From burden to blueprint: How Tanzania is paving the way for NTD elimination
Produced in partnership with
In Tanzania, a quiet revolution is underway. Despite bearing the burden of 15 of the 21 neglected tropical diseases, or NTDs, the East African nation has emerged as a global leader, demonstrating how government ownership, innovative partnerships, and community engagement don’t just inch the country closer to elimination targets — it transforms public health outcomes even amid global challenges.
Fatuma Saidi Majogo, 65, was accused of witchcraft. Suffering from trachomatous trichiasis, or TT — a painful form of the eye disease trachoma that starts with mild itchiness and can lead to severe visual impairment — she faced isolation, cut off from work and community life.
As well as tending to her farm and running her own business, Fatuma was the village chairperson for eight years. But after contracting trachoma, she was unable to work, forced to stay at home, and couldn’t participate in social events.
“I used to scratch my eyes until tears came out,” Fatuma said. “As this went on, what affected me a lot is that I couldn’t see very well. I didn’t understand what was going on. I even had to stop working because I was seeing double.”
Affectionately known in her community as “Mama Maua,” Fatuma’s standing in the community led to her being selected by a local screening team to help support with TT community mobilization and case identification.
As she worked, she realized the pain she’d been enduring for eight years was caused by the same debilitating condition — leading her to seek treatment herself.
Fatuma is one of 103 million people around the world living in a trachoma-endemic area. Trachoma is one of the 21 NTDs.
NTDs impact over 1 billion people globally — predominantly affecting impoverished communities in low- and middle-income countries where access to water, sanitation, and health care is limited.
Besides having a devastating impact on people’s health — from physical impairments to chronic pain, stigma, and death — NTDs have significant social and economic consequences. Adults are often physically unable to work. Children are in too much pain to attend school. Millions are cut off from society due to stigma and cultural misconceptions. According to the World Health Organization, the household income lost from out-of-pocket health expenditures and wages lost due to NTDs is estimated at around 33 billion international dollars per year.
In Tanzania, the majority of the nearly 70 million-strong population is at risk of NTDs, with 12.5 million people susceptible to trachoma infections alone.
In 2009, Tanzania’s Ministry of Health launched its Neglected Tropical Disease Control Program, or NTDCP. But rather than spread itself thin by tackling all 15 endemic NTDs at once, the government focused on five preventable and treatable diseases: schistosomiasis, lymphatic filariasis, onchocerciasis, soil-transmitted helminthiasis, and trachoma — all of which can be managed through preventive or curative care.
Becoming one of the first countries in the WHO African region to integrate control and elimination efforts, the plan brought together health education, morbidity management, and mass drug administration, or MDA, campaigns to accelerate progress.
MDA campaigns, the main intervention, are as much about prevention as cure. Drug donations from international partners have allowed the government to reach nearly every corner of the country. As a result, Tanzania’s Ministry of Health says it has achieved 100% geographical MDA coverage across all districts, drastically reducing the number of people requiring preventive chemotherapy treatment and helping to free over 35 million people from the burden of disease.
“Many countries rely on large-scale mass drug administration campaigns to fight NTDs, where entire communities are given preventative treatment at once to stop the spread of disease,” says Dr. Winnie Mpanju-Shumbusho, chair of the board at Uniting to Combat NTDs. “That approach is the backbone of elimination efforts, and it simply would not be possible without sustained drug donations at this level.”
Building bridges with communities
Community health workers such as Dr. Margreth Mumbua Muthoka form the backbone of Tanzania's elimination strategy. Trained and equipped by the ministry, they bridge the gap between donated pharmaceuticals and the communities that need them, ensuring treatments reach even the most remote villages through locally led distribution networks.
After 20 years working as a medical officer, Margreth has seen firsthand the various barriers preventing community members from receiving the care they need — from the remoteness of village life, financial restrictions, and lack of awareness about diseases such as TT, to the limited number of doctors.
“Finding out that [patients] are suffering from TT is very difficult for them; so many think that they are cursed. The only way to locate and identify them is through outreach programs. Even then, they don’t have the financial ability to get treatment.”
Tanzania’s MDA campaigns go beyond distributing medicine. Leaders at all levels — from national to village — help to engage, educate, and sensitize communities. Addressing misinformation and encouraging them to participate in NTD activities ensures progress continues long after distribution programs have ended.
In line with WHO guidelines, the government also collaborates with several ministries to implement water, sanitation, and hygiene, or WASH, interventions — giving communities access to safe, clean water and improving hygiene to stop the spread of infectious diseases.
The government doesn’t work alone. Partnerships such as those between Tanzania’s Ministry of Health and the END Fund, the WHO, the Gates Foundation, Uniting to Combat NTDs, and Sightsavers all help to increase access to treatment and support for community members who have suffered silently for years.
