% in 2022.
Note: Report pages 5–18 provide further 2022 information on the overarching and cross-cutting NTD road map indicators.
Number of people treated for NTDs
In 2022, approximately 848 million people received treatment for at least one NTD through preventive chemotherapy interventions, 49 million fewer than in 2021 but 50 million more than in 2020.
For further information, see pages 16-18.
Disease-specific global indicators
Pages 18-35 of the report provide a comprehensive review of the twenty one NTDs, including 2021- 2023 milestones and achievements and 2030 targets. The following NTDs are reported as targeted for eradication, elimination and control:
- Eradication: Dracunculiasis, yaws
- Elimination of transmission: Human African trypanosomiasis (gambiense), leprosy, onchocerciasis
- Elimination as a public health problem: Chagas disease, human African trypanosomiasis (rhodesiense), visceral leishmaniasis, lymphatic filariasis, rabies, schistosomiasis, soil-transmitted helminthiases, trachoma
- Control: Buruli ulcer, dengue and chikungunya, echinococcosis (alveolar and cystic), food borne trematodiases, cutaneous leishmaniaisis, mycetoma, chromoblastomycosis and other deep mycoses, scabies and other ectoparasitoses, snake bite envenoming, taeniasis and cysticercosis.
Definitions
Eradication: Permanent reduction to zero of the worldwide incidence of infection caused by a specific pathogen, as a result of deliberate efforts, with no risk of reintroduction.
Elimination of transmission: The reduction to zero of the incidence of a specific infection in a defined geographical area, with continued measures to prevent re-establishment.
Documentation of elimination of transmission is called verification.
Elimination as a public health problem: The reduction of a disease to a level at which it no longer poses a significant public health risk.
Documentation of elimination as a public health problem is called validation.
Control: Reduction of disease incidence, prevalence, morbidity and/or mortality to a locally acceptable level; as a result of deliberate efforts. Continued interventions are required to maintain the reduction.
Progress under NTD road map pillars
The report provides qualitative information on the progress of the three NTD road map pillars to support global efforts to control, eliminate and eradicate NTDs.
Pillar 1: Accelerate programmatic action against NTDs
In 2023, several NTD technical manuals were published, on-line training courses developed, and NTD videos made available on the WHO YouTube channel. Noma (cancrum oris), a severe gangrenous disease of the mouth and face was added to the list of skin NTDs in 2023 and WHO made available an online course and Fact Sheet on Norma.
Medicines: In 2023 an estimated 2.1 billion tablets and vials to treat NTDs were donated and delivered, 200 million more than in 2022. Inventory management practices were implemented, prequalification of pharmaceutical products was increased and research into new drugs progressed. Appendix 2 of the report covers the status of commitments for donations of medicines as of December 2023.
Diagnostics: A WHO pilot Expert Review Panel for NTD diagnostics was launched in 2023 to address quality assurance and accessibility of available diagnostic tests. A WHO Diagnostic Task Force was established to strengthen diagnostic capacity. Appendix 4 of the report lists diagnostic target product profiles for NTDs as published in 2023.
Gender equity and human rights: Progress is provided on gender inequalities, discrimination and other social and economic factors affecting women, refugees, migrants and indigenous peoples. A technical guide on sustainable pesticide management was developed to combat pesticides contaminating land, waters, food and ecosystems.
Pillar 2: Intensify cross-cutting approaches
Progress has been made on integrating interventions for several NTDs into national health programmes.
Integrating across NTDs: Focussing on consolidating the preventive chemotherapy strategy and the roll-out of the skin-NTD approach.
Cross-sectoral coordination: Including for One Health, the global vector control response, WASH, and health emergencies.
Main-streaming within national health systems: Including focussing on NTD positioning within universal health coverage, data collection, analysis and management for monitoring and evaluating NTD programmes (see pages 43-46 for detailed information).
Pillar 3: Change operating models and culture to facilitate country ownership
The report emphasises the importance of country ownership to sustain key interventions to prevent and treat NTDs.
Sustainability: Sustainability plans for national programmes are described with examples from Ghana and Uganda (see page 47).
Costing the road map: Post COVID-19, there have been severe NTD budget restrictions following the withdrawl of funding or cuts from major donors affecting NTD monitoring and MDA against lymphatic filariasis, onchocerciasis, schistosomiasis and soil-transmitted helminthiases. A Costing Task Team was convened in 2023.
