Lymphatic filariasis

Global Progress Towards Elimination

NTD Roadmap Target: Global Elimination as a Public Health Problem by 2020


Validation

A framework for the control, elimination and eradication of neglected tropical diseases (NTDs) has been developed which outlines a standardized process for reviewing and confirming the achievement of NTD roadmap targets. A process of validation will be used for formal confirmation of elimination as a public health problem. Countries wishing to be recognized for their success can make a request to WHO for such acknowledgement with adequate evidence that elimination targets have been achieved. The minimal information necessary for a dossier includes: (i) a description and supporting data of classification of endemicity for each implementation unit (IU); (ii) results of mass drug administration (MDA) and other interventions implemented; (iii) monitoring data on the interventions; (iv) epidemiological data from sentinel and spot-check sites; (v) results from Transmission Assessment Survey (TAS) prior to stopping MDA and subsequent TAS during post-MDA surveillance; (vi) data supporting availability and provision of the basic recommended package of care for lymphatic filariasis patients.

Milestones towards validation

  • Stop the spread of infection through mass drug administration

    • Implement MDA in all endemic areas (100% geographical coverage)

    • Reduce infection below a threshold at which transmission is not sustainable in all endemic areas and stop MDA

    • Demonstrate sustained reduction of infection below the threshold no earlier than 4 years after stopping MDA
  • Alleviate suffering by managing morbidity and preventing disability (MMDP)

    • Define burden of disease (estimates of the number of patients)

    • Recommended minimum package of care available in all areas of known patients (100% geographical coverage)

Progress

China and the Republic of Korea were declared to have eliminated lymphatic filariasis as a public health problem in 2007 and 2008, respectively. Of 73 countries listed by WHO as being endemic for lymphatic filariasis, 18 countries have completed interventions and are conducting surveillance to validate elimination. An additional 22 countries had delivered MDA in all endemic areas and are also on track to achieve elimination. The remaining 33 countries have not been able to achieve 100% geographical coverage; 10 of these have yet to initiate preventive chemotherapy or submit evidence that MDA is not required.

Mass treatment is ongoing in 45 countries. Ten countries have not started treatment or submitted evidence indicating treatment is not required.