As the world celebrates the 12 billionth treatment to protect people from the painful and debilitating disease lymphatic filariasis, we reflect on our collaborative journey towards eliminating it across Africa.
On 19 September 2024, people in Mzambarauni village in Zanzibar saw the 12 billionth global treatment for lymphatic filariasis (LF) being administered to Mzowele. Mzowele is a middle-aged mother of 10, who was diagnosed with lymphoedema, a form of LF that causes abnormal swelling of body parts.
In attendance was HRH Sophie, Duchess of Edinburgh, who was invited to the event organised by Zanzibar’s Ministry of Health, in collaboration with Sightsavers, Uniting to Combat NTDs, GlaxoSmithKline (GSK) and Unlimit Health.
A global health issue
Neglected tropical diseases (NTDs) are a group of 21 infectious diseases that can cause significant disfigurement, disability and even death. They affect more than a billion people worldwide and tend to thrive in warm climates and rural, poverty-stricken areas where access to clean water and health care is limited.
LF is a parasitic disease transmitted by mosquitoes that affects the infected person’s lymphatic system. It is characterised by abnormally enlarged body parts, known as lymphoedema, and can result in permanent physical changes. In men, it can cause hydrocele, a form of lymphoedema that causes the scrotum to swell, leading to pain, disability and stigma.
Figures from 2022 show that 288 million people were at risk of LF, making it one of the two NTDs that affect the most people globally. Eleven of the top 15 high-burden countries for LF are in Africa, yet only two countries in the continent, Malawi and Togo, have been validated by the World Health Organization (WHO) as having eliminated the disease. Without eliminating LF in Africa, we will not meet the WHO-led target of 100 countries eliminating at least one NTD by 2030.
What is lymphatic filariasis?
Lymphatic filariasis is a serious disease, with millions of people globally at risk. It can cause a range of symptoms, but is often characterised by abnormal enlargement of body parts.
Learn about the disease
Progress towards elimination is a collaborative effort
LF is treated using a combined drug therapy which includes albendazole tablets donated by GSK. Pharmaceutical companies have played a crucial role in the control and prevention of NTDs through their generous donation of the necessary medications. GSK has now donated more than 12 billion albendazole tablets to more than 66 countries since 1999, and has pledged to continue donating the medicine until LF is eliminated as a public health problem everywhere.
Dr Fatma Mohamed, deputy director of preventative services at the Ministry of Health in Zanzibar said: “The last mile is always the hardest. Because it is that one patient, that particular community, where you need to reach to make sure you know that you have eliminated. It is the partners who help us in drug distribution, but it’s actually very important to have community-own resource people.”
One of these people is Seif, a community volunteer who administered the 12 billionth treatment. He explained that visible health improvement in patients is changing community perceptions about receiving treatment: “Initially, I faced challenges. When we go there, people do not want them [the drug]. We went to a place where we were chased away. Now I felt a lot of comfort for myself, because I treated a person whose goal has been my own.”
A new lease of life
These simple white pills are having a huge impact on local health systems and community wellbeing. The medication helps Mzowele, who has a form of LF that can’t be cured, to manage her symptoms of lymphoedema, making life more bearable.
Her daughter, Zuleika said: “The medication helps us a lot and it is very good, because when she first started suffering, it is now different. Now you wouldn’t recognise her.”
Mzowele is keen for her daughter and her children to be protected from the disease by taking the medication before it is too late. She said: “My hope for Zuleika is that things go well for her and that she succeeds in life. For that time, let the medicine be brought to us. May my challenges lead to a better life, so that we can at least have life moving forward in a better direction.”
“The medication helps us a lot” Zuleika, Mzowele’s daughter
Scaling up the fight against LF across Africa
African countries such as Malawi, Togo and Egypt have successfully eliminated LF. Others, including Benin, Cameroon, Mali and Uganda, have now reduced disease transmission levels to a point where mass drug treatment campaigns are no longer necessary.
Sightsavers works closely with the governments of endemic countries to prevent and treat LF through mass drug administrations, medical care for lymphoedema patients and surgery for men affected by hydrocele. Programmes such as ARISE II are helping to overcome superstition and stigma towards LF patients, and our research is aiding decision-making about treatment campaigns.
The road to elimination is a long and complex one that requires the collaboration of key players to support governments in their elimination fight. New commitments like the expansion of the RLM Fund, of which Sightsavers is a partner, are bringing us one step closer to ending these diseases of poverty.
To reach the finish line, we must continue to trial new diagnostic techniques, carry out research and build capacity in local health care services. For millions of people, the difference between a future free from limitations due to disability and one filled with pain and stigma, could boil down to a simple intervention offered in the right place, at the right time.
Our progress
Sightsavers has supported more than 587 million treatments for LF and estimates that 9.9 million people are no longer at risk due to Sightsavers-supported interventions.
Learn about our work to eliminate NTDs
Sightsavers and NTDsStories about lymphatic filariasis
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In Burkina Faso, the ARISE II programme is helping to transform the lives of thousands of people who are suffering from lymphatic filariasis.
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Sightsavers’ Khadijah Bello travelled across north-central Nigeria to see how our programmes are fast-tracking the elimination of neglected tropical diseases.
Expanding the Reaching the Last Mile Fund: a game-changer for river blindness and lymphatic filariasis
The funding pledge is a huge step towards eliminating the diseases.