Regional and country progress
The report summarizes the achievements and progress made by each WHO Region in combating NTDs. For each Region the information provided includes:
- the number of people and percentage reduction in the population requiring interventions against NTDs.
- Information on NTDs controlled and eliminated.
Note: Progress in the African Region is reported on pages 50-51, the South-East Asia Region on pages 53-54 , and the Western Pacific Region on page 56.
Challenges to achieving NTD road map targets
- Slow return to health services and NTD activities following COVID-19.
- Insufficient funds for NTD interventions and uncertainties regarding future funding sources.
- Gaps in knowledge and operational tools preventing the development of NTD diagnostics, vaccines and more effective treatments and interventions.
- Population displacement, humanitarian crises, political instability and conflicts.
- Inadequate surveillance and case detection resulting in under-diagnosis and under-reporting of NTDs.
- Lagging national government ownership resulting in insufficient coordination, inefficient use of resources, inadequate funds, and slow adoption of new NTD interventions.
- Antimicrobial resistance and unavailability of second-line drugs.
- Increasingly, climate change and extreme weather events. Rising temperatures and changes in precipitation patterns are altering vector breeding habitats, pathogen development, changing the geography and distribution of diseases and transmission risks.. Once-controlled diseases are re-emerging 3.
Reaching the Last Mile Forum, December 2023:
“ Climate change threatens to undo decades of progress in global health – and the world’s ability to achieve health for all”.
Way forward
Important efforts continue to be made towards implementing the five key public health interventions* presented in the NTD road map.
* innovative and intensified disease management, preventive chemotherapy, vector control, veterinary public health, provision of safe water, sanitation and hygiene.
In June 2023 the NTD Global Partners Meeting addressed the status of NTDs globally and identified strategic priorities for the months and years ahead to include:
- Maintaining and expanding the partners/donor community.
- Building links between NTDs and other global programmes.
- Developing a work plan for 2025-2030 to achieve NTD targets, to include roles, responsibilities and cost estimates.
- Ensuring strategic approaches are constantly refined.
The report concludes that the strategic priorities can lead the way towards ending the neglect of individuals affected by NTDs, achieve the Sustainable Development Goals, and meet the road map targets set for 2030.
References
1 Global report on neglected tropical diseases 2024. WHO 2024 .
Access by entering the title in Google and clicking Download. A print version is available: ISBN 978
-92.4009154-2
2 Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030. WHO, Geneva 2020. https://iris.who.int/handle/10665/338565
3 Climate change, neglected tropical diseases and malaria: an urgent call for further research and action.
WHO Communique 30 November 2023. Access by entering title in Google.
Further reading
Clinical Infectious Diseases
Volume 78, Issue Supplement 2, 15 May 2024. New tools and nuanced interventions to accelerate achievement of 2030 Road map for Neglected tropical diseases. Papers contained in the Supplement can be accessed from https://doi.org/10.1093/cid/ciae070
Climate change and NTDs
Summarised from Climate change and NTDs: a perfect storm
The Lancet Global Health editorial Vol 13, Issue 2, E172, February 2025
Climate change is emerging as an important and growing threat to combating NTDs, intensifying the conditions that allow these diseases to persist. Little headway has been made in reducing case incidence and deaths from vector-borne diseases including dengue and chikungunya, transmitted by Aedes spp mosquitoes.
Temperature
Warmer temperatures enable mosquitoes to breed more rapidly, bite more frequently and expand their range outside of tropical and subtropical regions. Cases of dengue have consequently surged in areas that historically reported few or no cases such as Nepal, North America and Europe. Similarly, it is likely that warmer temperatures and other climatic factors that favour insect survival and mobility will drive wider the distribution of the sandflies that transmit leishmaniasis.
Rainfall
Changes in rainfall patterns, including more intense and irregular precipitation, can also fuel the spread of NTDs. Excessive rainfall and flooding lead to stagnant water that acts as a prime breeding ground for vectors including mosquitoes and snails, heightening the risk of diseases like lymphatic filariasis, dengue and schistosomiasis. Exposure to contaminated floodwater also increases the transmission of waterborne diseases, such as leptospirosis and certain skin NTDs. In regions with fragile sanitation infrastructure, these events exacerbate health risks, leaving communities vulnerable to overlapping outbreaks.
Communities most affected
Despite advances in diagnostics, vaccines, post-exposure prophylaxis and preventive chemotherapy, NTDs remain poorly controlled. They disproportionately impact the world’s poorest and most marginalised populations, perpetuating cycles of poverty and inequality.
