Progress in the elimination of lymphatic filariasis in the Western Pacific Region: successes and challenges

Abstract

The Western Pacific Region is the largest and most diverse region in the world, made up of 37 countries and territories in the Pacific, Oceania and parts of Asia, with a population of more than 1.9 billion people stretching over an area from China and Mongolia in the north to New Zealand in the south. In 1999, 22 countries and territories in the Pacific joined together and launched the Pacific Programme to Eliminate Lymphatic Filariasis. Shortly after, the Global Programme to Eliminate Lymphatic Filariasis was launched in 2000. In 2004, 12 countries in the Asia subregion of the Western Pacific Region and Southeast Asian Region joined and developed the Mekong-Plus Strategic Plan for Elimination of Lymphatic Filariasis. Since then, significant efforts have been made by all endemic countries, with annual mass drug administration (MDA) as a principal strategy, through strong partnership with the WHO and other donors and partners. As a result, by the end of 2019, 10 of 22 endemic countries in the region, including 8 of 16 countries in the Pacific and 2 countries in the Asia subregion, achieved WHO validation for elimination of lymphatic filariasis (LF) as a public health problem. All the other countries are either progressing with post-MDA surveillance or accelerating efforts by adoption of the new triple drug therapy strategy and enhancement of MDA campaigns to tackle persistent transmission. Some 85% of the originally endemic implementation units have stopped MDA and the number of people requiring MDA for LF in the Western Pacific Region was reduced by 72% from 2000 to 2018. This paper reviews the progress, key success factors and remaining challenges and indicates the way forward to achieve LF elimination in the Western Pacific Region.

Efficacy and safety of triple therapy versus dual therapy for lymphatic filariasis: A systematic review and meta‐analysis

“…[18] So, eradication of this disease, which is endemic in over 50 countries, is crucial. [6,18,29,33–41] In this systematic review and meta‐analysis, we assessed the efficacy and safety of IDA in microfilariae filtration and so on the elimination of LF.…”

The Importance of Partnership in the Rollout of Triple-Drug Therapy to Eliminate Lymphatic Filariasis in the Pacific

“…6 As a result, in recent years, the above mentioned countries have all failed a transmission assessment survey (TAS) or pre-TAS-either countrywide, in specific implementation units, or in some hotspots within endemic implementation units. 5,7 A series of studies has also demonstrated persistent transmission of LF in some of these countries, and research partners have provided continuous feedback to relevant health ministries/departments to emphasize the critical importance of intensifying and sustaining LF interventions to relevant health ministries/departments. [8][9][10][11][12][13][14][15][16] All these factors combined have made the development of a new strategy to accelerate LF elimination crucial.…”

“…Annual rounds of MDA have continued throughout the Pacific, and by the year 2020, 8 of 16 LF-endemic countries and territories (50%)—namely, Kiribati, Niue, Palau, Republic of the Marshall Islands, the Cook Islands, Tonga, Wallis and Futuna, and Vanuatu—had achieved elimination of LF as a public health problem and received validation of that status by the WHO. 5 …”

Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa

“…The Global Programme to Eliminate Lymphatic Filariasis (GPELF) has conducted an intensive mass drug administration (MDA) programme since 2000 to interrupt transmission of LF [3], and the burden of infection is estimated to have been reduced dramatically to 50 to 70 million infections in 2018 [1,2]. By 2020, 7.7 billion MDA treatments had been delivered and 17 countries or territories (eight of which are in the Pacific region [4]) have been validated as having eliminated LF as a public health problem [3,5].…”