Abstract
INTRODUCTION: Mass drug administration (MDA) has reached up to 1 billion people annually to combat neglected tropical diseases (NTDs). This study explores the evolving NTD landscape in Africa amid shifting disease patterns, funding cuts, and universal health coverage goals. METHODS: We analyzed data from ESPEN and Sightsavers databases to assess historical trends and forecast future treatment needs. RESULTS: By 2027, few or no MDAs for lymphatic filariasis and trachoma will be required and MDAs for onchocerciasis dropped sharply after 2024. In contrast, schistosomiasis and soil-transmitted helminths continue to require widespread MDA. CONCLUSION: To secure elimination gains, remaining MDAs must be completed and broader health systems approaches adopted.