Lymphatic Filariasis in India: A Journey towards Elimination

Abstract

The journey towards elimination of Lymphatic Filariasis (ELF) in India started with the deliberations in a meeting held at Delhi in 1996 recommending for pilot project of Mass Drug Administration (MDA) with DEC. Global Programme to Eliminate Lymphatic Filariasis (GPELF was launched in 2000 subsequent to World Health Assembly (WHA) resolution in 1997 making India as signatory. ELF campaign was launched on 5th June, 2004 with annual MDA in endemic districts. However, all the endemic districts could not initiate MDA due to logistics and preparedness issues, thus the journey initially experienced challenges of hurried start. Serious Adverse Events (SAE) and poor compliance were reported from many states which were tackled through advocacy and capacity building of health workers and community volunteers. MDA was managed with staggering of dates in different states and strong supervision helped in improving drug compliance. The improved reported drug coverage resulted in decline of microfilaria prevalence in many districts except some districts. India’s significant progress was recognised internationally as approximately 200 of 650 million population at risk of Lymphatic Filariasis (LF) was made free of risk by 2017 by passing Transmission Assessment Survey (TAS) though some districts could not clear TAS. Efforts to improve drug compliance were intensified and to achieve goal faster, MDA with three drug Ivermectin, DEC and Albendazole has been initiated in addition to ascertaining the current status of LF endemicity in non-MDA districts. Based on experience of long journey towards ELF with mix of success and challenges, it is suggested to intensify ELF in a mission mode with priority.