The last mile is the longest

(An excerpt from the Mectizan Donation Program Annual Highlights for 2021)

The World Health Organization (WHO) provides invaluable technical assistance along the road to river blindness and lymphatic filariasis elimination.

The last mile is the longest. It is at this stage when, after countries have achieved many years of consistently high treatment and geographic coverage, they are ready to begin the official process of verification of elimination of transmission of river blindness or validation of elimination of LF as a public health problem. This is a long and rigorous affair, and for good reason. Premature declaration of elimination could lead cash-strapped countries to abandon MDA and monitoring and evaluation while transmission is ongoing in undetected hot spots. This could lead to the disease returning to areas where it was thought to have been previously eliminated, a phenomenon known as recrudescence.

Niger is currently working on its dossier for the official verification of elimination of river blindness transmission and may soon become the first country in Africa to be verified by WHO. This would be a remarkable milestone after decades of elimination efforts in Niger, starting with larviciding with support from WHO’s Onchocerciasis Control Program in the 1970s, which was the frontline intervention until Mectizan was donated in 1987.




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