PROMOTED CONTENT
it would betray the spirit of equity at the heart of the SDGs. International partners still have a critical role to play. Continued funding, innovative financing mechanisms and political visibility remain essential to sustain momentum. But donors must also recognise that NTD elimination is not peripheral – it is one of the most effective ways to deliver equity, justice, and measurable returns on global health investments. Eliminating NTDs is achievable within our lifetime. The medicines are available, the strategies are proven and the benefits – for individuals, economies, and societies – are undeniable. What remains uncertain is not the science, but the politics. For governments, investing in NTD CHOOSING EQUITY, CHOOSING NTD ELIMINATION elimination means protecting citizens’ dignity, strengthening economies, and securing political legitimacy by serving the majority. For donors, it represents one of the best-value investments in global health, with extraordinary returns for a modest cost. Governments and partners must make deliberate choices: to protect funding for the poorest, to integrate NTD services into national systems, and to frame their elimination as a cornerstone of health equity. This means developing universal health coverage programmes that explicitly include NTDs, investing in community-led approaches that amplify the voices of those most affected, and ensuring data are disaggregated by geography, gender, age, and income so that resources can be targeted where inequities are greatest. These are not technical adjustments – they are political choices. By acting intentionally to improve the health of the so-called “bottom billion”, countries affirm that equity is central to health policy. The choice is stark: either accept persistent inequities, or act decisively to end diseases of poverty. In choosing NTD elimination, leaders choose fairness, resilience and a healthier, more equitable future – for their citizens, and for the world. ▪
health planning, progress has proven both resilient and sustainable. This transition is not merely about financial independence; it is about embedding equity within national systems. Community drug distributors and health workers trained in NTD programmes often deliver far more than medicines: they extend the reach of health systems, provide trusted advice, and connect families to essential services like maternal health, immunisation, and water and sanitation. Prioritising NTD elimination strengthens the very foundations of universal health coverage. TANZANIA: CHOOSING EQUITY THROUGH DOMESTIC RESOURCE MOBILIZATION Tanzania illustrates how political will can translate into concrete choices for sustaining NTD progress even when external support falters. When USAID froze funding in 2025, the Ministry of Health immediately mobilised domestic financing through the Comprehensive Council Health Plans and Medium-Term Expenditure Framework . For the 2025/2026 fiscal year, all 184 districts allocated funds for NTD interventions – a landmark demonstration of leadership. At the same time, the government integrated mass drug administration into other health campaigns such as immunisation and Vitamin A supplementation, and leveraged local community health workers to deliver treatment at lower cost.
These decisions were not inevitable. They were political choices that prioritised equity. By reallocating limited local resources, district medical officers and council planners signaled that even in an era of donor retrenchment, the poorest and most marginalised communities would not be abandoned. This act of domestic solidarity has allowed Tanzania to maintain momentum toward elimination – keeping trachoma down from 69 endemic councils in 2012 to just 7 in 2024, and lymphatic filariasis from 119 councils in 2015 to only 5 by 2024. Tanzania’s experience demonstrates that resource mobilisation is not simply a technical fix. It is an expression of political resolve: to sustain equity-driven health commitments, to embed NTD services within national systems, and to protect the gains of decades of investment. A TEST OF GLOBAL SOLIDARITY The fight against NTDs is a microcosm of the broader test facing global health today: whether we are willing to act in solidarity with those most excluded. The Sustainable Development Goals enshrine a promise to “leave no one behind”. But, achieving this vision depends on confronting precisely those conditions – like NTDs – that entrench inequities. Rising nationalism, shifting donor landscapes, and competing emergencies risk sidelining the diseases of poverty. Allowing this to happen would not only undermine decades of progress;
KELLY ZONGO Dr Kelly Zongo, PhD, MPH: Dr. Kelly Zongo is a Senior Director at the END Fund. She is a passionate advocate for health equity, with two decades of experience leading programmes across four continents. Trained in medical anthropology and public health, she brings deep expertise in gender and social justice, recognised globally through awards, mentorship, and publications that amplify marginalised voices in global health. CAROL KARUTU Dr Carol Karutu, DrPH, MPH: Dr. Carol Karutu is the Vice President of Programs at the END Fund. She is a seasoned global health leader with over two decades of experience directing large-scale USAID and NGO programmes across Africa. She has advanced HIV, maternal health, and workforce development initiatives, and holds advanced public health degrees from Boston University and a science degree from Kenya. VINCENT OKUNGU Dr Okungu is a Senior Advisor (Health Financing) at the END Fund. He is a seasoned Health Economist specialising in domestic resource mobilisation across African health systems. With a strong background in health financing, policy analysis, strategic planning, and stakeholder engagement, he supports governments in designing and implementing sustainable financing mechanisms that strengthen health sector resilience and equity, focusing on neglected tropical diseases (NTDs). With a deep commitment to universal health coverage, his work spans fiscal space analysis, public financial management reforms, and the integration of NTD priorities into national budgeting processes. Okungu is adept at aligning donor transition strategies with country-led investment plans, ensuring continuity and accountability in service delivery. endfund.org
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Health: A Political Choice – The Future of Health in a Fractured World
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