Lymphatic filariasis, commonly known as elephantiasis, is a neglected tropical disease. Infection occurs when filarial parasites are transmitted to humans through mosquitoes. Infection is usually acquired in childhood causing hidden damage to the lymphatic system.  Lymphatic filariasis is a preventable vector-borne disease that needs to be tackled effectively to meet the Health Ministry’s target of eliminating it in India by 2020.

Body:

Impact of Lymphatic filariasis on the poor:

• Over 40% of worldwide cases are found in India. Presently, India has 256 endemic districts across 16 States and five Union Territories including nine endemic districts in Karnataka.
• According to Indian Council of Medical Research (ICMR), India still has over 2.3 crore people suffering with lifelong disability due to lymphatic filariasis (LF).
• The painful and disfiguring visible manifestations of the disease, lymphoedema, elephantiasis and scrotal swelling (hydrocele) occur later in life and can lead to permanent disability.
• These patients are not only physically disabled, but suffer mental, social and financial losses contributing to stigma and poverty.
• LF has been a low priority among public health issues in the country and comprises only a minute portion of the overall health budget,
• There is often no coordination between the various funding and research bodies to prioritise the research agenda and minimise duplication.

Measures needed to overcome the challenges:

• Although the compliance rate (consumption of drugs) has gone up from 35% to 65% over the years, the need of the hour is to achieve 80%.
• There is a need for an integrated approach with multi-sectoral involvement in tackling the disease.
• Tackling the elimination of LF on a war footing, in June 2018, India renewed its commitment towards achieving the global LF elimination goal of 2020 with the launch of Accelerated Plan for Elimination of LF (APELF).
• Greater emphasis needs to be placed in employing strategies tackling the source of the disease – preventing mosquitoes to human transmission.
• The triple drug therapy, as recommended by WHO, with the long term aim of eradicating lymphatic filariasis should be implemented.
• An institutional mechanism at a national level to identify gaps in neglected diseases research, set priorities, liaise with research institutions, or monitor research output is the need of the hour.

Conclusion:

Lymphatic filariasis poses a grave threat to India.  A unified programme on neglected diseases encompassing research and elimination measures is likely to have a greater impact in prioritising the matter in the health agenda and streamlining efforts towards disease elimination. Creating an enabling environment for research and innovation will be crucial if India is to achieve the target set in sustainable development goal 3.3 to end epidemics of neglected tropical diseases by 2030.