*

U.S. was big player in NTDs

*

Drugs expire in warehouses

*

Eliminated diseases could return

By Emma Batha

LONDON, Aug 21 (Thomson Reuters Foundation) - Millions

of drugs used to treat debilitating and disfiguring tropical

diseases risk going to waste after U.S. aid cuts stalled

treatment campaigns, leaving vital medication to expire in

warehouses.

Experts fear the funding crisis could sabotage hard-won

progress in the global fight against conditions such as river

blindness and intestinal worms that blight the world's poorest.

"This has been a major blow," said Albis Gabrielli, a

disease expert at the World Health Organization (WHO).

"It could lead to diseases resurging and derail progress in

countries close to eliminating them."

Since 2006, the United States has invested more than

$1.4 billion in tackling what are known as neglected tropical

diseases (NTDs), helping 14 countries end at least one disease.

But the programme was axed this year after President Donald

Trump slashed foreign aid.

In Africa alone, about 1.6 million medicines - mainly

tablets - have already expired, 8 million more are set to by

year-end, and another 90 million by May 2026, according to WHO

figures provided to the Thomson Reuters Foundation.

The WHO is working with African countries and health

partners to save drugs close to expiry, piggy-backing deliveries

onto other community health services such as vaccination drives.

There are 21 NTDs which affect more than a billion people in

Africa, Asia and Latin America.

They afflict the poorest communities, and the sickness and

disabilities they cause only deepen that poverty by leaving

people unable to work.

Experts estimate the global toll in terms of lost wages and

health expenses amounts to at least $33 billion annually.

"Investing in NTDs is not just treating diseases, it also

helps free communities from poverty," Gabrielli said.

USAID, the now defunct U.S. aid agency, targeted five of the

most common diseases: schistosomiasis, river blindness,

elephantiasis, trachoma and intestinal worms.

Trachoma, which can turn eyelashes inwards so they scrape

against the eye, is the leading infectious cause of blindness

worldwide.

Elephantiasis, a stigmatising condition that causes the legs

and genitalia to balloon, often leaves sufferers ostracised.

Many of the diseases are ancient.

Evidence of schistosomiasis has been found in Egyptian

mummies. The parasitic worms, which stunt growth and can lead to

bladder cancer, affect about 250 million people.

DRUG DONATIONS

Before its termination, USAID worked with 26 countries, most

in Africa, supporting the delivery of billions of drugs provided

for free by major pharmaceutical companies.

Every $1 invested by the United States leveraged $26 in

donated medicines, according to a USAID factsheet.

Most are used in "mass drug administrations" which treat

everyone in a given area, infected or not. The WHO said the U.S.

cuts had delayed 47 treatment campaigns.

The crisis has also cost jobs - in Sierra Leone alone,

30,000 community drug distributors have lost work.

Pharmaceutical companies are keeping a close watch.

Merck Group, which provides up to 250 million doses of

praziquantel a year to treat schistosomiasis, has already cut

production for 2026, although it remains ready to scale back up.

"We can't risk delivering drugs with a relatively short

shelf life into countries which don't have funding to deliver

them," said Johannes Waltz, head of Merck's schistosomiasis

elimination programme.

He said there had been "a lot of fire-fighting" to prevent

treatments going to waste, but there were still drugs sitting in

warehouses with no guarantee they could be distributed.

"These worms lay hundreds of eggs a day so even one missed

treatment could lead schistosomiasis to explode, wiping out

years of progress," he added.

DISEASES ELIMINATED

The cuts could undermine a WHO goal of 100 countries

eliminating at least one disease by 2030.

So far, 57 countries have reached that target, with some

ending three or four.

In January, Niger became the first country in Africa to be

declared free of river blindness, a disease causing intense

itching, disfiguring skin conditions and vision loss.

Other successes this year include the elimination of

sleeping sickness in Kenya and Guinea, and trachoma in Senegal,

Burundi, Mauritania and Papua New Guinea.

But Trump is not the only donor to turn away.

Britain ended its NTD programme in 2021, while recent

reductions in global aid have further squeezed funding.

Following the U.S. cuts, 50 African countries met in June to

hammer out plans to target the most pressing NTDs. A key goal is

to fold NTD treatments into domestic health services.

The Africa Centres for Disease Control and Prevention said

nearly $700 million was needed to tackle NTDs on the continent

over the next two years.

Drug treatments are only part of the picture.

Preventing diseases requires investment in water and

sanitation - another sector hit by aid cuts - and robust

monitoring to stop any resurgence.

Solomon Zewdu, CEO of the END Fund, a philanthropic

organisation focused on NTDs, warned the cuts could have

consequences down the line if surveillance is neglected.

Ridding Niger of river blindness has been hailed as a beacon

of hope - but the black fly that spreads it can travel 400 km

(250 miles) a day.

"Diseases don't understand borders," Zewdu said.

"The cuts could threaten the long-term success of the wins

we've had, if we take our eye off the ball."

(Reporting by Emma Batha; Editing by Lyndsay Griffiths. The

Thomson Reuters Foundation is the charitable arm of Thomson

Reuters. Visit https://www.context.news/)