In a significant progress against neglected tropical diseases in WHO South-East Asia Region, Maldives and Sri Lanka have eliminated lymphatic filariasis, a disease that was crippling people for decades, forcing them to lead a life of stigma, discrimination and poverty.

Elephantiasis  of leg due to filariasis/CDC
Elephantiasis of leg due to filariasis/CDC

“The achievement by Maldives and Sri Lanka demonstrates the resolve of these countries and the Region as a whole to eliminate all neglected tropical diseases, which have no reason to continue and mar the lives of people,” Dr Poonam Khretrapal Singh, Regional Director, WHO South-East Asia Region, said. The success in Maldives and Sri Lanka follows intensified mosquito control efforts; treatment of the infected population, disability prevention and control; strengthening of surveillance; and closely monitoring and evaluating these efforts which together helped eliminate lymphatic filariasis (LF) as a public health problem.

“The neglected tropical disease (NTD) is typically of the ‘neglected’ population, the poor and the marginalised. By eliminating this NTD as a public health problem, Maldives and Sri Lanka have shown the way for reaching these populations with other health interventions, much needed to improve their overall health,” Dr Khetrapal Singh said.

Eliminating NTDs is also critical to sustainable development goals which emphasises on ‘no one being left behind’.

“Maldives is committed to enhancing health and wellbeing of its population. Achieving the goal of eliminating lymphatic filariasis, as a public health problem, has been possible with tireless efforts of hundreds of health workers across the island nation,” Ms Iruthisham Adam, Minister of Health, Maldives, said.

“Lymphatic filariasis elimination as a public health problem in Sri Lanka is a major public health success which has been possible with our strong commitment, dedication of our health workforce and active participation and support of the community,” Dr Rajitha Senaratne, Minister of Health, Sri Lanka, said.

Lymphatic filariasis (LF) is believed to have been endemic in Maldives since 12th and 13th century and is traced back to much earlier in Sri Lanka, with the mosquitos transmitting the bug found in abundance across the two countries.

Commonly known as elephantiasis, LF occurs when filarial parasites are transmitted to humans through mosquito bites. Infection is usually acquired in childhood and the painful and profoundly disfiguring visible manifestations appear much later in life, often in the form of elephantiasis which causes permanent disability. These patients suffer the disease and also suffer mental, social and financial losses contributing to stigma and poverty.

In 2012, the WHO neglected tropical diseases roadmap set the year 2020 as a target for achieving elimination of lymphatic filariasis as a public health problem. For LF elimination, WHO’s strategy is based on two key components – stopping the spread of infection through large-scale annual treatment of entire populations at risk in an area or region where infection is present; and alleviating the suffering caused by lymphatic filariasis through increased disease management and disability prevention measures.

In the South-East Asia Region, WHO has been prioritising finishing the task of eliminating diseases on the verge of elimination. Following Maldives and Sri Lanka’s success, LF endemic countries working towards elimination is now reduced to seven in the Region.