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PLOS BLOGS Speaking of Medicine

Eliminating Lymphatic Filariasis in Cameroon

PLOS NTDs Editors-in-Chief Peter Hotez and Serap Aksoy discuss new research and the global effort towards eliminating lymphatic filariasis.

One of the most significant, yet often unheralded, accomplishments from the 2000-2015 Millennium Development Goals (MDGs) and now continuing through the Sustainable Development Goals (SDGs) has been progress towards the elimination of lymphatic filariasis (LF).  LF is a horrific and disfiguring illness that affects approximately 40 million people in the poorest countries of South Asia (e.g., India), Southeast Asia (e.g., Indonesia), Africa, and Haiti in the Americas.

Coinciding with the launch of the MDGs and through a 1997 World Health Assembly resolution (WHA 50.29), the World Health Organization (WHO) created the Global Programme to Eliminate LF (GPELF) in 2000.  Together with a Global Alliance to Eliminate LF (GAELF) for advocacy and technical support, the organizations shaped a two-decade-long vision and goal for mass drug administration (MDA) to stop transmission, while promoting morbidity control efforts directed at lymphedema, hydrocele, and elephantiasis.  These activities were accelerated beginning 2005-06 through integration with other neglected tropical diseases (NTDs) and expanded financial support from USAID and DFID, and then again in 2012 through a London Declaration for NTDs.  Drug donations from Merck & Co (Ivermectin), Eisai (DEC), and GSK (albendazole) were central to these successes.

Today GPELF may represent one of WHO’s most successful programs ever, and one of the true success stories of the MDGs.  According to the Global Burden of Disease Study 2015, between 2005 and 2015 there has been a 63.5 percent reduction in the age-specific prevalence of detectable microfilaremia due to LF.  This week in PLOS NTDs, scientists from Cameroon, together with the ENVISION partnership (and with support from USAID), report on progress towards LF elimination, with the first evidence of LF transmission interruption in Cameroon. National MDA for LF was implemented almost a decade ago in Cameroon, and the PLOS NTDs paper reports that in three evaluation units located in northern Cameroon where LF is endemic, the prevalence was found to be below the threshold at which “transmission is likely no longer sustainable”.

According to the WHO, so far China and South Korea have eliminated LF as public health problems, while 18 of 73 nations (where LF is endemic) have completed their MDA interventions.  These nations are now conducting surveillance activities to confirm that they too have achieved elimination targets.   In so doing we hope that Cameroon’s success story will be replicated in the coming years!

 

Discussion
  1. I am not sure that Cameroon was really endemic for LF as such. It would be better to say that Cameroon does not have LF than saying LF has been eliminated from Cameroon. the cross reactivity between ICT and L. loa was very misleading at the beginning of the programme. we have enough scientific evidence today to proof that the LF map of Cameroon was false because of the non differentiation between L .oa and LF by ICT. The Alere FTS worsening the situation in the L. loa endemic areas

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