Indigenous communities face greater risks than their non-indigenous counterparts because many live in remote, NTD-endemic regions where access to health care is limited. Beyond their immediate health impacts, NTDs can lead to chronic illness or disability, blindness and stigma, which impair education and employment opportunities. The dual crisis of climate change and NTDs, further entrench social and economic inequities in vulnerable communities.
Action required
Gaps remain in understanding the impact of climate change on NTDs, underscoring the need for further research. However, research alone will not be enough. Decisive action is needed to integrate evidence-based insights into health policies and initiatives. By combining information from different sectors at the human-animal- environment interface will allow decision makers to anticipate transmission risks and tailor elimination efforts.
To protect the most vulnerable populations and sustain NTD elimination progress, climate resilience must be embedded into every element of global health policy. There must be investment in early warning systems and predictive modelling, scale up of vector control, improvement in sanitation systems, and interventions tailored to at risk communities.
Only a small proportion of multilateral climate funding is directly allocated to health, leaving NTDs at risk of further neglect. Increased advocacy and funding coupled with multi-sectoral climate-conscious strategies are imperative to avoid undoing decades of hard-won gains.
Further reading
Klepac P et al. Climate change, malaria and neglected tropical diseases: a scoping review.
Trans Roy Soc Trop Med & Hyg, Vol 118, Issue 9, Sept 2024, Pages 561-579 https://doi.org/10.1093/trstmh/trae026
Skin NTDs App updated
In 2023 WHO with the collaboration of Until No Leprosy Remains (NLR), launched an updated free of charge mobile Skin NTDs App1 to assist front-line health workers diagnose and manage skin-related tropical diseases and common skin diseases through changes on the skin.
What is included in WHO Skin NTDs App ?
The following NTDs are included in the WHO Skin NTDs App: Buruli ulcer, cutaneous leishmaniasis, post kala-azar dermal leishmaniasis, leprosy, lymphatic filariasis, mycetoma, onchocerciaisis, scabies and other parasitic infections of the skin, and yaws (endemic treponematosis). NTDs are frequently associated with morbidity, long-term disability, stigmatization and mental health problems.
The App provides skin lesion images, clinical features, treatment protocols, geographical distribution and prevalence of skin NTDs and common skin conditions. It includes a Skin NTDs Learning Section based on the WHO manual Recognizing neglected tropical diseases through changes on the skin – A training guide for front- line health workers.
How is the Skin NTD App powered ?
The App is powered by two artificial intelligence-based algorithms, one covering 12 skin NTDs and the other, 24 common skin diseases. It can be operated offline in remote settings using Android and iOS devices. The App is available in English and French with plans to translate it into Spanish, Portuguese and other languages. Studies are underway to assess the impact of the App on disease management, its usefulness in the field and its cost-effectiveness 2.
Note: Examples of screenshots from the Skin NTDs App can be found in the article, WHO’s skin mobile application as an educational tool for front-line health workers. Journal of the International Foundation for Dermatology 2024; Volume 20(1). Access by entering the title of the article in Google.
Reference
1 Access by entering the following title in Google: Skin-related neglected tropical diseases: WHO launches new version of the WHO Skin NTDs mobile application. 9 October 2023.
2 Access by entering the following title in Google: The WHO Skin NTDs App shows encouraging results in Kenya study. 4 December 2024.
Further reading
Cano M et al. Evaluating the World Health Organization’s Skin NTDs App as a training tool for skin neglected tropical diseases in Ghana and Kenya: Cross-sectional study. J Med Internet Res. 2024 Apr 30. doi:10.2196/51628
Rapid tests used in the elimination of lymphatic filariasis
Lymphatic filariasis is endemic in 72 countries with Wuchereria bancrofti being found in nearly all endemic countries causing 90% of cases, and Brugia species present in limited areas of a few countries in South-east Asia.
NTD Roadmap 2030 targets for the Global Programme to eliminate lymphatic filariasis (GPELF)
- 58 (80%) countries validated for elimination as a Public health problem – defined as:
- infection sustained below transmission assessment survey thresholds for at least 4 years after stopping MDA,
- availability of essential package of care in all areas with known patients.
- All lymphatic filariasis endemic countries implementing post-MDA or post- validation surveillance.
- MDA no longer required.
