What are the health needs and challenges?

Lymphatic filariasis (LF), or elephantiasis as it is commonly known, is a mosquito-spread infectious disease that affects 120 million people in more than 50 countries worldwide. Another 856 million people are at risk of infection.

Found in the tropical and sub-tropical areas of Africa, Asia, the Pacific, the Middle East and the Americas, LF is one of the world’s leading causes of disability. It is characterised by severe swelling of the legs and arms and skin infections, and many people affected are unable to work and therefore forced into a life of poverty.

Partnership activities and how they address needs and challenges

The World Health Assembly passed resolution 50:29 in 1997 calling on Member States, working with other partners, to take advantage of the simplified and highly effective strategies to eliminate the disease. In support of this goal, the Global Alliance to Eliminate Lymphatic Filariasis (GAELF) was created to foster partnership together with the WHO in order to support the Global Programme in bringing together ministries, implementing organisations, academia and research organisations to coordinate these efforts.

Mass Drug Administration (MDA)

Elimination of LF is possible by stopping the spread of the infection through preventive chemotherapy. The WHO recommended preventive chemotherapy strategy for LF elimination is mass drug administration of albendazole (donated by GSK), MECTIZAN (donated by MSD), and DEC (donated by Eisai).

WHO recommends the following MDA regimens:

• albendazole (400 mg) alone twice per year for areas co-endemic with loiasis
• ivermectin (200 mcg/kg) with albendazole (400 mg) in countries co-endemic with onchocerciasis
• diethylcarbamazine citrate (DEC) (6 mg/kg) and albendazole (400 mg) in countries without onchocerciasis

Following recent evidence that indicates that the combination of all three medicines can safely clear almost all microfilariae from the blood of infected people in a shorter duration, WHO in 2017 recommended the following MDA regimen, called the IDA regimen, in countries without onchocerciasis:

• ivermectin (200 mcg/kg) together with diethylcarbamazine citrate (DEC) (6 mg/kg) and albendazole (400 mg) in certain settings.