African regional progress and status of programme to eliminate lymphatic filariasis: 2000-2020

To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious gaol. In this article we review the progress and status of LF programme in Africa through WHO neglected tropical disease PC database, Expanded Special Project for Elimination on Neglected Tropical Diseases (ESPEN) Portal and WHO and other publications. In the African Region, there are 35 countries endemic for LF. The Gambia, was reclassified as not requiring preventive chemotherapy in 2015 whilst Togo and Malawi have eliminated LF as a public health problem in 2017 and 2020 respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 out of 31 countries requiring MDA achieved 100% geographic coverage. Although, much remains to be done morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes particularly malaria vector control had a profound effect in stopping transmission in some of endemic countries in the region. In conclusion, significant progress has been made in the LF programme in the Region whilst we identify the key remaining challenges towards achieving an Africa free of LF.