Rapid tests used in lymphatic filariasis elimination programmes
W. bancrofti antigen
In endemic areas for W. bancrofti lymphatic filariasis, rapid immuno- chromatographic tests are used to detect qualitatively circulating W. bancrofti antigen in blood samples. W. bancrofti antigen takes 12 months or more to appear following infection and persists several years after adult worms no longer reproduce or have died. Antigen tests include the widely used Filariasis Test Strip (FTS) manufactured by Abbott Bioline and the recently developed STANDARD Q Filariasis Ag Test (QFAT) manufactured by SD Biosensor.
In field laboratory comparisons* the QFAT showed comparable diagnostic performance to the FTS. The QFAT was preferred by users because it used a smaller sample volume (20 µl compared to 75 µl for the FTS), the QFAT cassette was easier to handle than the loose FTS strip and tray, and test results were clearer.
* Scott J L. et al. Field laboratory comparison of STANDARD Q Filariasis Antigen Test (QFAT) with Bioline Filariasis Test Strip (FTS) for the detection of lymphatic fiilariasis in Samoa, 2023..
PloS Negl Trop Dis. 2024 Aug 5;18(8):e0012386.doi: 10.1371/journal.pntd.0012386
Brugia species antibodies
In areas endemic for Brugia lymphatic filariasis, the Brugia Rapid cassette immunochromatographic test is used to detect Brugia malayi and Brugia timori IgG4 antibodies qualitatively in serum, plasma or whole blood. The test is
manufactured by Reszon Diagnostics International. Brugia antibodies may indicate an active infection or previous infection. The test shows cross-reactivity with W. bancrofti.
Important: In the elimination of lymphatic filariasis, new diagnostic tests are required for post-elimination surveillance and post-MDA. Target product profiles have been developed to assist test manufacturers *.
*Won K et al. Diagnostics to support elimination of lymphatic filariasis – Development of two target product profiles. PloS Negl Trop Dis.2021 Nov 15;15(11):e0009968.doi 10.1371/journal.pntd.0009968
Further information
WHO Lymphatic filariasis Fact Sheet, November 2024. Access by downloading the title in Google.
Role of the laboratory in onchocerciasis elimination mapping
More than 99% of people with onchocerciasis live in sub-Saharan Africa and Yemen. The remaining 1% live in the border between Brazil and Bolivarian Republic of Venezuela. In 2023 WHO estimated that at least 249.5 million people required preventive treatment against onchocerciasis. Mass drug administration (MDA) with ivermectin is used to eliminate onchocerciasis with a minimum of 80% coverage.
Countries verified as free of onchocerciasis
Countries that have been verified by WHO as free of onchocerciasis following elimination activities are Colombia (2013), Ecuador (2014), Mexico (2015),
Guatemala (2016), and Niger (2025).
Senegal stopped MDA and is now under post-treatment surveillance. WHO reports that MDA has stopped in at least one focus in Uganda, Tanzania, Ethiopia, Equatorial Guinea, Mali, Nigeria, Sudan and Bolivarian Republic of Venezuela.
Mapping areas for onchocerciasis transmission
The WHO Road map for NTDS 2021-2030 has set a target for the elimination of onchocerciasis by 2030. This requires large areas of Africa to be mapped to identify all areas of active onchocerciasis that require ivermectin MDA.
In 2025 WHO published Onchocerciasis elimination mapping: handbook for national elimination programmes to assist countries identify areas of transmission requiring interventions and to provide evidence supporting the classification of non- endemic areas. This comprehensive handbook includes how to carry out, manage and interpret onchocerciasis elimination mapping (OEM) surveys and how to train survey teams.
Laboratory analysis required for OEM
The WHO handbook includes details of the laboratory analysis required for OEM. The Ov16 RDT is recommended and the test method is described. The test detects antibodies specific to Onchocerca volvulus. Standard operating procedures for collecting, packing and shipping dry blood spots (DBS) for use in the Ov16 test are also included. Testing in a central laboratory is recommended. Following the laboratory analysis, data from the epidemiological assessments are reviewed and interpreted to classify areas as either endemic or non-endemic. Results are compiled into summary tables and action maps.
Further information
WHO Onchocerciasis Fact sheet January 2025. Access by downloading the title in Google.
WHO Onchocerciasis Technical Advisory Subgroup Report of the eighth meting, Spain 9-12 Dec 2024. Access by entering title in Google.
Onchocerciasis Elimination Mapping: A Handbook for National Elimination Programmes. Dec 2024. Access by downloading the title in Google.
