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This article was originally published in The EastAfrican newspaper on 25 January 2025.

Rwanda has emerged as a regional leader in the fight against Neglected Tropical Diseases (NTDs), proving that eliminating these health challenges is not merely a goal but a collective responsibility. Through innovative strategies, cross-sector partnerships, and unwavering government commitment, this small East African nation has made significant strides in reducing the prevalence of NTDs and offers a powerful model and invaluable lessons for other countries in the region.

Milestones in Rwanda’s NTD journey

Rwanda’s fight against NTDs has yielded remarkable achievements. In 2022, the World Health Organization (WHO) validated the elimination of human African trypanosomiasis (HAT) as a public health problem.

Efforts to combat Neglected Tropical Diseases (NTDs) were outlined by Ladislas Nshimiyimana, Director of NTDs & Other Parasitic Diseases, Ministry of Health, Rwanda, during a recent interview with The East African newspaper, and explained that this milestone was achieved through sustained surveillance and targeted interventions, particularly in previously endemic areas such as Akagera National Park.

He said in addressing soil-transmitted helminths (STH) and schistosomiasis, the country has also seen significant reductions in prevalence. Following a 2020 impact assessment that revealed high infection rates among adults, Rwanda expanded its mass drug administration (MDA) programs to include adult populations.

Government funding has played a pivotal role in sustaining these initiatives, with 89 percent of administrative zones meeting elimination criteria for schistosomiasis.

Integration and data-driven decision-making have been some of the key tools the country has used in the fight against NTDs.

Rwanda’s success is underpinned by its ability to integrate NTD interventions into existing health initiatives, explained Nshimiyimana. “Programs such as the Maternal and Child Health Week offer comprehensive health services, including immunizations, nutrition screening, and NTD treatments, ensuring efficient use of resources while addressing broader health needs.”

“Data has been central to these efforts. Rwanda’s health management information system enables real-time monitoring of NTD prevalence, while digitized community health platforms facilitate village-level data collection and reporting. Mapping exercises and sentinel site surveillance ensure that interventions are evidence-based and targeted,” he added.

This success has been greatly assisted by their integrated Malaria and NTD scorecard, a simple yet comprehensive tool used to review progress, identify bottlenecks, and guide targeted interventions. By enabling improved data management and evidence-based decision-making, the scorecard has facilitated the implementation of innovative, high-impact strategies against NTDs.

The integration of NTD and malaria activities began in Rwanda in 2012, with the scorecard developed in 2017 and key programme indicators added in 2019. The scorecard is now a cornerstone for the Malaria and Other Parasitic Diseases Division (MOPDD) and its partners, fostering collaboration and resource optimization across the two programs. For example, to address gaps in Schistosomiasis Control, malaria vector control teams supported national snail mapping surveys by leveraging their expertise in mosquito larvae collection in marshlands. This collaboration extended to the development of a snail xenomonitoring and surveillance plan that integrates snail surveillance into existing malaria mosquito surveillance sentinel sites.

Further highlighting the integration, Rwanda’s 10 malaria field supervisors now support the NTD programme during Mass Drug Administration (MDA) campaigns and contribute to NTD data quality assessments. Additionally, five vector control staff assist in creating NTD vector control strategies. Ten malaria sentinel health centers have also incorporated snail xenomonitoring and surveillance activities for NTDs, demonstrating the seamless integration of efforts.

Breaking silos across sectors to achieve shared goals on elimination of NTDs in the country emphasizes the importance of collaboration across ministries and departments.

According to Nshimiyimana, “The health sector alone cannot address the complex challenges posed by NTDs, which are closely linked to social determinants such as access to clean water, sanitation, and hygiene (WASH). Rwanda’s multi-sectoral approach which engages sectors such as agriculture, water and veterinary sectors to address zoonotic diseases, improve vector control and hygiene within populations, has been another success point. Investments in WASH infrastructure have been particularly impactful, reducing exposure to disease vectors and fostering long-term health improvements.”

Sustainable financing for sustained progress

A cornerstone of Rwanda’s strategy has been its commitment to increasing domestic financing for NTD programs. Between $200,000 and $300,000 in government funding was allocated last year, excluding costs for donated medicines and healthcare provider salaries. This funding supports surveillance, coordination, and interventions, ensuring the continuity of programs despite fluctuating donor support.

“The government aims to allocate 40 percent of the NTD budget from domestic resources, reducing dependency on external donors and ensuring long-term sustainability,” revealed Nshimiyimana. He explained that this commitment is crucial as international donor priorities shift and global funding becomes less predictable.

Despite significant progress, challenges remain. Limited staffing, gaps in financing, and insufficient WASH investments slow the pace of elimination efforts. However, Nshimiyimana emphasizes that Rwanda’s integration of NTD services into broader health initiatives and its emphasis on domestic financing provide a roadmap for overcoming these barriers.

He advocates for regional collaboration highlighting the need for shared knowledge and resources, noting that by adopting proven interventions and reducing duplication of effort, African nations can accelerate progress toward eliminating NTDs.

Looking ahead: a vision for elimination

Rwanda is actively working toward the elimination of other NTDs, including onchocerciasis and trachoma. Epidemiological studies and validation processes are underway to secure further WHO certifications. Meanwhile, diseases like lymphatic filariasis, which no longer require MDA in Rwanda, are closely monitored to ensure sustained control.

Strong surveillance systems remain a cornerstone of Rwanda’s strategy, ensuring that eliminated diseases do not resurge. Nshimiyimana reveals that these systems are particularly critical in addressing vector-borne diseases, where environmental factors can lead to re-emergence.

As Rwanda continues its journey toward eliminating NTDs, it serves as both a beacon of hope and a blueprint for action. It sets an example of how nations across the continent can ensure that these diseases—disproportionately affecting the most vulnerable—become relics of the past.

“Rwanda’s experience underscores the value of collaboration across the continent,” says Nshimiyimana. He underscores the need in communicating and sharing effective interventions and pooling resources, across the continent so that African nations can overcome resource constraints and move closer to a future free of NTDs. This shared responsibility requires sharing tools and innovations, integrating services, prioritising sustainable financing, and learning from each other’s successes and challenges.

He invited the global and African communities to join in this mission, by uniting, committing, and sharing knowledge around NTDs.