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# Campaign to eliminate disfiguring disease is stepped up

BMJ 2002; 324 (Published 11 May 2002) Cite this as: BMJ 2002;324:1176
1. Fiona Fleck
1. Geneva

A global campaign spearheaded by the World Health Organization to eliminate one of the world's most disfiguring diseases, lymphatic filariasis, has been stepped up to reach 350 million people—a third of the billion people at risk—by 2005.

Members of the Global Alliance for the Elimination of Lymphatic Filariasis, a coalition of 80 countries, 30 aid agencies, donors, research institutes, non-governmental organisations, and two pharmaceutical companies, GlaxoSmithKline and Merck, set the ambitious target at a conference in Delhi this month.

While smallpox is the only disease that has so far been eradicated, polio and guinea worm disease (dracunculiasis) are close to being eliminated, and WHO officials believe that lymphatic filariasis, which mainly affects the world's poorer countries, could be the next in line.

To prevent spread of the disease, each person deemed to be at risk must take a dose of two drugs once a year for four to six years to kill the parasitic worms or microfilariae that carry the infection in the blood. So far 26 million people in 22 countries have been treated.

GlaxoSmithKline has donated $1bn (£0.7bn; €1.1bn) for the first 20 years of the campaign, launched in 2000, a gesture described by the Financial Times as “the biggest single act of corporate philanthropy in any industry.” The alliance has also received other substantial donations, including$20m from Bill Gates.

WHO officials said they still needed to continue raising funds but that the main challenge now was to implement the programme.

“It will take commitment from governments and a high level of social mobilisation to distribute and administer the drugs,” said Dr Gaudam Biswas, a WHO medical officer.

More than 120 million people have developed lymphatic filariasis. Of those, 40 million suffer serious incapacity or disability from the build up of millions of worms in the body, causing gross swelling of the limbs, known as elephantiasis, and swelling of the genitals, when the scrotum can swell to the size of a football. The disease can also cause internal damage to organs and the lymphatic system.

People already with the disease cannot be cured by drugs, but symptoms can be relieved relatively simply. Careful washing of the infected area can prevent the most severe effects. Researchers have found that the most extreme symptoms of the disease are largely due to secondary bacterial or fungal infections that can be prevented with improved hygiene.

Lymphatic filariasis does not kill, but it stigmatises and can have serious economic and social effects on people with the disease when they are ostracised by their own community. People with advanced disease often have difficulty finding work or a partner, or their husband or wife may leave them.

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