ISBN 978-92-4-009922-7 (electronic version) ISBN 978-92-4-009923-4 (print version)
Addition of noma to WHO NTDs
Noma, also called cancrum oris or gangrenous stomatitis was designated by WHO a neglected tropical disease (NTD) in December 2023. It is a severe rapidly fatal gangrenous disease of the mouth and face involving polymicrobial organisms that live in the mouth. It is an opportunistic non-contagious disease mainly affecting malnourished children aged 2-6 years with weakened immune systems and mostly found in sub-Saharan Africa but has also been reported from Latin America, Asia and other areas.
Diagnosis and prevention of noma
There is no point-of-care test available to diagnose noma. The disease is diagnosed clinically. WHO classifies noma into 5 clinical stages following simple gum inflammation, Stage 1 – acute necrotizing gingivitis, Stage 2 – oedema, Stage 3 – gangrene, Stage 4 – scarring, Stage 5 – sequelae ( drooling, missing and exposed teeth, problems affecting opening of the jaw, eating, speaking, breathing, vision).
Norma is treatable with antimicrobials, oral hygiene and nutrition supplements but is frequently not diagnosed and reported due to its rapid progression, lack of awareness, associated social stigma and poor health care services.
In adding noma to its list of NTDs, WHO recommends a more integrated approach to preventing and controlling noma by: “… improved awareness of the disease among populations and mental health counselling helping to remove stigma and enhance the reintegration of noma survivors and their families into society “. Integration of noma into existing health surveillance can improve data availability, accessibility and multisectoral collaboration.
WHO course and brochure on noma
To assist in the early awareness of noma, in addition to the WHO noma factsheet, a free of charge WHO course on noma is available in English, French, Hausa, Hindi and Portuguese. A 24-page well illustrated brochure includes information on the prevention, control and complications of noma*. For each clinical stage, the brochure provides main signs and symptoms, information on medication and management by health workers, family and friends.
*Access by entering in Google: WHO information brochure for early detection and management of noma.
Further information
Noma WHO Fact Sheet, 15 December 2023.
MSF What is Noma? Available at https://noma.msf.og
Galli et al. Prevalence, incidence, and reported global distribution of noma: a systematic literature review. Lancet Infectious Diseases, 2022, 15:S1473-3099(21)00698-8
WHO NTD Fact Sheets
Neglected tropical diseases (NTDs) fact sheets are available on the WHO website, providing the key facts and overview of each disease. Depending on NTD, also included are clinical signs and symptoms, transmission, distribution, treatment, diagnosis, prevention and control. Each fact sheet covers the WHO response, including technical support, management of outbreaks, consultations, new tools and diagnostics, publication of guidelines and handbooks, training, record gathering, and progress on NTD elimination programmes and the WHO 2021-2030 Roadmap for the global control of NTDs.
The fact sheets are kept up-to-date. The following are as of October 2025:
2025 Fact Sheets
Dengue
Trachoma
Chagas disease
Chikunganya
Dracunculiasis (Guinea-worm disease)
Leprosy
Onchocerciasis
2024 Fact Sheets
Lymphatic filariasis
Rabies
2023 Fact Sheets
Noma
Chromoblastomycosis
Sporotrichosis
Snakebite envenoming
Prodoconiosis (non-filarial lymphoedema)
Scabies and other ectoparasitoses
Human African trypanosomiasis
Tungiasis
Schistosomiasis
Buruli ulcer
Leishmaniasis
Soil-transmitted helminth infections
Yaws
2022 Fact Sheets
Chromoblastomycosis and other deep-seated mycoses
Taeniasis and cysticercosis
2021 Fact sheets
Echinococcosis
Foodborne trematode infections
Recent NTD publications
La Course J et al. Molecular tools reveal hidden schistosome hybrids hindering schistosomiasis control in Africa. Biochem Lond (2025) 47 (3):6-12 https://doi.org/10.1042/bio_2025_118
Paper includes microscope images of schistosome hybrid eggs
WHO guidelines for clinical management of arboviral diseases: dengue, chikungunya, Zika and yellow fever. World Health Organization, 2025.
ISBN 978-92-4-01111-0 (electronic version)
ISBN 978-92-4-01111-7 (print version)
Map showing countries that have eliminated at least one NTD
Dated 17 July 2025, the map can be accessed from:
https://www.who.int/images/default-source/maps/elimination
|
