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Brazil is eliminating lymphatic filariasis as a public health problem
The World Health Organization (WHO) congratulates Brazil on eliminating lymphatic filariasis as a public health problem.
“Disease elimination is a significant achievement that requires unwavering commitment,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “I congratulate Brazil on its efforts to free its people from the scourge of this painful, disfiguring, disabling and stigmatizing disease. This is another example of the incredible progress we have made against neglected tropical diseases and gives hope to many other nations still fighting lymphatic filariasis that they too can eliminate this disease.”
Lymphatic filariasis, also known as elephantiasis, is a debilitating parasitic disease spread by mosquitoes. For centuries, this disease has affected millions worldwide, causing pain, chronic, severe swelling, severe disability and social stigmatization.
Effective investments at country level
Over the past several decades, Brazil has implemented integrated actions to eliminate lymphatic filariasis, including the development of a national plan to combat this disease in 1997, mass distribution of antiparasitic drugs, vector control activities, and strong surveillance, especially in the most affected areas. With these efforts, the country achieved an end to transmission of the disease in 2017.
Elimination of lymphatic filariasis was also one of the goals Healthy Brazil programa multi-sectoral initiative aimed at ending socially determined diseases with a whole-of-government approach and civil society participation, including the involvement of affected people in the implementation of disease control efforts. The program was launched in February 2024 by President Luiz Inácio Lula da Silva in a ceremony attended by Dr Tedros Adhanom Ghebreyesus, WHO Director-General and Dr Jarbas Barbosa, Director of the Pan American Health Organization (PAHO) and WHO Regional Director for the Americas. In the post-elimination phase, Brazil, PAHO and WHO will continue to closely monitor possible re-emergence of infections.
“This milestone is the result of years of dedication, hard work and collaboration between health workers, researchers and authorities in Brazil,” said Dr Jarbas Barbosa, Director of PAHO and WHO Regional Director for the Americas. “Brazil's extensive and unique health system, together with solid specialized laboratory expertise and strong surveillance, were key to breaking the chain of transmission, inspiring other countries to move towards the elimination of lymphatic filariasis and other neglected tropical diseases.”
Global progress
Globally, Brazil joins 19 other countries and territories that WHO has confirmed have eliminated lymphatic filariasis as a public health problem. These are Malawi and Togo in the African region; Egypt and Yemen in the Eastern Mediterranean region; Bangladesh, Maldives, Sri Lanka and Thailand in the Southeast Asia region; and Cambodia, Cook Islands, Kiribati, Lao People's Democratic Republic, Marshall Islands, Niue, Palau, Tonga, Vanuatu, Vietnam, and Wallis and Futuna in the Western Pacific region.
In the Americas, three endemic countries (Dominican Republic, Guyana, and Haiti) still require mass administration of drugs to stop transmission and are working toward the goal of elimination.
Except it's 20th country to be confirmed for the elimination of lymphatic filariasis as a public health problem, Brazil also became the 53rd.rd a country that has eliminated at least one neglected tropical disease globally.
Note to the editor
Lymphatic filariasis, also known as elephantiasis, is a neglected tropical disease. Infection occurs when filarial parasites are transmitted to humans via mosquitoes. The infection is usually acquired in childhood and causes hidden damage to the lymphatic system.
The painful and deeply disfiguring visible manifestations of the disease – lymphedema, elephantiasis and swelling of the scrotum – occur later in life and can lead to permanent disability. These patients are not only physically handicapped, but suffer mental, social and financial losses that contribute to stigma and poverty.
Elimination of lymphatic filariasis is possible by stopping the spread of infection with preventive chemotherapy. The preventive chemotherapy strategy for elimination of lymphatic filariasis recommended by the WHO is mass drug administration (MDA). MDA involves administering an annual dose of medication to the entire population at risk. The drugs used have a limited effect on adult parasites, but they effectively reduce the density of microfilariae in the bloodstream and prevent the spread of parasites to mosquitoes.
In 2023, 657 million people in 39 countries and territories lived in areas requiring preventive chemotherapy to stop the spread of infection. In the Americas, Costa Rica, Suriname and Trinidad and Tobago were removed from the WHO list of lymphatic filariasis endemic countries in 2011. Roadmap of neglected tropical diseases for the period 2021-2030 aims to prevent, control, eliminate and eradicate 20 diseases and disease groups by 2030. Progress in the fight against lymphatic filariasis and other neglected tropical diseases reduces the human and economic burden they impose on the world's most vulnerable communities.
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