Mapping the gaps: The power of data to drive NTD elimination

Fifty-six countries. Tens of millions fewer people needing treatment. Endemic countries are making remarkable progress toward the elimination of neglected tropical diseases, or NTDs, particularly in Africa — a region endemic for 20 of the 21 priority NTDs. And yet, these preventable diseases still affect more than 560 million people across the continent. Many at-risk communities still lack access to the interventions that could prevent or eliminate these diseases. In some areas, decades of treatment have left gaps, and entire populations remain unmapped — making it impossible to know who needs care.

The Expanded Special Project for Elimination of Neglected Tropical Diseases, or ESPEN, is out to change that. Established by the World Health Organization Africa Regional Office in 2016, the program supports countries in mapping, coordinating, and delivering interventions for the highest-burden NTDs, ensuring that efforts are guided by data and national priorities.

“ESPEN is focused on driving the elimination of NTDs that can be prevented through mass community treatment,” Dr. Elizabeth Juma, clinical research scientist and team lead at ESPEN, told Devex. “The critical thing for me [is highlighting] the gap that still persists. We are moving toward the SDG target  — that [no one should need] NTD treatment by 2030. But there are groups of people that haven't even started yet … for river blindness — the disease that started all this progress in 1974; that's 51 years ago. I find that totally unacceptable. By 2030, every community should at least know whether interventions are needed. Whether they get that intervention becomes the second stage, but we can't be in limbo.”

As countries prepare for the 80th session of the United Nations General Assembly, Devex spoke to Dr. Juma to understand how ESPEN works with African countries to close these gaps and use data-driven approaches that could make elimination efforts more efficient and sustainable.

This conversation has been edited for length and clarity.

What is ESPEN, and how does it work with ministries and partners to accelerate the elimination of NTDs?

Unlike a single organization, ESPEN really functions like a collaborative hub by bringing together public-private partnerships, including ministries of health, donors, pharmaceutical companies that supply essential medicines, NGOs, and research institutions. Its role is to connect these different actors, ensure resources are used effectively, and provide hands-on technical assistance tailored to each country’s priorities. Today, ESPEN works directly with 47 ministries of health across Africa, helping coordinate national programs and partner support to ultimately speed up progress toward NTD elimination.

One of ESPEN’s hallmarks is its emphasis on subnational data. How is access to district-level data changing the way countries plan and deliver NTD interventions?

Sub-national stratification, which is the process used to generate this data, is essential for delivering tailored interventions against NTDs. By focusing on district and sub-district level mapping, ESPEN helps countries identify disease hotspots, adapt interventions, and monitor progress with greater precision.

The ESPEN data portal serves as a tool and a resource, allowing countries to host this data and use it for decision-making and monitoring results. This granular approach avoids blanket strategies, ensuring resources go where they’re needed most to maximize impact and cost-effectiveness.

Can you share a case of how data from the ESPEN portal helped a country identify a hotspot or shift its strategy for greater impact?

The ESPEN portal holds decades of data, particularly on onchocerciasis and lymphatic filariasis. In the Republic of Congo, for example, the data showed that onchocerciasis transmission persisted despite 20 years of interventions being implemented, which has called for a strategic review of the package of interventions to determine what was truly needed.

In Niger, the portal helped identify small pockets of persistent transmission — and in response, the program increased treatment frequency and added entomological surveillance (the monitoring of disease-carrying insects to track ongoing transmission). Niger became the first African country verified for onchocerciasis elimination in January 2025, and it continues post-verification surveillance today.

What are some of the most effective ways endemic countries are using ESPEN’s tools to coordinate across disease areas and maximize both domestic and donor investments?

Countries are increasingly using ESPEN tools to harmonize planning and conduct impact assessments; not just for NTDs, but across other health areas as well. For example, the Implementation Unit Planner helps ministries of health and donor partners align funding, thus reducing fragmentation or duplication of funding for activities. Likewise, the Geospatial Microplanner supports district-level planning for community interventions, whether for NTDs or other activities that can be jointly implemented. Then the ESPEN Collect survey tools allow countries to integrate mapping and impact surveys with other efforts, such as skin NTD surveillance or guinea worm detection.

How has ESPEN helped integrate NTD programs with other health priorities — such as immunization, WASH, or malaria?

Integration is essential, especially when resources are limited. ESPEN provides countries with the technical support to align their NTD campaigns with broader community health initiatives, such as supplementary immunization efforts.

In Madagascar, for instance, mass treatment for lymphatic filariasis was combined with polio immunization, resulting in higher coverage for both diseases at a much lower cost than if delivered separately. Similarly, in Uganda, schistosomiasis treatment was integrated into the WHO’s Child Health Weeks and Days campaign that also included immunization and vitamin A supplementation. These efforts really help to reduce duplication, optimize funding, and strengthen integrated service delivery within the health sector and within other systems as well.

Why is it important for endemic countries to lead and guide NTD programs, and how does ESPEN help strengthen their leadership and ownership?

Country leadership and ownership really are the cornerstone of sustainable NTD elimination. At ESPEN, our role is to support governments, particularly ministries of health, in embedding NTDs into national health plans, budgets, and policies, making them part of broader health priorities.

We also advocate for and help facilitate government-led coordination platforms where partners, stakeholders, and even non-health sectors can jointly shape the national agenda, agree on implementation plans, and hold each other accountable. This way, the vision for NTD elimination is truly owned by governments, rather than driven by external partners.

As we head into UNGA, where health financing will be a key focus, what message would you like to leave with donors and partners about the future of NTD elimination?

NTD elimination is one of the highest-impact, most cost-effective health investments available. It’s not just a health goal; it's a smart investment that transforms and saves lives. At ESPEN, we’ve shown that with the right tools, data, and partnerships, countries can lead integrated programs that deliver real results.

But recent shifts in global financing risk are slowing this momentum. As we head into UNGA, we urge donors to see financing for country-led NTD programs as an entry point for strengthening health systems and achieving sustainable elimination in Africa. We really urge them to continue supporting government-led efforts, rather than siloed initiatives, to transform lives across the continent.

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.

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