Although the treatments for human African trypanosomiasis (HAT), leishmaniasis and Chagas disease (CD) still rely on drugs developed several decades ago, there has been significant progress in the identification, development and use of novel drugs and formulations. Notably, there are now two drugs in clinical trial for HAT, fexinidazole and acoziborole; the liposomal amphotericin B formulation AmBisome has become an essential tool for both treatment and control of visceral leishmaniasis; and antifungal triazoles, posoconazole and ravuconazole, together with fexinidazole, have reached clinical trials for CD. Several other novel and diverse candidates are moving through the pipeline; sustained funding for their clinical development will now be the key to bring new safe, oral, shorter-course treatments to the clinic.

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