Abstract
The 6th Meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF6) was held 1-3 June, 2010 in Seoul, Korea, with 150 participants from 38 countries. The year 2010 marks the midpoint between the first GAELF meeting, in 2000, and the World Health Organization (WHO) 2020 goal of global elimination of lymphatic filariasis (LF) as a public health problem. The theme of the meeting, "Half-time in LF Elimination: Teaming Up with Neglected Tropical Diseases (NTDs)," reflected significant integration of LF elimination programmes into a comprehensive initiative to control NTDs. Presentations on LF epidemiology, treatment, research, and programmes highlighted both accomplishments and remaining challenges.The WHO strategy to interrupt LF transmission is based on annual mass drug administration (MDA) using two-drug combinations. After mapping the geographic distribution of LF, MDA is implemented for ≥ 5 years, followed by a period of post-MDA surveillance, and, ultimately, verification of LF elimination. Morbidity management further reduces disease burden.Of 81 countries considered LF-endemic in 2000, 52 (64.2%) have begun MDA; 10 (12.3%) others with low-level transmission are unlikely to require MDA. In 2008, ~695 million people were offered treatment (51.7% of the at-risk population); ~496 million participated. Approximately 22 million people have been protected from LF infection and disease, with savings of ~US $24.2 billion. Morbidity management programmes have been implemented in 27 (33.3%) countries.Significant challenges to LF elimination remain. These include: initiating MDA in the remaining 19 countries that require it; achieving full geographic coverage in countries where MDA has started; finding alternative strategies to address the problem of Loa loa co-endemicity in Central Africa; developing strategies to treat urban populations; initiating and sustaining MDA in settings of armed conflict; developing refined guidelines and procedures for stopping MDA, for post-MDA surveillance, and for verifying the elimination of LF; and integrating morbidity management into all LF elimination programmes. Scientific research and enhanced advocacy for NTDs remain critical for addressing these challenges.GAELF6 was characterized by enthusiasm and recognition that "teaming up with NTDs" offers opportunities for new partnerships, fresh perspectives, enhanced advocacy, and greater programmatic integration in a rapidly changing global health environment.
Highlights
The 6th Meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF6) was held 1-3 June, 2010 in Seoul, Korea, with 150 participants from 38 countries
The results suggest that the lymphatic filariasis (LF) elimination effort is having a huge impact, with some 16.1 million persons receiving direct LF benefits (6.6 million newborns protected and disease progression halted in 9.5 million), and 32 million disability-adjusted life years (DALYs) averted
The ensuing discussion focused on the pathophysiology and treatment of serious adverse event (SAE), on the need for accelerated research, and on various strategies to overcome the challenges posed by Loa loa for LF elimination in Central Africa
Summary
The GAELF6 meeting provided a rich opportunity for 150 attendees from 38 countries to take stock, reflect, celebrate, and plan for the future. Professor Molyneux described “major routes” on the journey of the GAELF These have included a global commitment to LF elimination; a strong research agenda, with support from numerous public and private institutions; and enhanced advocacy for NTDs. The GAELF has travelled extensively on “country roads,” which include years of commitment to LF control before 1997 by the governments of China, Korea, India, Thailand, Sri Lanka, and Suriname amongst others; a unified embrace of WHO’s strategy for LF; successful efforts to “scale up” programmes to the national level in many countries; and the substantial financial contributions to LF elimination made by filariasis-endemic countries themselves. Half-time Around the World: Case Studies Elimination of Lymphatic Filariasis in India Dr PK Srivastava, Joint Director of the National Vector Borne Disease Control Programme, Ministry of Health and Welfare, reported that LF is endemic in 250 districts in 20 states in India, with an at-risk population of 600 million. The programme advocated by the IAD integrates the principles of Ayurvedic medicine; western biomedicine; Yoga (Pranayama); traditional skin care; and patient counselling and education
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