Unburdening the Poor: Elimination of Lymphatic Filariasis in the Maldives

Abstract

AbstractThe Maldives is one of three countries in the WHO South-East Asia Region to have eliminated lymphatic filariasis as a public health problem. Efforts to address the problem in the Maldives go back to much before the country became free in 1965. WHO-supported surveys were undertaken in 1951 in 34 habitable islands. It was found that 37% of inhabitants in these islands were either infected with W. bancrofti or exhibited clinical signs of lymphatic filariasis. Since 1968, when the National Filaria Control Programme was established, the unswerving political commitment and allocation of dedicated financial resources for case detection and treatment served as cornerstones of the Maldives’ successful effort to eliminate lymphatic filariasis. The unique geography and scattered population in the country poses logistical challenges in rolling out health initiatives. However, highly trained health workers, linked to the WHO-supported global surveillance system for lymphatic filariasis, helped catalyse case-finding and treatment services in the Maldives. Another significant move was to make lymphatic filariasis a notifiable disease under the Public Health Protection Act, which came into force in 2012. The law provides for mandatory reporting of communicable diseases. The elimination of lymphatic filariasis from the Maldives has also demonstrated how technical capabilities, backed by strong political will and financial backing, help countries to tackle the scourge of NTDs. The resolve of the Maldives to achieve the elimination target ahead of the global deadline of 2020 set for elimination of lymphatic filariasis could serve as a template worth emulating by health systems in the Region and other countries facing the challenge of NTDs.