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Taking advantage of growing global momentum on neglected tropical diseases (NTDs), Sierra Leone has established an integrated programme that has treated over five million of the country’s estimated six million people each year for the past four years – a programme that has reduced prevalence for the four targeted NTDs dramatically. In spite of the brutal, decade-long civil war that ended in 2002, which caused extensive destruction to infrastructure and resources, the post-conflict country is now one of West Africa’s leading performers on the control of NTDs and, in 2014, is expected to move its focus from control to elimination. Five drivers of progress explain this:

• a pioneering history of efforts to control NTDs
• an integrated approach to NTD control, delivered via a post-conflict reconstructed and scaled-up health sector
• government commitment, external funding and strong partnerships
• a bottom-up approach that has resulted in community ownership
• a broader context of progress leading to improved and scaled-up delivery.

Sierra Leone has demonstrated that NTDs can be controlled and potentially eliminated even by countries with limited resources and very fragile health system infrastructures. It provides a workable model for an integrated approach to tackling NTDs and offers lessons for many of the world’s other low-income countries – every one of which faces endemic NTDs that blight their prospects for development. This is good news for the 17 African countries that are yet to start mass drug administration, and this case study recounts a story of real hope in development progress.