Today, Uniting to Combat NTDs publishes an Africa league table showing how countries on the African continent are progressing in the fight against neglected tropical diseases (NTDs) as part of the African Leaders' Malaria Alliance (ALMA) forum.

According to the new Africa NTD league table, several countries in sub-Saharan Africa that are in the top ten for gross domestic product (GDP) per capita are the bottom countries on the NTD index score. By comparison, countries with modest or low GPDs like Chad, Burkina Faso, and Burundi are top of the leaderboard in the fight against NTDs.

Overall, the latest NTD league table shows positive progress on beating NTDs in Africa. Compared to 2015, fewer people require treatment for at least one NTD. Simultaneously, the number of people receiving preventive treatments for at least one NTD is going up. Countries are achieving elimination goals too, with Malawi joining Togo as the second country in sub-Saharan Africa to successfully eliminate lymphatic filariasis as a public health problem.

From the 2019 NTD Index, the latest available, the top five countries in the NTD league table are:

1 - Burundi (up from 33rd in 2018);

2 - Malawi (up from 31st in 2018);

3 - Liberia (up from 8th in 2018);

4 - Burkina Faso (down from 2nd in 2018); and

5 - Rwanda (up from 6th in 2018).

Thoko Pooley, Executive Director of Uniting to Combat NTDs, said: "Every year the NTD league table enables us to take a deep look at where we are seeing progress towards beating NTDs and where that progress has slowed. It is striking to see that when it comes to fighting neglected tropical diseases, wealthier nations are amongst the poorest performers. Hopefully this league table will spur countries with the means into action to change the lives of their poorest citizens by ending these diseases of poverty. There is simply no excuse."

Despite the positive trend, progress across Africa is not happening quickly enough to reach the Sustainable Development Goal target of a 90% reduction in the number of people requiring an NTD intervention by 2030.

The provision of treatment has not been consistent from year to year. The peak seen in 2017 has not been repeated. Far too many NTD programme rely on donor funding, most of which is programmed on a 12 month cycle, with no guaranteed multi-year funding.

The donation of drugs has been positive and significant, but recently there has been a huge impact on donated medicines, some of which have been expiring in a number of countries before they can reach the targeted populations due to a lack of resources to distribute them. As the latest NTD league table suggests, it is the wealthier countries in Africa that could help to speed progress up and inject the necessary domestic resources that are needed.

Investing in neglected tropical diseases is not just the right thing to do, it is also a smart investment. According to a study by The World Bank Group (1), investing in NTD interventions helps countries to avoid out of pocket health expenditures and lost productivity, which has the potential to exceed costs of hundreds of millions of dollars. The net benefit for each individual affected by NTDs is US$25 for every one dollar invested by public and philanthropic funders - a 30% annualised rate of return.

Research has shown that interventions to end NTDs are affordable for the governments of most NTD-endemic countries, particularly because investments are often offset by generous drug donations. These interventions cost less than 0.1% of domestic health spending.

Pooley adds: "2021 marks a crucial moment for the fight against NTDs with the recent launch of the World Health Organization's new NTD Roadmap. Whilst it is likely that we will see disruptions in treatments across Africa due to COVID-19 in the 2020 NTD league table, many NTD programs adapted quickly to respond to the pandemic, enabling life-changing and life-saving interventions to continue."

"What the world has achieved in its collective efforts to combat COVID-19 has been encouraging and it is crucial that afterwards we extend that energy and resources to deliver real change for the 1.7 billion people affected by neglected tropical diseases."