Across Africa, progress against neglected tropical diseases (NTDs) depends on political commitment that translates into sustained fiscal spending. Nigeria’s state governments are leading in showing how this can be achieved with the next round of budget decisions providing an opportunity to build on this commitment for sustained progress.
Nigeria bears about 25% of the burden of NTDs – a group of 21 diseases that can cause disability, disfigurement and death – in Africa, affecting about 100 million people. This has created urgency for increased efforts towards ending NTDs.
Nigeria’s State Ministries of Health have been at the forefront of championing sustainable, domestic funding for NTDs in their budgets. In 2026, 23 states created dedicated budget lines for NTDs. Some States have also made remarkable progress in domestic funding for NTDs with Kano State committing an additional 100 million Naira (US$75,000) toward snakebite envenoming efforts. The Kano State House of Assembly has also indicated that it will coordinate closely with its State Ministry of Health to increase budgetary allocation for NTDs by at least 50% building on the progress made towards sustained financing for NTD control and elimination efforts in 2025 and 2026.
These commitments build on progress made in 2025, when 19 of the country’s 36 states established over $1 million in dedicated NTDs budget lines to support treatment campaigns, local government area coverage, logistics and surveillance, community mobilisation, among other critical response services. The dedicated budget lines are an important and necessary step towards stronger domestic ownership of NTD programmes, particularly as international development financing declines. It also reflects growing state-level leadership in planning and financing the NTD response.
By prioritising NTDs in their fiscal agenda, state governments in Nigeria are laying a foundation for sustainable country-led progress towards eliminating these diseases that are devastating communities. The challenge now is sustaining the momentum and political will for lasting progress, which is significant, beyond raising domestic financing. It demonstrates how state governments can collaboratively work with national governments and partners to address pressing public health challenges.
The state-led efforts are particularly critical to protect hard-won gains in NTD elimination. Sustained financing for NTD programmes will ensure continuity of ongoing interventions and enable states to tackle priority gaps in line with national plans. It will also maximise the impact of partner support through medicines, technical assistance and delivery.
Nigeria’s experience adds to a wider record of Africa’s leadership and commitment to tackling NTDs, which is delivering progress. By December 2025, 26 African nations had eliminated at least one NTD, with several eliminating multiple diseases, according to WHO data. African countries also helped advance the first ever resolution by the United Nations Human Rights Council that recognised NTDs as a public health and human rights issue.
Efforts against NTDs are a litmus test of the continent’s commitment to universal health coverage. Eliminating these diseases that disproportionately affect communities with the least access to healthcare and essential services represents a public health achievement and meaningful progress towards more equitable health systems. It will also improve the health and quality of life of the affected people.
Investing in NTD elimination makes a compelling economic case for governments with competing fiscal priorities. NTDs impact households’ health and weaken economic productivity. Elimination will enable adults to return to work thus boosting productivity. For Nigeria, achieving its 2030 NTD-elimination targets could translate into projected gains of approximately US$19 billion in increased productivity, according to a Deloitte analysis commissioned by the END Fund.
The benefits of NTD elimination go beyond productivity. By enabling affected children to return to school, learning outcomes improve. Reduced healthcare spending by those who require NTD interventions frees up households’ resources for other priorities, while improving their mental and physical health and reducing stigma. It also cuts the longer-term costs associated with preventable illness and disability.
All this is attainable if states protect the gains made and accelerate progress towards elimination. As state governments prepare their 2027 budgets, they must prioritise maintaining or increasing existing NTD budget lines; establishing dedicated budget lines in states that do not yet have them; and supporting timely release and effective use of allocated funds, while aligning state investment with national plans and available partner support. Additionally, sustaining dedicated budget lines for NTDs will unlock additional external investment in the national NTD programme from donors including the Reaching the Last Mile Fund (RLMF) and the World Bank.
Nigeria’s state governments have an opportunity to continue demonstrating leadership in delivering better health, stronger communities and greater economic opportunity. Together, they can make the country’s progress against NTDs a lasting national and continental legacy; while ensuring that no community is left behind on the path to elimination
This experience offers lessons for the rest of Africa: that political commitment must translate into sustained domestic investment and more diverse financing sources if the continent is to continue progressing towards NTD elimination. Beyond recognising the need, governments must commit resources, provide sustained leadership and coordinate action across all levels to make it a reality.
