India is making significant strides in the fight against lymphatic filariasis (LF), a debilitating disease commonly known as elephantiasis. The disease, transmitted by the bite of a Culex mosquito that breeds in dirty or polluted water, is one of the world's leading causes of long-term disability. While not fatal, it significantly impairs quality of life, leading to severe physical debility and imposing substantial social and economic burdens on affected individuals, their families, and entire communities.
The Indian government has taken extensive measures to combat and control the disease, which is endemic to the country. A key strategy has been the implementation of a mass drug administration (MDA) campaign, launched nationwide in 2004. The campaign, aimed at controlling and eliminating neglected tropical diseases, achieved a remarkable 82.5 per cent coverage in 2023. It involves a door-to-door administration of preventive medications in endemic areas.
Lymphatic filariasis (LF) is a complex disease that has multifaceted social, environmental, and economic determinants. We cannot eliminate it by working in silos; it requires a collaborative effort from various sectors working together seamlessly, said Rajshree Das, Senior Director, PCI India. PCI works as a technical assistance partner to the National Vector Borne Disease Control Programme (NVBDCP), of the Ministry of Health & Family Welfare.
In March 2023, then Union Health Minister Mansukh Mandaviya called for eliminating lymphatic filariasis three years ahead of the global target through a five-pronged roadmap by 2027. The global target is 2030. In August of the same year, the government launched the second phase of the bi-annual nationwide MDA campaign for lymphatic filariasis elimination. It targets 63 endemic districts in Bihar, Jharkhand, Karnataka, Odisha, Telangana, and Uttar Pradesh.
If LF is left untreated, it can progress to chronic symptoms including lymphoedema (tissue swelling) or elephantiasis (skin/tissue thickening) of limbs and hydrocele (scrotal swelling) leading to disability. Lymphatic filariasis is the second most disabling disease in the world after leprosy. In India, till 2023, 6.19 lakh cases of lymphoedema and 1.26 lakh cases of hydrocele were reported from endemic districts, said Dr Aruna Sharma, a practitioner development economist and retired GOI secretary.
Sharma, who has worked extensively on panchayat-level governance models and across ministries, also called for using technology and inclusive education to spread awareness about the disease to make a holistic approach towards disease elimination.
Another major component of India's strategy to eliminate LF is Morbidity Management and Disability Prevention (MMDP). India's MMDP strategy involves distributing MMDP kits for home-based morbidity management of lymphoedema, providing hydrocele surgeries in CHCs, district hospitals and medical colleges, as well as distributing disability certificates to eligible patients, Das said. These facilities are available free of cost.
Frontline workers like ASHAs, community leaders, Women's Self-Help Groups, Schools, National Service Scheme, and civil society organisations have come together and worked tirelessly to mobilise communities and encourage participation in the MDA rounds.
The fight against LF in India is reminiscent of the country's successful battle against polio. In both cases, the government has leveraged mass drug administration campaigns, community mobilisation, and public health workers to combat the diseases. The lessons learned from the polio eradication campaign have undoubtedly informed the current strategies being used to eliminate LF.
