Shrinking the map: Elimination of lymphatic filariasis in the Western Pacific
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A drawing from the late 12th century showing a woman with elephantiasis: “Byosoushi-emakimono” (Tokyo National Museum).
Overview Lymphatic filariasis, also known as elephantiasis, is a neglected tropical disease which causes disability and stigmatization among the most vulnerable populations in the world. It exists in 22 countries and areas in the WHO Western Pacific Region. The World Health Organization has a goal of eliminating lymphatic filariasis globally by 2020. In the Region, WHO has verified elimination in three countries. Based on current progress, ten more should be verified by 2016. Achieving this goal will contribute to poverty alleviation and protect future generations from this disfiguring disease.
Vietnamese children who will benefit from elimination of lymphatic filariasis.
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What is lymphatic filariasis? Lymphatic filariasis is a parasitic infection caused by worms that are transmitted to people by mosquitoes. Infection with these worms can cause: swelling of genitals, requiring surgery swelling of the limbs and breasts, requiring daily washing to prevent worsening of disease swollen limbs with thickened, hard, rough skin (elephantiasis), requiring life-long care.
A female Aedes aegypti mosquito, one of the LF vectors.
Lymphatic filariasis is acquired early in life, but severe disability develops years later and keeps adults from participating in economic and community activities. Timely treatment can prevent, halt, or even reverse disability.
A microfilarial worm in peripheral blood.
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Why is eliminating lymphatic filariasis feasible? The strategy to eliminate lymphatic filariasis has two pillars: Stopping transmission by giving all at-risk individuals medicines once a year for at least five years. Managing disease through teaching patients to care for themselves and providing surgery for those who need it. The strategy is low cost and effective: Medicines are safe and come with available donation packages. China and the Republic of Korea already eliminated lymphatic filariasis due to strong political commitment, dedicated national budgets and good community support. More than US$40 million has been saved in health-care costs through preventing infection and disease progression in the Region.
Mass drug administration for lymphatic filariasis in Viet Nam.
A nurse in Kiribati teaches a lymphoedema patient how to care for her leg.
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What is needed to shrink the map? Ten countries and areas are in the final stages of lymphatic filariasis elimination and need to collect information to verify that transmission has stopped. Approximately US$2 million over the next five years is needed to support these countries and areas. These countries and areas are: - American Samoa - Cambodia REPUBLIC OF KOREA CHINA
- Niue - Tonga - Vanuatu - Viet Nam - Wallis and Futuna - Palau or the Federated States of Micronesia or New Caledonia
- Cook Islands - Marshall Islands
LAO PDR CAMBODIA
VIET NAM PHILIPPINES BRUNEI DARUSSALAM MALAYSIA PALAU GUAM
NORTHERN MARIANA ISLANDS
MARSHALL ISLANDS
FEDERATED STATES OF MICRONESIA NAURU SOLOMON ISLANDS VANUATU
KIRIBATI TUVALU WALLIS AND FORTUNA SAMOA AMERICAN SAMOA NIUE COOK ISLANDS FRENCH POLYNESIA
PAPUA NEW GUINEA
AUSTRALIA
NEW CALEDONIA
FIJI
TONGA
NEW ZEALAND
Lymphatic filariasis eliminated Lymphatic filariasis awaiting verification Lymphatic filariasis on-going interventions
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Progress towards lymphatic filariasis elimination Unfinished business: Eliminating lymphatic filariasis ensures that future generations will be protected from infection and disabling disease. A small amount of resources will enable us to conclude this ‘unfinished’ business in the Region’s development agenda.
Future generations will be free from lymphatic filariasis infection and its stigmatization.
Photo credits: cover and on page 3: Dr Nguyen Phu Cuong; page 2: Yoshihito Otsuji; page 4: upper photo: James Gathany provided by Prof Frank Hadley Collins, lower photo: Dr Mae Melvin; page 5: upper photo: Viet Nam Ministry of Health; page 7: Brian Chu. All photos not credited were contributed by staff of the WHO Regional and Country offices.
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