Elimination of Lymphatic Filariasis in the Pacific - A PacELF success
This special issue of Tropical Medicine and Health has been produced and published to record and celebrate the successes of PacELF - the Pacific Programme for the Elimination of Lymphatic Filariasis. PacELF was designed as a regional programme driven by the 22 island countries and territories in the Pacific for the sole purpose of eliminating lymphatic filariasis (LF). These countries have a wide range of transmission intensity and mosquito vectors. The main strategy for achieving this goal is annual mass drug administration (MDA) using diethylcarbamazine (DEC) with albendazole to stop transmission, together with clinical management of infections to minimize progression of pathology in individuals already infected.
At the start of PacELF, 16 of the 22 Pacific countries and territories were classified as LF endemic. Mass drug administration (MDA) has been conducted in all endemic countries, with the first starting in 1999. Many countries completed MDA in the mid-2000s, although some are continuing to the present day. The following have received validation of elimination by 2017: Cook Islands, Niue, Republic of the Marshall Islands, Tonga and Vanuatu. Several other countries are close to this achievement. Problems and challenges for some countries include delay in rapidly and completely scaling-up interventions, the possibility of resurgence from remaining LF hotspots of transmission, and the difficulty of ensuring that those with residual chronic morbidity are provided with quality services.