Eradicating lymphatic filariasis

The neglected tropical disease, lymphatic filariasis (LF), is endemic in 73 countries, primarily among impoverished populations. Infection with LF can damage the lymphatic system, causing permanent disability including hydrocele, lymphedema, and elephantiasis. In 1997, LF was named by the World Health Assembly as a potentially eradicable disease, in part because it is preventable through once yearly treatment administered through mass drug administration (MDA) using albendazole with ivermectin or diethylcarbamazine citrate (DEC). This PhD thesis presents evidence-based guidance on the rationale for investing in LF eradication by providing estimates on the duration of MDA necessary and number of treatments needed to reach local elimination for a variety of transmission archetypes, as well as the potential economic and financial investment needed, the potential health impact and cost-effectiveness of eradicating LF, and the potential health systems savings and gains in worker productivity as a result of averted LF-related morbidity. The results show that across all considerations, including: time, treatments, level of investments necessary, health impact, cost-effectiveness, and broader economic benefits, scaling-up MDA coverage to all endemic communities immediately provides the most favorable results. Ultimately, though, the success of eradicating LF will depend on the political engagement and enthusiasm at all levels.