The ENVISION Impact: A story of USAID investment in Neglected Tropical Diseases

RTI | Int'l Dev
Apr 22 · 5 min read

By: Lisa Rotondo, Director, USAID’s ENVISION Project

Students in Indonesia are given a dosage of medicine to prevent lymphatic filariasis. Photo Credit: RTI International/ Muhammad Fadli.

More than one billion people are at-risk for painful diseases that hinder their potential and productivity.

Eight years ago, the United States dared to envision a world free from many of these diseases.

Today, that world is within reach.


As a group of parasitic and bacterial illnesses, neglected tropical diseases (NTDs) affect the world’s poorest and most vulnerable people. They often cause pain, disfigurement, and disability; but they are also preventable and often treatable with early detection.

In 2011, the United States Agency for International Development (USAID) launched ENVISION, a global flagship initiative to help endemic countries fight NTDs and tapped RTI International to lead the project.

It was a bold endeavor at the time. Yes, ENVISION would carry forward NTD-fighting work that the U.S. had started back in 2006. But it would also take a bigger leap: ENVISION would grow to support 19 countries in Africa, Asia, and Latin America and the Caribbean to not just fight NTDs, but to back country-driven goals to control or even eliminate them.

Since then, we haven’t looked back.

In partnership with national Ministries of Health and Education, ENVISION has strengthened national NTD programs, increased the reach of treatment to those that need it, and supported the tracking of progress.

Over the past eight years, we have told stories about many moments — big and seemingly small — in the global fight against NTDs. We’ve celebrated with Nepal, Cambodia, Laos, and Vietnam as they achieved elimination of lymphatic filariasis and/or trachoma. We also shared stories of individuals like Francis, Bijaya, Khady, Dorothy, and many more, whose lives and communities have been impacted by NTDs and the efforts to combat them.

As the project draws to a close, we’re launching a campaign to tell the story of ENVISION’s achievements since its debut in 2011. It’s the story of how…

·More than 1.4 billion NTD treatments have been delivered with ENVISION support.

· 43% of people who were at-risk for lymphatic filariasis (LF) — more than 230 million people — no longer have to worry about this disabling and disfiguring disease.

· 41% of people living in endemic areas — more than 86 million people — are no longer at-risk for trachoma, the world’s leading cause of preventable blindness.

· More than 6 million people are no longer at risk for onchocerciasis, also known as river blindness, and three ENVISION-supported countries — Mali, Nigeria, and Uganda — have districts that stopped treatment for the illness.

· More than 446 million NTD treatments have been provided to school-aged children — many of these to treat worm infections such as schistosomiasis and soil-transmitted helminths —

As a result of these impacts, many ENVISION-supported countries are on track to reach their control and elimination goals for NTDs within the next five years.

Truong Van Duc and his grandchildren in Ly Nhan district, Vietnam. Mr. Duc suffers from lymphedema caused by lymphatic filariasis, an NTD that was recently eliminated as a public health problem in Vietnam. Photo credit: RTI International/Nguyen Minh Duc

With results like these, we believe ENVISION has been part of one of the most underrated global development success stories of our time.

It’s a success story written by many authors:

· The endemic countries at the forefront of the global fight against NTDs, setting goals, crafting plans, and ensuring U.S. investment made the biggest impact possible

· The members of U.S Congress whose steadfast bipartisan leadership and support for foreign assistance and global health specifically, through USAID, made ENVISION a reality

· The pharmaceutical companies who donated more than 1 billion safe and effective treatments in what has been one of the largest public-private partnerships in USAID’s history

· The countless stakeholders also committed to the fight against NTDs, our many colleagues and friends in the NGO community, and the World Health Organization who set the standards

And, finally, we can’t forget the people and communities whose dedication has powered progress against NTDs. From public health officials, to teachers, to lab technicians and community volunteers, millions of people continue to contribute to the control and elimination of NTDs in their countries. In 2016 alone, ENVISION supported the training of nearly 1 million people to implement NTD programs.

Volunteer community drug distributors during a training in Cross River State, Nigeria. Photo credit: RTI International/Ruth McDowall


Beyond ENVISION’s past successes, the project’s legacy will reverberate far into the future.

ENVISION has helped strengthen national health systems and build platforms that can deploy NTD-fighting experience and tools more effectively and further than ever before. And the impact extends far beyond 19 countries; through ENVISION, USAID has made global NTD impact, reaching more than 81 countries with training and tools on best practices in implementing NTDs programs. The project also serves as a sort of ground truth for global NTD policy and guidance, facilitating programmatic learning and operational research that will impact far beyond our immediate footprint.

And although the project ends this year, USAID is continuing its commitment through the Act to End NTDs project. RTI will implement Act to End NTDs | East, continuing to provide global support for countries to cross the finish line of NTD control and elimination.

To reach these goals and maintain achievements well into the future, Act| East will increase its focus on cross-sectoral partnerships, health systems strengthening, and support to help governments increase ownership and domestic resources for NTDs.

ENVISION was an investment in accelerating progress against NTDs. Check.

Act to End NTDs | East is an investment in finishing the job so future generations grow up free from NTDs.

Children in Tanzania enjoy candy after having their eyes checked for trachoma, an NTD that can cause blindness. Photo Credit: RTI International/Shea Flynn

For more information on the impact of ENVISION, including results, lessons, stories, publications, photos, and more, please visit:

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RTI's #globaldev team applies science and knowledge to improve lives in developing countries around the world. An official @RTI_INTL feed.