“Programs like Sightsavers … help us reach every district, every ward, every village, and every neighborhood,” Margreth said. “We’re thankful to them, because we receive a lot of support in providing medicine and helping [patients] through recovery.”
But this network of collaborators isn’t just about getting medicine to distribution points. It ensures donor-funded programs align with the country’s NTD plan, helping to coordinate control efforts, improve surveillance, and create lasting change.
To strengthen the sustainability of its efforts, Tanzania has built a patient-centered data system to monitor door-to-door coverage of NTDs while tracking each stage of its control and elimination efforts.
Training modules for health courses also ensure new health care workers start their careers with sufficient knowledge of NTDs.
School-based MDA campaigns ensure donated pills — such as those used to prevent schistosomiasis, an NTD caused by intestinal worms that primarily impacts school-aged children — reach classrooms to improve children’s health, attendance, and performance.
Educational interventions such as NTD awareness and the promotion of WASH practices are also integrated into the curriculum, educating the next generation to ensure elimination remains in sight.
Restoring hope for the future
Shabanni Ramadhani, a subsistence farmer from the village of Rudiga in Talanda, has lived with hydrocele, caused by lymphatic filariasis, or LF — an NTD that causes damage to the lymphatic system, resulting in severe swelling and often permanent disability — since 2010. The debilitating disease progressed over time, leading to frequent stomach pain and vomiting, sapping his energy, and leaving him unable to work or care for his small family.
After receiving several minor treatments that did little to alleviate his suffering, he received free surgery from visiting doctors in 2024, helping him reclaim his life.
Shabanni made a swift recovery and was able to resume physical labor, working on his farm where he grows maize, cassava, and cowpeas.
But Shabanni’s dreams extend beyond the farm. “Now that I’ve recovered, I want to do work that will help me earn, so that my family is taken care of. I want to … build a house. I want to support my children and get a motorcycle just like my peers.”
For over 30 years, Rosemary suffered from TT, causing her eyelashes to scrape her eyes with every blink, threatening blindness. Despite the pain, she ran a tailoring business in Fukayosi Village in Tanzania’s Pwani region while raising her grandson Tito, who had a painful condition requiring surgery.
In 2023, Rosemary advocated persistently at a free medical camp to get Tito treated. Her determination paid off. During follow-up, medical staff discovered her eye condition and later performed surgery. After recovery, Rosemary returned to tailoring and supporting Tito’s education. Her journey shows how, by integrating NTD programs with other diseases, Tanzania is building a more resilient health system.
Since receiving free corrective eyelid surgery through Sightsavers’ Trachoma Elimination Programme, along with donated painkillers and antibiotics, Fatuma’s vision has been restored. Today, she is able to read and write again, has resumed her small business of weaving traditional mats, and has reclaimed her place in the community.
Fatuma continues to advocate for her fellow villagers, creating awareness and addressing fears that prevent people from seeking the care they need.
“I pray that God continues to give the doctors who helped me the capacity to help the community, or rather, Tanzania at large. After all, Tanzania is a community, and this disease is everywhere.”
“Drug donation programmes are a lifeline for communities affected by NTDs. They make it possible to both treat and prevent NTDs at the scale needed to reach entire populations, often in the most underserved areas. These medicines alleviate suffering: they help adults return to work, allow children to stay in school, and restore dignity to people who might otherwise live with pain, disability, or stigma for years. When people are healthy, families can thrive, and communities can invest in their futures rather than in the consequences of debilitating illness.”
For patients such as Fatuma, Rosemary, and Shabanni, the government’s efforts to improve access to treatment have been life-changing.
“I’m grateful to the one who funded this treatment for us,” Shabanni said. “I pray for their continued prosperity and safety, and that they can keep helping more people who are like me.
“I commend the government, I commend the doctors, and I commend other people who go to get the treatment and hope that they’re at peace.”
Receiving treatment not only alleviates physical symptoms but also gives people back control of their lives socially and financially, restoring their hopes of a better future for themselves and their families. The ripple effect also boosts development and helps to create safer, more prosperous, and more stable societies.
“My hopes are that I can continue to prosper,” Fatuma said. “I can weave and sew again. Truthfully, I’m doing well. Now, I’m putting my two grandchildren through school.
Thanks to government leadership, collaboration, and innovation, Tanzania is making remarkable progress — including reducing trachoma prevalence from 69 districts to seven districts and LF from 119 to 5 districts, according to the country’s Ministry of Health.
“This is why ownership matters,” says Dr. Winnie. “Elimination isn’t a single campaign; it’s consistent execution over years — setting targets, aligning partners, investing in data and surveillance, and protecting morbidity care.
Produced in partnership with
Visit Escape the Neglect — a series exploring the extraordinary progress that countries are making in eliminating neglected tropical diseases, or NTDs, and showcasing promising opportunities to build on recent wins.
This content is produced in partnership for our Escape the Neglect series. Click here to learn more.
Built with Shorthand