Ending the Neglect
Kigali Declaration on Neglected Tropical Diseases
Incredible progress has been made against neglected tropical diseases (NTDs) – a group of 20 diseases which debilitate, disfigure, and can kill – proving that ending NTDs is possible. 43 countries have eliminated at least one NTD so far, 600 million people no longer require treatment for NTDs and cases of some of these diseases that have plagued humanity for centuries, such as sleeping sickness and Guinea worm disease, are at an all-time low.
As outlined by Dr Tedros Adhanom Ghebreyesus, the World Health Organization’s (WHO) Director General, many factors underpin this success. Two elements are particularly relevant to continued progress. The first is country and regional ownership. Progress would not have been possible without countries translating international targets into national strategies and delivering them. Going forwards, continued country leadership and ownership is essential if we are to deliver tangible results at scale. Second, from the beginning, the movement to end NTDs has been defined by partnerships and collaboration among a wide range of stakeholders – governments, donors, civil society, the private sector, and academia. Such partnerships must be promoted and continued as it is only through coordinated and collaborative action that we can meet the Sustainable Development Goal (SDG 3) target to reduce the number of people requiring interventions for NTDs by 90% and achieve the ambitions endorsed by Member States in the WHO 2030 roadmap including the eradication of two NTDs and the elimination of at least one disease in 100 countries.
Efforts to tackle NTDs are a global health success story, but there is still a lot more work to be done until the world is free of NTDs. NTDs currently affect 1.7 billion people around the world. By preventing children from going to school and adults from being able to work, NTDs trap individuals and whole communities in cycles of extreme poverty. COVID-19 has affected essential health care services across the world with NTD programmes extensively disrupted. Concerted action is needed to avoid pandemics unravelling years of progress and exposing millions of children to preventable diseases. Equally, COVID-19 has shown the critical importance of investing in strong community delivery systems and public health functions which can respond to endemic diseases, such as NTDs, and ensure the world is more resilient to pandemics.
We have a once in a lifetime opportunity to change the lives of over 1.7 billion people who are affected by NTDs. These diseases are preventable or treatable, so it is in our power to end NTDs. Therefore, we each pledge to do our part at the global, regional, national, community, and partner level to ensure that NTDs are eradicated, eliminated, or controlled by 2030.
Building on the progress of the London Declaration on NTDs and recognising that empowered and informed individuals and communities everywhere take charge of their own health, we, the signatories of this declaration, come together to commit to ending NTDs. We recognise that Universal Health Coverage cannot be achieved whilst 1.7 billion people continue to suffer from NTDs.
All signatories to this declaration commit to the achievement of the SDG3 target on NTDs and to the delivery of the targets in the WHO 2030 roadmap (2021-2030) “Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021−2030”. We will deliver on our commitments and contributions laid out in this declaration by:
- Enabling mutual commitment and accountability from the public and private sector, with endemic countries as leaders and stewards of this global public private effort uniting countries, the world’s largest drug donation programmes, country donors, private donors, research institutions, civil society organisations and affected communities and individuals.
- Working in an integrated manner; rooted in primary health care and embedded within resilient national systems that serve affected communities.
- Collaborating across the partnership to increase the provision of services that enable equitable access to prevention, diagnosis, and treatment interventions against NTDs.
- Unlocking domestic resources, including public health infrastructure necessary to deliver effective NTD programmes, complemented by public and private donor resources.
- Identifying new and sustainable financing opportunities and being stewards of the resources at our disposal to maximise programmatic impact and value for money.
- Investing in innovation in new drugs and diagnostics for areas prioritised in the WHO 2030 roadmap and facilitating technology transfer and financing modalities to ensure there is a sustainable supply of commodities for NTDs.
- Improving the collection and use of data to target programmes, increase effectiveness and accelerate progress.
- Transparently monitoring and reporting through appropriate mechanisms on the commitments and contributions laid out in this declaration, and on the programmatic progress made, holding each other accountable, whilst supporting national ownership of country programmes.
