With a population of 13 million, all of which live in endemic areas, the
Burkina Faso LF Elimination Programme started in December 2001 has been
able to ramp up quickly and treat over 10 million individuals at the
end of 2005. The primary reason for the programme’s effectiveness is
centered around the innovative development from Dr Dominique Kyelem (the
previous programme manager) and the continued management and leadership
of Dr Roland Bougma the current programme manager combined with the
national comitment to eliminate LF. Under their leadership, the
Elimination Programme has secured funding from local and international
funders and developed partnerships with NGOs to help fulfil components
of the mass drug administration and morbidity work. The government
funding for the last MDA represented more than of ¾ of the total
expenditure. The morbidity component is lagging behind as more funds are
needed. There is a real integration with onchocerciasis control
Despite the support of international donors and strong local partners, it is anticipated that the Burkina Faso LF Elimination Programme will need an estimated $3.5 million over the next five years to ensure five consecutive years of mass drug administration to at least 80 percent of the endemic population. The total outstanding need is 60 percent of the budget ($2.1 million), which may decrease depending on how much partner organisations provide.
The integration approach within the NTDs is in its early stages and is believed to provide more opportunities to the LF Programme.
China Breaks the Cycle
China initially targeted LF in the 1950s, because it was one of five diseases draining the country’s agricultural productivity. With commitment and will, China broke the cycle of LF transmission by distributing drugs on a mass scale and fortifying table salt with DEC, an anti-parasitic drug. Before implementation, 330 million people were at risk of infection. As of 1994, China achieved basic elimination of LF. International verification that transmission has been interrupted is on track to occur in 2005. The successful programme proved extremely cost-effective. In one province, China calculated a cost-benefit ratio of 1 to 5.7 (One Yuan spent on filariasis control produced 5.7 Yuan in benefits). Lessons learned in China, and other affected countries, are speeding up the elimination of LF on a global scale.
The Story of Egypt
Documents Egypt's effort to rid itself finally of lymphatic filariasis, an ancient and disfiguring disease. Above all it is the story of a bold national effort combined with unprecedented public-private international cooperation. The LF elimination programme in Egypt faced the daunting challenge of mass drug administration to 2.5 million people over a two-week period every year for five years. Available in English and French.
* This publication has been made possible by a financial contribution from the Arab Fund for Economic and Social Development.
Regular meetings with key partners, sharing experiences, and a new advocacy plan have proved positive for Ghana. Follow the link for details of Ghana's Success Stories.
A combination of factors - political instability, 2010's devastating earthquake and cholera epidemics - have both detracted attention from LF and made LF control more challenging. Since 2007, Haiti has benefited from MDA (mass drug administration) scale-up with the assistance of 18 000 community volunteers. Read the report for more information.
The Republic of Kiribati's geography poses unique challenges to eliminating LF - 32 atolls spread over 3.5 million kilometres of ocean. The 22 inhabited islands have high-density populations, over-crowding and difficulty accessing fresh water, which increases prevalence of LF. Click here to read about Kiribati's LF elimination strategy.
Imagine a large West African country of 13 million people all at risk of being disabled by a parasitic disease that leads to fevers, swollen limbs, and enlarged genitals, which make those infected unable to work in the fields that often provide the only means of survival in an already impoverished economy. This is the case with Mali, where all eight districts are endemic of LF, as revealed by disease mapping completed in 2005.
The Ministry of Health recognizes the seriousness of the consequences of an entire population at risk of becoming disabled and the impact this can have on an already struggling economy. In 2011, Mali was able to successfully establish an LF elimination program within the Ministry of Health after a meeting with a representative of the Global Alliance, Ms. Sandra Libunao, the Minister of Health, Maïga Zeïnab Mint Youba, and the new LF Program Manager, Dr. Massitan Dembélé.
After successfully gaining support within the ministry, Dr. Dembélé and Ms. Libunao turned their attention to raising awareness about LF within the international and domestic health community in Mali. As with many countries, the stigmatization that accompanies LF results in ignorance about the origin and consequences of the disease that is deadly to any elimination programme. The first order of business was to inform multilateral agencies, such as UNICEF and the World Bank, about the critical situation of LF in Mali and the Programme’s plans for elimination.
NGOs are also known for their ability to extend the capacity of the Malian government and the LF elimination duo met with many reputable NGOs, such as the Red Cross, Helen Keller International and Catholic Relief Services. A major highlight of the week-long awareness campaign was the televised “plaidoyer,” or solicitation session, which presented the need for LF elimination in Mali to local NGOs to garner support and encourage cooperation, organized by Dr. Dembélé and supported by the World Health Organisation and Dr. Dembélé’s directors in the Ministry.
Dr. Dembélé has also successfully approached the private sector to identify sources for financial support of the mass drug administration (MDA) component of the LF Elimination Programme. Supported by Ms. Libunao, she met with Bramali, a brewery company in Bamako, Pari Mutuel Urbain, the state lottery, Sotelma, the state telecommunications company, among others.
Dr. Dembélé and the Global Alliance hope to celebrate the first round of MDA in late 2005, starting in the region of Sikasso. Elimination plans call for the scaling up of the Programme with three additional regions, Koulikoro, Kayes, and Segou in 2006.
Despite the burst with which the Malian LF Elimination Programme has started and the pledges of support from international and domestic actors, the programme requires even further support to be able to reach all regions in this large country and successfully save future generations from a life of disability and poverty. Specific needs include funds for mass drug administration, morbidity management, social mobilization, and monitoring and evaluation.
Nigeria takes an integrated approach
Distributing drugs to eliminate LF can be integrated into existing national and local public health strategies quickly and cost-effectively, often with little need for extra resources. For instance, two states in Nigeria distribute drugs to treat LF at the same time as they are treating river blindness (onchocerciasis) and schistosomiasis. Administrative and drug delivery resources have been shared between the LF and river blindness programmes, helping reduce costs for both. The schistosomiasis programme has grown in parallel with the LF programme and treated approximately 190,000 people in 2003. The LF mass drug administration programme reached 3.1 million people in 2003.
A study by an independent research group in Sri Lanka found great improvements with CHBC methods. Click here to read the full report.
In a new approach, community members have been trained to reach remote populations with drugs for LF patients. This increases rural populations' faith in the medicines provided, and raises awareness of controlling NTDs.
Available in English.
The Story of Zanzibar
Tells the story of the first year's activities of the LF Elimination Programme in Zanzibar, United Republic of Tanzania. It portrays the dedication of the many people who were convinced of the importance of the programme and who made the 2001 mass drug administration campaign a success. It is the story of the hard work and commitment of the people of Zanzibar.
Available in English of French.
* This publication has been made possible by a financial contribution from the Bill & Melinda Gates Foundation.