Lymphatic Filariasis (Elephantiasis)

Sub-Saharan Africa (SSA) carries nearly one-third of the global burden of lymphatic filariasis (LF), a vector-borne and debilitating disease that afflicts the poorest population. Wuchereria bancrofti is the only species responsible for the disease and is mainly transmitted to humans by mosquito species belonging to Anopheles and Culex. The disease is estimated to be transmitted in 35 out of the 48 South Saharan countries with an estimated at-risk population of 432 million people. Recognizing the burden of the disease and the availability of new tools, the World Health Assembly took in 1997 the resolution WHA 50.29 calling for the elimination of LF as a public health problem. The subsequent Global Programme to Eliminate Lymphatic Filariasis was set up with the aim of eliminating the disease by 2020. Although after two decades of program implementation in SSA the initial goal has not been attained, great progress has been made. Indeed two countries (Malawi and Togo) are validated by the world Health Organization (WHO) to have achieved the elimination of LF as a public health problem; two countries (Mali and Uganda) are under post-treatment and the treatment is scaled-up in all implementation units in 23 countries. In 2019, nearly 30% of the 1736 implementation units covering 155 million people completed transmission assessment surveys (TAS) and have stopped mass treatment. The morbidity alleviation, now fully part of the validation process, is getting more attention from the country programmes and their partners.

The goal set for LF in the new WHO 2021–2030 NTD road map is that by 2030, all countries would be either validated or entirely under post treatment surveillance. If commitment is maintained at all levels, this goal is achievable as opportunities and alternative treatments including albendazole alone in Loa loa endemic countries and triple therapy in countries where there is no onchocerciasis, are available to accelerate LF elimination in endemic countries.