We believe that by working together and engaging across sectors, we can meet the SDG goal on NTDs and targets in the WHO 2030 roadmap, sustainably decreasing the number of people requiring interventions for NTDs by 90%, sustaining that achievement, and continuing the progress towards health and prosperity, helping to relieve suffering and decreasing the health-related drivers of poverty for a stronger, healthier future.
Stakeholder Commitments and Contributions
Achieving the objectives set out in this declaration depends upon all stakeholder groups working together and fulfilling their obligations. Each stakeholder group makes a unique and vital contribution that collectively translates into progress being made.
As National Governments
We commit to demonstrating political leadership and country ownership through:
- Embedding NTD programme interventions into the national health system.
- Ensuring programmes to prevent, diagnose and treat NTDs are prioritised, fully integrated and resourced within national strategic plans for health and allied ministries such as agriculture, veterinary health, water and sanitation, and environment in the framework of a One Health approach.
- Making sufficient financial allocations and commitments towards NTD interventions.
- Maximising existing NTD medicine donation programmes from industry partners by ensuring that the resources needed to deliver the medicines are available.
- Improving surveillance, mapping and data collection and use – including through improved digitization – to better target and deliver drug donations.
- Removing barriers to access such as duties and clearance taxes for donated NTD medicines to ensure these medicines that are intended for poor and vulnerable communities are distributed on a timely basis.
- Developing national public health policies on NTD prevention and treatment.
- Ensuring health management information systems are in place to manage programme data and provide financial and programmatic reporting on national key performance indicators for NTD programmes.
- Reporting on national NTD progress as part of the follow up and review mechanism for the 2030 Agenda for sustainable development.
- Transiting from receiving large-scale medicine donations to providing affordable essential diagnostics and medicines within the health system – starting with those most at need and using domestic resources in collaboration with the private sector. Sustainability will depend on the continuity of these donations in the short-term, and a transition to country-procured and financed diagnostics and medicines in the medium-to-long-term.
We commit to the use of the political levers at our disposal to raise awareness about the human cost of NTDs, adopt legislation and budgets that showcase political will, leadership, and accountability to end these poverty-related diseases by the end of this decade.
As Mayors and Local Government Leaders of Affected Countries
We commit to:
- Accelerating rural and urban development, through a properly empowered and funded approach, to create healthy and prosperous environments.
- Engaging with community groups and leaders in identifying public health challenges such as NTDs and their persistent local risk factors, finding home-grown solutions, and being accountable for implementation.
- Coordinating services across sectors to improve the built environment, emphasizing housing, infrastructure development and maintenance, water and sanitation, and environmentally safe waste disposal, to reduce the transmission of NTDs and other communicable diseases.Working with civil society organisations who provide an important bridge between local government and hard to reach communities, alongside government, the private sector, and other key stakeholders. We will ensure women and young people are included in policy and decision making.
As Continental and Regional Bodies
We commit to:
- Providing political leadership for the recognition of NTDs as health and development priorities in our regions, to supporting coordinated multisectoral action in our Member States, to reviewing progress on these diseases and taking the necessary steps for course correction, to celebrating countries as they achieve key milestones, and to showcasing and championing best practice towards ending NTDs by 2030. Providing a platform, such as the ALMA scorecard, to support regional accountability towards achieving NTD targets across member states.
- Coordinating and where possible harmonizing approval and guideline setting for tools to prevent and treat NTDs and minimise the time for adoption of new available diagnostics, drugs, and vaccines.
- Increasing the advocacy for the control and elimination of NTDs among the various stakeholders including Member States.
- Providing platform for convening meetings and fora that will promote the advocacy and partnerships for the control and elimination of NTDs.
As the United Nations
We commit to providing political leadership and advocacy for equitable access to health and development for the people and communities affected by NTDs in line with the principles of the Sustainable Development Goals and Universal Health Coverage.
As the World Health Organization
We commit, through our network of WHO offices to:
- Providing global health leadership, as well as technical and programmatic support and guidance to countries to implement their national NTD programmes as recommended in the WHO 2030 roadmap.
- Monitoring and reporting progress towards the WHO 2030 roadmap targets.
- Providing timely policy guidance to support rapid scale up of effective interventions.
