Ahead of this year’s World Neglected Tropical Diseases (NTDs) Day, marked yearly on January 30, the Country Director of Sightsavers Nigeria, Prof. Joy Shu’aibu, spoke with NKECHI ONYEDIKA-UGOEZE on Nigeria’s high disease burden, progress recorded so far, and the challenges threatening the control and elimination of NTDs in the country.

How would you describe the NTDs situation in Nigeria?
Nigeria bears about 25 per cent of the global burden of NTDs and nearly 50 per cent of Africa’s burden. According to the World Health Organisation (WHO), one in every three Nigerians is affected by at least one NTD. At least 15 of the 21 NTDs recognised by WHO are endemic in Nigeria, and all 36 states, including the Federal Capital Territory, are endemic for at least one NTD.

On the positive side, the country has made significant progress towards elimination. Guinea worm disease has been eradicated, while five NTDs, river blindness, trachoma, bilharzia, intestinal worms and lymphatic filariasis are targeted for elimination by 2030.

Two states, Nasarawa and Plateau, have successfully eliminated river blindness. Eleven other states have met WHO and national thresholds for interruption of transmission, while the remaining 23 states and the FCT are advancing steadily towards elimination. Nigeria is also making remarkable progress in eliminating lymphatic filariasis, with 434 out of 583 endemic local government areas having interrupted transmission. Trachoma interventions have scaled down from over 129 LGAs to fewer than 20 across the most endemic states, placing Nigeria sixth globally.

What are the key drivers of NTDs, and how accessible is treatment?
NTDs are driven by several interrelated factors, including poor hygiene and sanitation, poverty, inadequate access to safe drinking water, environmental changes, vector abundance, and gaps in knowledge, attitudes and practices among at-risk populations. Limited awareness, especially in underserved communities, further fuels transmission, as NTDs disproportionately affect the poorest and most marginalised groups.

From a control and prevention perspective, treatment for NTDs is largely available and affordable. Mass Administration of Medicines (MAM) campaigns are conducted yearly or biannually, and in some cases more frequently, by trained community drug distributors at no cost to beneficiaries. In addition, the national programme continues to expand capacity for case management by training health personnel to improve coverage and reach, ensuring that NTD-related morbidities are effectively managed even in hard-to-reach areas.

What are the major challenges facing NTD control and elimination in Nigeria?
Despite the progress made, several obstacles persist. Chief among them is rising insecurity and hostile environments, which severely affect the delivery of effective and efficient programme implementation.

This has significantly slowed progress. For instance, for the past four years, efforts to conduct assessments in 14 local government areas of Zamfara State, needed to determine whether treatment for lymphatic filariasis can be stopped, have been unsuccessful due to insecurity. In Imo State, NTD assessments could not be completed for over five years until December 2025.

Other challenges include inadequate government commitment and programme ownership, declining donor funding, particularly recent USAID funding cuts that have affected Nigeria’s NTD landscape and high attrition of trained health workers in some states, which undermines programme continuity.

Political instability also poses challenges. For example, the state of emergency declared in Rivers State led to the suspension of key programme activities in 2025. In addition, insufficient public awareness of the impact of NTDs continues to hinder progress, while new government policies and restrictions on the importation of donated NTD medicines could have far-reaching implications for sustaining gains already achieved.

How effective has the implementation of Nigeria’s NTD master plan been?
Nigeria has recorded commendable progress in implementing its NTD master plan. I am proud of the collective achievements resulting from sustained collaboration between government institutions and NGO partners at the federal, state and local levels.

All five Preventive Chemotherapy and Transmission Control (PCT NTDs) have completed epidemiological mapping nationwide, with at least one round of treatment delivered to eligible communities across the country.

Innovative approaches, such as trichiasis surgeries, have prevented hundreds of thousands of Nigerians from avoidable blindness in the past three to five years.

More recently, strengthened morbidity management and health system interventions supported by the Foreign, Commonwealth and Development Office (FCDO) and Reaching the Last Mile (RLM) have consolidated gains, ensuring that people affected by lymphatic filariasis are protected from permanent disfigurement and can participate fully in society.

At Sightsavers, we apply a “leave no one behind” strategy to ensure inclusive and equitable programme delivery, aligned with the WHO and Sustainable Development Goals. As we move into the final phase, I am optimistic that with sustained commitment, Nigeria will come very close to eliminating NTDs.

What is being done to meet the 2030 SDG targets?
Nigeria remains focused on the 2030 target outlined in the WHO roadmap for NTD elimination. The country is working towards stopping mass administration of ivermectin for river blindness and aims to be among the 12 countries globally to halt treatment across the entire endemic population. Achieving this, however, depends largely on improvements in security and population mobility.

By 2030, Nigeria is also expected to stop treatment in more than 90 per cent of at-risk populations for trachoma, lymphatic filariasis, bilharzia and intestinal worms. Achieving these milestones would reduce disability-adjusted life years associated with NTDs by at least 75 per cent.

What role has Sightsavers played in NTD control in Nigeria?
Sightsavers has worked in Nigeria for over 70 years, providing funding and technical support to combat NTDs. The organisation has received significant funding from donors such as RLM, FCDO, Accelerate donors and others, and has served as a coordinating partner for fund disbursement to both international and indigenous NGOs, while ensuring quality implementation aligned with WHO standards.

We lead several NTD consortia aimed at accelerating elimination. In December 2025, Sightsavers, in collaboration with the Federal Ministry of Health, concluded a $5 million Gates Foundation-funded project awarded in 2022. The project provided evidence that 31 million Nigerians no longer require treatment for lymphatic filariasis, while 16 million no longer need treatment for river blindness. Sightsavers is also coordinating the RLM project, supporting 20 states with funding, programme and technical assistance to eliminate river blindness and lymphatic filariasis by 2030.

What must be done to ensure Nigeria meets the 2030 elimination target?
To meet the 2030 NTD elimination target, the Federal Government must sustain existing gains by increasing domestic funding, ensuring steady availability of medicines and commodities, and strengthening leadership and ownership of the NTD programme.

All stakeholders must remain focused and demonstrate Nigeria’s leadership role in Africa by committing to the elimination of NTDs. I call on federal, state, local governments and communities to unite and act decisively. The fight against poverty and inequality will not be won until NTDs are eliminated.