We can't let climate change make the task of preventing neglected tropical diseases harder

In December, the Cop28 world stage hosted a coalition of African leaders and global donors who, together with the UAE, pledged more than $777 million towards combating neglected tropical diseases (NTDs). It was a landmark moment, bringing an international spotlight to bear on a group of diseases that have long been overlooked in global health priorities, yet affect more than a billion people worldwide. NTDs are a diverse group of diseases that are largely preventable and treatable. Spread by worms and insects, these 21 diseases blind, disable and disfigure people living in some of the most impoverished corners of the world, perpetuating cycles of disease, stigma and poverty. A shared lack of funding and attention has bound these diseases together. Today, led by endemic countries and partners, including the UAE, this is changing. Efforts to end NTDs are bearing fruit. By 2023, 50 countries had stamped out at least one NTD, and more were on their way. Worldwide, 88 million fewer people require treatment for NTDs compared to 2013 – a remarkable win that reflects decades of country-led work and investments. These gains have been hard-won. But climate change now threatens to reverse them, endangering decades of global health and development progress, and leaving vulnerable communities at risk. NTDs are highly vulnerable to climatic changes, and even small fluctuations can trigger a surge in disease transmission. For instance, changes in temperature and rainfall affect the breeding and survival rates of mosquitoes, which spread diseases such as dengue. In 2023, dengue cases came close to a historic high, with over 5 million globally. This is just the tip of what could become an unfolding pandemic of diseases spread by climate-sensitive insects like mosquitoes and ticks. Africa accounts for over 40 per cent of the global NTD burden and is also the continent most vulnerable to the affects of a warming planet. To ensure progress against NTDs is not lost in the face of climate change, we must galvanise the political, technical and financial resources needed to stay the course. To begin, we need more and better data to inform policymaking and resource allocation. Recent work carried out by the World Health Organisation, with support from Reaching the Last Mile, showed there are gaping holes in our knowledge of how climate change affects many NTDs. Sustained investment to help close these gaps, and shape climate mitigation and adaption strategies is a critical concern. This must also be supported by robust cross-border surveillance systems that can detect and adapt to shifting disease risks. This proactive approach not only curbs the spread of NTDs into new areas, but ensures resources can be used to protect vulnerable communities from emerging health threats. Second, we need sustained funding and country leadership to help accelerate action against NTDs, before climate change causes us to lose ground. This means investing to build equitable and climate-resilient health systems that can respond to endemic diseases, and shield communities against future health and climate shocks. The health commitments made at Cop28 reflect the collaborative action we need to deliver a health-centred climate response. So too does the Reaching the Last Mile Fund , a multi-donor initiative established in 2017 by President Sheikh Mohamed, to combat two NTDs: lymphatic filariasis and onchocerciasis, or river blindness . At Cop28, the fund expanded from $100 million to a target $500 million, with the ambitious goal of eliminating these two diseases from the entire continent of Africa. This goal builds on the fund’s existing success, which saw it pioneer a blueprint for the elimination of the two NTDs in sub-Sahara Africa. Since launch, the fund has provided over 100 million treatments and trained 1.3 million health workers. It also played a part in Niger’s journey to eliminate the transmission of river blindness, following decades of country-led investment and effort. This milestone – once thought to be scientifically impossible in Africa – stands as an example of what can be achieved when countries and partners unite in pursuit of a shared goal. The next few years represent a tipping point for NTDs. But we have a vital opportunity to unite, act and eliminate NTDs before climate change makes the job even harder. We call on both countries and donors to join us in relegating NTDs to the history books. The time for action is now.