- Developing quality M&E protocols and guidelines to programmes and countries.
- Verifying, validating or certifying disease elimination and eradication.
As Private Sector Pharmaceutical Organisations
We commit to:
- Supporting national and international NTD medicines access programmes in alignment with the WHO 2030 roadmap through our committed donations of reliable safe and effective medicines, other health products, and supportive complementary funding to control, eliminate and eradicate NTDs.;
- Supporting innovation and its timely delivery to people and programmes for safe and impactful scale up as required to meet the WHO 2030 roadmap goals and beyond, with a view to control, eliminate and eradicate NTDs.;
- Together with national and international partners, co-creating sustainable local health systems strengthening solutions, that enhance successful, time-bound individual country transition plans that are aspiring to eventual self-financing independence and meaningful long-term impact.
We, as public and private sector donors, commit to deploying our technical and financial resources in support of countries to achieve the WHO 2030 roadmap goals by:
- Partnering and collaborating with endemic countries to support their plans and stewardship of resources to achieve disease specific goals while building the resilience of country health systems.
- Facilitating sustainable financing through collaboration with domestic funding processes and ensuring NTD donor resources complement rather than undermine or replace country resources.
- Collaborating with country governments, academia, WHO and industry to fund research for new treatments and diagnostics to accelerate progress against NTDs in line with endemic country priorities.
As Multilateral Organisations
We commit to:
- Investing in health system strengthening, continuing to finance core programme interventions and support integrated service delivery that support NTD programme interventions.
- Advocating for robust and impact driven national strategic plans for NTDs, supporting countries in developing their national strategic plans on NTD elimination and to supporting countries with programme implementation.
- Resource mobilisation in support of national NTD programmes, diagnostics and medicine development.
- The development and maintenance of an open-access tracker that shows the number of people tested for NTDs around the world so those figures can be monitored and presented.
As Non-Governmental Organisations
We commit to a world free of NTDs through:
- Coordinating our contributions to achieve the ambitions of the WHO 2030 roadmap.
- Supporting country leadership of NTD programmes and of cross-sector collaborations with other health and development sectors needed to deliver results (including WASH, nutrition, mental health and education, human rights and livelihood).
- Enabling greater participation of country stakeholders and those directly affected by NTDs in all levels of programme planning and implementation, policy and influencing, and monitoring and evaluation.
- Safeguarding the communities we serve by prioritising efforts to do no harm while scaling up services to reach those in need.
- Establishing best practices based on robust data and evidence for the NGO community, focusing on sustainability, resilient health systems, and integrated programming at scale and for impact.
We commit to:
- Using our voice to engage, empower and support youth communities and young leaders towards delivering and achieving the WHO 2030 roadmap thereby making sure that no young people are left behind in the fight against NTDs.
- Bringing our creativity, our energy, our sense for innovation and skills with new technologies, thinking and talent in the fight against these diseases.
- Engaging and supporting international, regional, and local decision-making bodies in carrying out advocacy and delivery of the WHO 2030 roadmap.
- Promoting and adopting healthy practices that prevent NTDs.
As Academic and Research institutions
We commit to fight against NTDs by familiarizing ourselves with the new NTD roadmap and working with NTD programs and community members to:
- Building a better understanding of how all NTDs work and how we can address them, ranging from disease-specific, cross-cutting and system-wide knowledge about the problems and the solutions that can be translated into policy and practice;
- Developing the interventions that can effectively respond to the complex needs of the populations affected by NTDs in their national and local contexts;
- Working in partnership, under a coordinated research agenda for NTDs, to deliver these interventions with a strong emphasis on innovation, access, and equity;
- Advancing comprehensive curricula on the prevention and treatment of NTDs for all stages of educational development worldwide, with a focus on building the capacity and excellence of the health and research workforce in endemic countries;
- Advocating for an increase in R&D expenditure as a proportion of GDP and in national health expenditure in research and research capacity strengthening, as per the Sustainable Development Goals;
- Establishing robust monitoring and evaluation mechanisms across sectors that can measure the progress against controlling, eliminating, and eradicating all NTDs.