Reaching the Last Mile Fund

The Reaching the Last Mile Fund (RLMF) is a global coalition of countries, donors and partners uniting to accelerate progress towards eliminating onchocerciasis and lymphatic filariasis in Africa.

Since its launch, RLMF has supported national neglected tropical disease (NTD) programmes to scale up treatment, conduct essential surveys, strengthen surveillance systems and build the capacity of the health system needed to make lasting progress in the fight against NTDs.

The fund is supported by Gates Foundation, the Mohammed Bin Zayed Foundation for Humanity, Children’s Investment Fund Foundation, the UK’s Foreign, Commonwealth and Development Office and other philanthropic partners.

What is Sightsavers’ role?

Sightsavers is one of three coordinating partners for the RLMF. We’re working in partnership with governments, communities, technical partners, civil society and funders to deliver high-quality elimination activities in some of the most hard-to-reach settings.

As part of the RLMF, the UK’s Foreign, Commonwealth and Development Office has supported our work in 12 African countries through the Eliminating Lymphatic Filariasis in Africa (ELFA) programme. ELFA has a systems-strengthening approach and helps to build countries’ capacity to deliver care for patients with lymphatic filariasis, including hydrocele and lymphoedema.

RLMF is built on the principle that elimination can only succeed when communities lead. Sightsavers is working with local volunteers, health workers and residents to drive the programme’s success, from planning and treatment delivery to monitoring and advocacy, and ensuring sustainability post elimination.

Where do we work?

Under the RLMF umbrella, Sightsavers supports work in Benin, Burkina Faso, Cameroon, Republic of Congo, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mozambique, Nigeria, Sierra Leone, Uganda, Togo and Zambia.

Each country faces unique challenges from conflict-affected regions and mobile populations to remote riverine communities. RLMF focuses on reaching everyone as progress accelerates towards eliminating the two NTDs.

What are the main aims of RLMF?

• Delivering high-quality mass drug administration in endemic areas
• Reaching communities in remote or insecure areas where coverage is typically low
• Supporting essential surveys to provide quality data for programme decision-making and measuring progress towards elimination milestones
• Improving capacity in national health systems to deliver quality care for those affected by the two NTDs
• Strengthening government leadership and national NTD programmes
• Supporting countries to meet World Health Organization (WHO) thresholds for stopping treatment and achieving validation of elimination

Our impact so far

Through RLMF support, millions of people continue to receive the treatments they need to protect them from the two diseases. In 2024, Sightsavers helped to deliver 22.6 million  treatments for lymphatic filariasis and 28.1 million treatments for onchocerciasis.

In 2025, with some mass drug administration data still pending validation, Sightsavers has already delivered 6.1 million treatments for lymphatic filariasis and 31.3 million treatments for onchocerciasis.

Note: The figures for onchocerciasis include the contribution of our partner The Carter Center in Nigeria.

Elimination: the ultimate goal

The RLMF aims to help countries eliminate the two NTDs as public health problems. This means:

• Minimal transmission below WHO-defined thresholds
• Health systems are supported to deliver NTD-related services
• Communities are freed from disability, stigma and poverty associated with the diseases
• Long-term resilience against NTD resurgence

RLMF’s investment in the ‘last mile’ of NTD elimination is critical: these final steps are often the hardest, but they create lasting health gains for generations.