TANZANIA has accelerated domestic financing and district-led delivery for Neglected Tropical Diseases (NTDs) following an abrupt withdrawal of external funding in early 2025.

As a result, 130 councils are now running their own Mass Drug Administration (MDA) campaigns, with a national push underway to raise council-level domestic financing to 80 percent by 2026, according to the country’s NTD Programme Manager, Dr Clarer Jones Mwansasu.

Speaking in an interview on the reforms, Dr Mwansasu said the funding disruption became a turning point that strengthened government ownership, improved accountability, and increased local responsibility across the health system.

“The abrupt change in the NTD funding landscape was a wake-up call. It showed how powerful domestic efforts can be, especially in difficult moments,” she said.

Dr Mwansasu explained that the government’s response built on earlier fiscal reforms that had already expanded national resources for NTDs.

 Tanzania increased its NTD budget from TSh 1.8 billion in 2021 to TSh 16.9 billion by 2024, while domestic financing rose from 25 percent to more than 60 percent in 2025.

She said the expectation is that many councils will further strengthen their own allocations in 2026, continuing the upward trend seen over recent years.

The funding shift came at a sensitive moment, with more than 17 million people at risk of NTDs nationwide. This includes approximately 10 million children at risk of schistosomiasis and soil-transmitted helminths, making continuity of preventive and treatment interventions a public health priority.

According to Dr Mwansasu, the reforms were reinforced by deliberate political and fiscal prioritisation, including faster steps toward full government ownership of NTD programmes and measures to institutionalise NTD financing and delivery within routine health planning.

Key decisions included integrating NTDs into the Health Sector Strategic Policy Priorities for 2025/26, incorporating NTD medicines—such as praziquantel and albendazole—into the Universal Health Insurance Package, and decentralising financing and delivery responsibilities to all 184 district councils. 

She said decentralisation shifted budgeting and service delivery closer to affected communities, enabling councils to plan, implement, and account for interventions locally.

This approach supported 130 councils to successfully carry out MDAs for schistosomiasis and soil-transmitted helminthiasis in 2024.

“We are moving away from ‘blanket treatment’ to what we call ‘Smarter Spending’. We aren’t just treating administrative districts anymore; we are mapping the actual ecological limits of disease. For schistosomiasis, we are treating at ward level to target high-risk communities,” she said. 

Performance and financing gaps are now tracked through tools such as the NTD Scorecard, while DHIS2 has made NTD data more visible and usable for planning, budgeting, and identifying gaps.

 Dr Mwansasu also highlighted efficiency gains from integrating campaigns, noting that in 2025, combining deworming with Vitamin A distribution reduced costs and saved staff time.

 Using teachers as distributors in school-based campaigns has also improved coverage and strengthened community trust.

She applauded domestic drug donation programmes, describing them as the backbone of Tanzania’s Preventive Chemotherapy strategy, which has reduced the population requiring treatment by 76 percent between 2021 and 2025.

However, she cautioned that any decline in domestic financing could threaten sustainability following donor withdrawal, as the elimination framework now relies on co-financing under a devolved ownership and delivery model.

Dr Mwansasu said Tanzania is increasingly being positioned as a practical example for other African countries navigating donor transitions, demonstrating how strong political will, decentralised systems, and data-driven accountability can transform a funding shock into long-term health sector reform.

Neglected tropical diseases are a diverse group of conditions caused by a range of pathogens and toxins, often associated with long-term disability and significant social and economic loss if left untreated.

They remain most prevalent among poorer communities in tropical settings. In Tanzania, diseases such as schistosomiasis, soil-transmitted helminths, lymphatic filariasis, onchocerciasis, and trachoma remain endemic in various areas, alongside several zoonotic diseases, with many communities facing overlapping risks.