Nineteen countries have been able to eliminate the disease, according to WHO
A filariasis patient. Photo: iStock Lao People’s Democratic Republic has eliminated lymphatic filariasis (LF), a disease that cripples and has significant social and economic impact on the affected communities according to the World Health Organization (WHO).
This is the country’s second neglected tropical disease (NTD) to be eliminated in six years, following the elimination of trachoma as a public health hazard in 2017.
The WHO attributed the success to decades of hard effort by the Lao government, health-care workers, communities, and national and international partners.
Lao PDR is now the second country after Bangladesh to eliminate lymphatic filariasis (LF) in 2023. Nineteen countries have been able to eliminate LF, according to the WHO progress report on the disease released on October 13, 2023.
Of the 19 countries, 11 belong to the WHO Western Pacific Region (WPR). Lao PDR is 11th country in the WPR region to successfully eliminate LF.
Four countries in the WHO South-East Asia region have also eliminated LF: Bangladesh, the Maldives, Sri Lanka and Thailand.
In WHO Africa region, two countries -- Malawi and Togo – have eliminated the disease. The disease has been eliminated in the WHO Eastern Mediterranean’s Yemen too, according to the progress report on LF included in the WHO Weekly epidemiological report.
The most cost-effective method for treating all affected residents of LF-endemic areas and stopping future transmission is mass drug administration (MDA).
WHO recommends the triple therapy combination of ivermectin (I), diethylcarbamazine (D) and albendazole (A), for MDA against LF. Multiple rounds of MDA, covering over 65 per cent of the population, are required.
Over the last 15 years, the global population requiring LF interventions has decreased by 53 per cent. According to WHO, this is due to concerted efforts by governments and partners under the Global Programme to Eliminate Lymphatic Filariasis launched in 2000.
LF, also known as elephantiasis, is a preventable mosquito-borne infectious disease targeted for global elimination as a public health problem. It occurs when one of the filarial parasites — Wuchereria bancrofti, Brugia malayi and B. timori — are transmitted to humans through mosquito bites.
The parasites nest in the lymph vessels, damaging them. This leads to hydrocele, lymphedema, and elephantiasis.
More than 935.5 million individuals in 72 LF-endemic countries have received more than 9.3 billion cumulative treatments since 2000 because of MDA.
According to the WHO report, 10 countries stopped MDA nationally, which means these are on the right track to eliminating LF. These include -- Benin, Cameroon, Eritrea, Mali, Sao Tome and Principe, Uganda, Brazil, Dominican Republic, Timor-Leste and Brunei Darussalam. But these countries are yet to meet the criteria for validation.
Kenya too is progressing in its efforts towards eliminating LF and may no longer need MDA, said WHO in its report.
The Road Map for NTDs 2021-2030 had a target to eliminate LF from 23 countries by 2023.
Some 794 million people required MDA for the treatment of LF globally in 2022. More than half of those in need of MDA during the year were from India. However, just 152.2 million people, or about 34 per cent, were reported to have received treatment in the country, according to a WHO report. According to WHO, Gabon in Africa has not yet begun MDA.
Only 326 million people or 41 per cent of the 794 million people who needed MDA in 2022, were treated globally.
The elimination of NTDs by 2030 is one of the primary objectives of the United Nations-mandated global sustainable development goal of “health for all” (SDG 3).
“The elimination of LF in the Lao People’s Democratic Republic is an outstanding accomplishment, one that sets an example for many countries,” said Ibrahima Socé Fall, director, WHO Global NTD Programme.
“This is a victory not just for Lao people, but for the world. Together, we are moving closer to a world free of NTDs,” Fall added.
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