News Our take on India’s latest lymphatic filariasis elimination figures Last week the World Health Organization (WHO) released a report looking at the global programme to eliminate lymphatic filariasis (LF). In that, it considered each country’s progress in trying to reduce the number of people affected by the parasitic disease which is transmitted via mosquito. India, which has a population of over 1.2 billion, reports that they have achieved 98.6% geographical coverage when it comes to mass drug administration (MDA). This is the process used to prevent the disease from being contracted. It involves government health workers delivering preventative medication once a year for five years to each household hoping to stop people living with the extreme swelling that LF causes to various body parts. The global programme working towards the elimination of the neglected disease, sometimes known as elephantiasis, says MDA needs to be distributed across 85% of the geographical area of the national population for elimination to occur. The WHO’s report says India is reaching 98.6% of the country which implies it’s well on the way to achieving that, but we think that the reality is a little different. In our own research in the Indian states of Odisha and Andhra Pradesh, we have found that while the drugs had been distributed to 83% of the 4,152 interviewees, only 50% had actually consumed the medication. This means that, while the recent WHO figures look impressive, if people are receiving the drugs but not actually consuming them as is the case in Odisha, then in fact India is far from reaching the global target to eliminate the disease by 2020. We believe that in order to reach the target, the MDA process must be accompanied with health education and community mobilisation so that people know more about what the disease is, why the drug is necessary and where to go for help should they need it. Sarah Nancollas, our Chief Executive, said: “It is not enough to merely hand a person a pill and hope that they will take it without adequate explanation and understanding as to why. Given that many won’t have the disease, it can be hard for them to justify the reasoning to take a pill for something they show no symptoms of. We have proven that, combined with campaigns that really tell people what LF is, along with information on the medication itself, consumption rates rise significantly.” We previously conducted research in the district of Puri, also in the state of Odisha, and found that by implementing education campaigns around LF, the consumption rate doubled to 92%. “The government needs to be more strategic in their administration. They need to think about when they are visiting households, is it meal time, is it a holiday period? The pill has to be taken with food and distributing it around meal times will increase the likelihood of somebody consuming the tablet. It is not enough to merely handover a pill and assume it is being taken – after all would you take a drug if a stranger handed it to you on your doorstep?” There is a real danger that if not enough investment is made to ensure that people take the drug, through community mobilization and health education, LF could eventually be declared eliminated in India when many are still at risk of contracting it and millions are still enduring the painful effects. Read more about our projects in India, helping people affected by LF here.