Global donors at the 2023 Reaching the Last Mile Forum have pledged a collective more than AED2.6 billion (US$777.2 million) to help control, eliminate, and eradicate neglected tropical diseases (NTDs), to accelerate progress towards achieving the goals outlined in the World Health Organisation’s 2030 roadmap on NTDs.

Uniting efforts with NTD-endemic countries, donors answered the urgent call to step up the fight against NTDs in the face of climate change, and to work together to improve the lives of the 1.6 billion people worldwide affected by these devastating yet preventable diseases.

The pledging event was hosted by Reaching the Last Mile (RLM), the global health initiative driven by the philanthropy of President His Highness Sheikh Mohamed bin Zayed Al Nahyan, in partnership with the Bill Melinda Gates Foundation. The forum took place on the first ever Health Day during the United Nations Climate Change Conference (COP28).

H.H. Sheikh Abdullah bin Zayed Al Nahyan, Minister of Foreign Affairs, was joined by world leaders including Samia Suluhu Hassan, President of Tanzania; and Dr. Austin Demby, Minister of Health and Sanitation for Sierra Leone, in a demonstration of endemic country leadership against NTDs.

Bill Gates, Co-Chair of the Bill Melinda Gates Foundation, and H.H. Sheikh Theyab bin Mohamed Al Nahyan, Chairman of the Office of Development and Martyrs Families Affairs at the Presidential Court, which oversees Reaching the Last Mile, were also in attendance, alongside ministers and global health leaders.

Sheikh Abdullah bin Zayed stated, “The UAE is proud to host this pivotal conference and expresses gratitude to all those who have seized the opportunity to renew their commitment to end neglected tropical diseases. Today’s demonstration of global solidarity reflects a shared determination to deliver a better and more dignified future for all. Incredible progress over the last two decades has proved that a world free of NTDs is an achievable goal. We warmly thank governments, donors, and partners for standing with us as we strive to achieve it.”

Reaching the Last Mile joined with the Gates Foundation and global partners to announce a milestone expansion of the Reaching the Last Mile Fund (RLMF) from more than AED367 million to more than AED1.8 billion (US$100 million to US$500 million). The expansion will increase the reach of the fund from seven countries to 39 across Africa and Yemen, with the ambitious goal of eliminating two NTDs, lymphatic filariasis and onchocerciasis (river blindness), from the continent of Africa.

The funding builds on the pioneering success of the RLMF, which launched in 2017 as a 10-year, multi-donor fund, to establish a model for eliminating the two diseases in sub-Saharan Africa.

Sheikh Theyab bin Mohamed said, “Today we reaffirm our pledge to eliminate these diseases of poverty, and save and improve lives worldwide. Climate change is already affecting the patterns of infectious diseases and risking the tremendous gains countries have made to date.
“With endemic countries leading the way, the Reaching the Last Mile Fund represents a historic opportunity to free communities across Africa from the threat of two NTDs, and in partnership unlock the potential for a healthier world.”

Bill Gates, Co-chair of the Bill Melinda Gates Foundation, said, “Climate change is inextricably linked to poverty and diseases affecting millions. That is why funding for lifesaving healthcare is critical and why we’re joining global partners to build on the tremendous progress of the Reaching the Last Mile Fund to date, and accelerate the elimination of LF and river blindness across Africa and beyond.”

Reaching the Last Mile’s new more than AED367 million (US$100m) commitment, matching the Gates Foundation’s commitment, represents a five-fold increase over the contributions made, respectively, to the fund at its launch.

Further contributions from country and donor partners including Sierra Leone, the Carter Center, Sightsavers, the Children’s Investment Foundation Fund (CIFF), The Helmsley Charitable Trust, the END Fund, and Abu Dhabi National Insurance Company will see RLMF significantly broaden its scope, with the aim of ensuring over 350 million people no longer require treatment for these diseases by 2030.

Julius Maada Bio, President of Sierra Leone, said, “There is clarity of vision as well as growing demand and energy in Africa to see the continent free of NTDs. Political commitment has been sustained and energised through the Kigali Declaration, and through the Continental Framework and Common Africa Position on NTDs, which Sierra Leone is proud to have endorsed. That is why Sierra Leone is proud to pledge towards an Africa free of river blindness and lymphatic filariasis. Neglected tropical diseases cause suffering to millions, and we simply cannot afford to neglect them any longer.”

Samia Suluhu Hassan, President of Tanzania, said, “I am immensely proud to have been at the centre of the launch of this ambitious vision of an Africa free of river blindness and lymphatic filariasis. Tanzania commits to increase domestic contribution for combating NTDs but also counts on continued support from development partners in this endeavour.

“While gaps in global funding for NTDs remain, this initiative signifies a crucial step forward in enhancing the health and quality of life not just for Tanzanians, but for all who live on the African continent. Together, we can end these terrible diseases, forging a path to a healthier and brighter future for us all.”

Over five years the RLMF has provided over 100 million treatments, trained 1.3 million health workers, and established nine laboratories to support NTD surveillance and testing. The fund also played a critical role in interrupting the transmission of river blindness in Niger, an achievement once thought to be scientifically impossible in Africa, and has supported Senegal in nearing this milestone.

The wider pledging moment saw new, multimillion-dollar commitments made by organisations including the Anesvad Foundation, CIFF, USAID, Global Health EDCTP3, UBS Optimus Foundation, NALA Foundation, Evidence Action, Helen Keller Intl, and the Fred Hollows Foundation, in addition to the governments of Germany and Belgium.

These pledges will help close the funding gap needed to expedite progress towards the WHO roadmap targets which call for at least 100 countries to have eliminated at least one NTD by 2030, and to reduce by 90 per cent the number of people requiring treatment for NTDs.

To date, 50 countries have eliminated at least one NTD and 600 million people no longer require treatment. Cases of some diseases that have plagued communities for centuries, such as Guinea worm disease and sleeping sickness, are at an all-time low. However, climate change is affecting the reach and prevalence of infectious diseases like NTDs, threatening to erase elimination gains and stall future progress.

The commitments will help finance essential programmes and treatments, support new research and innovations, and strengthen frontline health systems and workforces, among other investments.

Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation, said, “In light of the pledges made today at the 2023 Reaching the Last Mile Forum, I would like to express my profound gratitude to the global community, especially the pivotal leadership role of the United Arab Emirates, led by His Highness Sheikh Mohamed bin Zayed Al Nahyan.

“This commitment is a significant stride towards eradicating, eliminating, and controlling NTDs, aligning seamlessly with the 2021- 2030 NTD road map. The collaborative efforts of countries and global donors exemplify an unwavering dedication to improving the lives of the 1.6 billion people affected by these diseases. This partnership, especially in the face of challenges posed by climate change, represents a beacon of hope and a testament to what can be achieved through united global action.”

The 2023 Reaching the Last Mile Forum convened more than 450 government ministers, global health and development experts, philanthropists, and civil society leaders to galvanise concrete commitments towards mitigating the effects of the climate crisis on human health.