Health officials in central Cameroon and other parts of sub-Saharan Africa warn that neglected tropical diseases, long pushed toward elimination, may rebound after key U.S. aid was cut in 2025. On Feb. 3, 2026, clinicians in rural districts reported interruption of mass-drug distribution that had nearly stopped illnesses such as onchocerciasis, or river blindness. Local health leaders say the halt in funding stopped planned deliveries of preventive medicines and surveillance, raising the risk of renewed transmission. The pause has immediate consequences for communities that had been on track to achieve official disease-free status.
Key Takeaways
- Onchocerciasis (river blindness) is among 21 diseases classified by WHO as neglected tropical diseases (NTDs); WHO estimates they affect more than 1 billion people globally.
- Adult onchocerciasis worms can live up to 15 years, sustaining infection cycles unless mass treatment is maintained.
- U.S. funding cuts in 2025 interrupted drug-distribution programs in multiple countries, including community-based campaigns in parts of Cameroon.
- Programs had brought some districts close to formal WHO declaration of elimination; officials now report stalled fieldwork and gaps in surveillance.
- NTDs are rarely fatal but cause chronic disability, blindness, disfigurement and economic loss among the poorest populations.
- Health workers warn that even a short interruption in mass treatment can allow parasite transmission to rebound within a few years in high-risk riverine areas.
- Restoring supply chains, surveillance, and community outreach will require renewed funding and coordination between national programs, WHO and donors.
Background
Neglected tropical diseases are a group of largely preventable and treatable infections concentrated among people with limited access to health care and sanitation. WHO lists 21 conditions as NTDs; together they impose a heavy burden of disability rather than high mortality, and they have historically received less research and donor attention than higher-profile diseases. Mass-drug-administration campaigns, vector control and targeted surveillance have been the core tools that pushed several NTDs toward elimination in pockets of Africa and elsewhere.
Onchocerciasis, transmitted by black flies that breed in fast-flowing rivers, has been a particular target of long-running campaigns supplying ivermectin and organizing regular distribution to at-risk communities. Because the parasite can persist for many years in people and produce millions of larvae, sustained annual or biannual treatment is required to interrupt transmission. In recent decades, international partnerships — including bilateral U.S. aid — financed drugs, logistics and community health workers who delivered those programs in remote areas.
Main Event
Field teams in central Cameroon report that activities funded by U.S. assistance were halted after funds were sharply reduced in 2025. Local district health chiefs say that scheduled community-drug distributions were postponed and monitoring visits cancelled, leaving gaps in both treatment coverage and laboratory surveillance. In several villages along rivers, residents who once received annual ivermectin treatments say they have not seen health teams for months.
Officials describe practical consequences: drug stockpiles were not replenished, outreach campaigns were scaled back, and health workers were reassigned or left without stipends. Those operational failures, they say, mean fewer people are being treated, and fewer infection surveys are being conducted to confirm whether elimination thresholds have been reached. In some districts, formal steps toward being declared free of onchocerciasis were delayed because required data could not be collected.
Public-health staff emphasize that the biology of these parasites makes interruptions consequential. If community coverage falls below target levels, transmission can resume and the gains of prior years can be lost. Local clinics also report a rise in patient complaints consistent with ongoing transmission, including severe itching and eye problems, though confirmatory testing remains uneven.
Analysis & Implications
The reported program interruptions illustrate how dependent many NTD-elimination efforts are on steady external financing and logistics. When donor support shifts, national programs often struggle to fill the gap quickly because domestic budgets are limited and procurement chains for donated medicines are complex. This fragility means political or fiscal changes in donor countries can produce outsized effects on health outcomes in recipient communities.
Economically, resurgent NTD transmission would impose direct health costs and longer-term losses in productivity and education. Disability from diseases like onchocerciasis reduces earning potential and increases caregiving burdens. The populations most affected are already among the poorest, so setbacks would worsen health inequities and could slow broader development gains in affected regions.
Regionally, a patchwork of interrupted programs can undermine cross-border elimination goals. Flows of people and vectors across national frontiers mean that success in one district requires coordination at larger geographic scales. International bodies such as WHO typically set verification criteria that rely on continuous surveillance data; gaps in that data complicate certification and may delay access to long-term funding tied to validated elimination.
Comparison & Data
| Indicator | Reported Value / Fact |
|---|---|
| WHO-listed NTDs | 21 diseases (WHO) |
| People affected | More than 1 billion globally (WHO) |
| Onchocerciasis adult worm lifespan | Up to 15 years |
| Key funding disruption | U.S. aid reductions in 2025 halted some programs |
These baseline facts show why consistent, multi-year interventions are required: long parasite lifespans and large populations at risk mean that even temporary funding gaps can have prolonged effects. The table draws on WHO classifications and on local reporting about program interruptions following the 2025 aid changes.
Reactions & Quotes
Local and international actors responded quickly to reports of service disruption; public statements and field remarks underscore both alarm and calls for rapid remedial action.
“We were within reach of declaring our district free, and then our delivery chain stopped; people are rightly afraid of what that means,”
Dr. Vivien Sil Mabouang, district head of health services, Cameroon
District officials used this statement to summarize field observations about missed distributions and stalled verification steps; it reflects local urgency to restore programs so historical progress is not reversed.
“Cuts to support risk reversing decades of coordinated public-health gains against NTDs unless replacement funding and operational plans are put in place,”
World Health Organization representative
The WHO comment emphasizes the need for international coordination and sustained surveillance to secure elimination achievements and meet verification criteria.
Unconfirmed
- Exact magnitude of post-2025 resurgence: field reports indicate increased symptoms locally, but comprehensive, multi-district prevalence data confirming a sustained rise are not yet published.
- Precise breakdown of U.S. funding decisions and which bilateral or NGO channels were closed remains incomplete in public records; detailed budget figures have not been released by all agencies.
- The timeline for restoring treatment coverage and the availability of replacement donors or domestic budget allocations is not finalized and varies by country.
Bottom Line
Short-term interruptions to NTD programs can yield long-term consequences because parasites and vectors can sustain transmission for years without consistent mass treatment. The 2025 reductions in U.S. support reported by field teams in Cameroon and elsewhere have created operational gaps that put recent gains at risk and complicate the verification process for elimination.
Preventing a meaningful resurgence will require swift action: reestablishing drug supply chains, funding community distribution and rebuilding surveillance systems. Policymakers and donors should weigh the relatively low per-person cost of NTD control against the high human and economic costs of disability if these diseases regain ground.
Sources
- The New York Times (news report)
- World Health Organization — NTDs (official WHO program page)
- World Health Organization — Onchocerciasis (technical factsheet)
- U.S. Agency for International Development — NTDs (official donor program overview)