The Ministry of Local Government has called on districts to include the prevention of neglected tropical diseases (NTDs) in their development plans and performance contracts.

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Bob Gakire, Permanent Secretary at the Ministry of Local Government, said districts should use existing planning systems to prevent NTD infections by addressing gaps in access to safe water and handwashing facilities, especially in communities living near wetlands.

He was speaking in Kigali on Thursday, August 13, during the annual high-level national stakeholders’ advocacy meeting on prevention and control of NTDs and WASH integration.

The call comes as Rwanda seeks to improve coordination between NTD programmes and water, sanitation and hygiene (WASH) interventions. The newly unveiled National NTD Strategic Plan 2026–2030 identifies weak coordination between the two areas as one of the challenges facing efforts to eliminate the diseases.

Gakire said NTD-related activities should be included in district development strategies, performance contracts and annual action plans rather than being treated as separate programmes.

"If we make this a bridge between district development strategies and other strategic documents we use as a government, and if we target these activities through performance contracts, we believe we can do this within the timelines available,” Gakire said.

The Ministry of Health and Rwanda Biomedical Centre (RBC) and partners are working to reduce bilharzia and intestinal worm infections to below 2 percent in Bugesera and Ruhango districts by 2027.

A 2023 assessment in Bugesera and Ruhango found that six in 10 households had never heard of bilharzia as a disease. This means that they did not know it existed and or how they could prevent it. In Ruhango, the figure was nearly seven in 10. The assessment also found that nearly nine in 10 households did not have facilities to wash their hands with soap and water.

Nooliet Kabanyana, Executive Director of the Rwanda NGOs Forum on HIV/AIDS and Health Promotion, said the findings highlight the need to address NTDs beyond medical treatment.

"NTD elimination cannot be achieved by one institution or one sector. It requires collective leadership, shared responsibilities, sustained investment and meaningful community participation,” she said.

Kabanyana added that NTD elimination requires more than medical interventions, with stronger integration of water, sanitation and hygiene, as well as better coordination across sectors.

Dr Brian Chirombo, WHO’s Country Representative to Rwanda, said districts with persistent bilharzia and soil-transmitted intestinal worm infections need targeted support.

"In Rwanda, districts with persistent bilharzia and intestinal worm infections need to be prioritised for WASH investments, school health interventions, community behaviour change, environmental management and primary healthcare support,” he said.

Chirombo noted that integration should involve planning and resource allocation, rather than being limited to meetings between sectors.

"Integration should not be limited to occasional coordination meetings. It should involve shared planning, shared data, identifying high-burden communities, appropriate resource allocation and joint accountability for results,” he said.

Gakire said existing community meetings, including Umuganda, could also be used to raise awareness about NTD prevention.

He said NTD prevention should also be considered when development activities are carried out, especially in wetlands where changes to the environment can affect disease transmission.

Dr Albert Tuyishime, Head of Department Institute of HIV/ AIDS, Disease Prevention and Control at RBC, said the country's decentralised health system provides an opportunity to expand NTD prevention through community health workers.

"We are well positioned to reach people and provide preventive services. If we use the community health workforce, we will make a difference, move faster and reach the targets we have,” he said.

Tuyishime said declining external funding is still a challenge for NTD programmes and urged stakeholders to make better use of the resources available.

"External financing is still declining, but I believe we can do more with the resources available without compromising our objectives,” he said.

The NTD strategy aims to increase domestic financing to at least 70 percent of the national programme budget by 2030.