FOREWORD

2024 will be remembered as a year of geopolitical turbulence that also saw the beginnings of drastic cuts to global health programmes and assaults on international health cooperation. Millions of the world’s poorest and most marginalized people are losing access to life-saving health tools and services. The fundamental values that underpin DNDi’s action for neglected patients – collaboration, scientific integrity, and equity – are themselves under attack. We stand firmly with our allies working to resist these alarming threats and stand ready to work with countries confronting urgent new challenges with bolstered leadership and conviction.

Solidarity in science unites our teams and partners and propels our progress. Amidst great worry and uncertainty, we are proud to share highlights of our impact.

In 2024, Guinea achieved the elimination of sleeping sickness as a public health threat – proving that scientific innovation and collaboration can deliver transformative impact. The country has also played an essential role in DNDi’s Phase II/III studies of acoziborole, a promising single-dose cure for the disease in development with Sanofi and partners that can be administered at the point of care. We are nearing completion of clinical trials for the new drug and are very hopeful that the simplified ‘test-and-treat’ strategies it can enable will play a decisive role in saving lives and boosting and sustaining elimination efforts across endemic countries.

In a major milestone with real potential to ensure global readiness and equity in future health crises, WHO Member States adopted the Pandemic Agreement in May 2025. DNDi engaged in extensive consultation with Member States over more than three years of negotiations, advocating especially for provisions that compel countries to tie public funding for medical R&D to guarantees of timely and equitable access to resulting health tools. Article 9.5 of the agreement makes it the first international health accord that requires countries to develop national and regional policies to do so.

We are also making encouraging progress confronting the growing threat of dengue. Fuelled by warmer temperatures and urbanization, 2024 was dengue’s deadliest year on record, with cases roughly doubling year on year since 2021. Half the world’s population is now at risk of the debilitating and potentially deadly mosquito-borne disease. Yet, there is no specific treatment that can prevent the development of life-threatening complications and no diagnostic tool to monitor disease progression. Collaborating with leading research institutes in countries hit hardest by the disease, we continue work on multiple fronts with the Dengue Alliance and our science and industry partners – advancing host-directed therapies in pre-clinical testing, researching biomarkers that can predict disease progression, accelerating clinical development of a promising new monoclonal antibody treatment, and conducting much-needed research on the burden of dengue in Africa.

National leadership and resolve against another climate-sensitive disease – visceral leishmaniasis (VL) – is also growing. We have worked to transform the treatment landscape for leishmaniasis from our earliest days, delivering safer, simpler treatments with existing drugs that have saved lives and bolstered elimination efforts in South Asia. In Eastern Africa, now home to over 70% of the global burden of VL, DNDi was proud to join WHO and partners in 2024 to help shape a landmark regional framework aimed at VL elimination – reaffirmed by six Eastern African countries in a May 2025 Memorandum of Understanding.

Looking to deliver longer-term, game-changing impact, we are also focused on getting all-new, all-oral treatments to the R&D finishing line that can remove the need for hospitalization far from patients’ homes and help suppress new outbreaks to achieve and sustain elimination. LXE408, our promising front-runner in development with Novartis, is advancing in Phase II trials in Ethiopia and India that we hope to complete by late 2025.

At the mid-point of our 2021-2028 strategic plan, 2024 was also a moment for our teams to take stock of our progress and examine the factors that will sustain DNDi’s impact for neglected patients in the years to come. Our reflection culminated in our revised theory of change, which sets out the activities that anchor and enable our influence in delivering new treatments tailored to patient and health system needs. It reaffirms our commitment to centre patients and communities in our decision-making at every stage of the R&D process – and reinforces our drive to draw lessons from our experience to push for public leadership and accountability for equitable and inclusive R&D.

Today’s formidable headwinds require us to redouble our resolve – hand in hand with the communities we serve and the health systems they rely on. Our commitment to the transformational power of medical innovation will not waver.

We thank our partners, supporters, and staff for your solidarity in science for the most neglected.