**Abstract**

*Schistosomiasis* and other Neglected Tropical diseases (NTDs) affect about 2 billion people globally. Africa shares approximately 90% of the global burden of *schistosomiasis* disease. Despite, World Health Organization (WHO) effort to control the disease, it remains neglected in most African countries. Historically, *schistosomiasis* is as long as 4,000 years in Africa, but lack accurate data and commitment to combat the disease. Control programs exclude adults in Mass Drug Administration (MDAs), and water, sanitation, and hygiene (WASH) as Praziquantel drug is used for the treatment. However, migratory patterns of the neglected population and the interplay of social, economic, political, and cultural factors introduce the disease into previously eliminated or/and new areas. The question is would Africa be able to achieve the new goals of the WHO NTDs 2021–2030 Roadmap, for schistosomiasis elimination? The chapter argued for and against if Africa changes the current top-down approach to *schistosomiasis* control and incorporates a dynamic approach. Or if the previous pattern of late implementation, dependent on only one drug and shifting focus to other diseases of relevance continues. If a new approach is not adopted the dance in the cycle has just begun.

**Keywords:** Africa, control programme, neglected tropical disease (NTDs), *Praziquantel*, *Schistosomiasis*
