Since 1997, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) has been facilitating the scale up of mass drug administration programs in LF endemic countries. I thought about trying to include some pictures on this post of people suffering from LF, especially advanced hydroceles, but then thought better of it. This stuff really makes my stomach turn. I have never that the chance to see really advanced stage disease in person, but have seen moderates cases of swollen limbs on a recent trip to Tanzania. It is no wonder it is given the name elephantiasis.

Eric Ottensen and colleagues have recently released estimates of how much of the global burden has been averted due to the scale up of these programs in roughly half of the global LF endemic countries. The result:

More than 6 million cases of hydrocele and 4 million cases of lymphoedema prevented, translating into more than 32 million DALYs averted

What is even more remarkable, is that this is just an estimate of the direct impact of the program, and excludes the likely enormous deworming effect of these same drugs on the treated population on other helminthic infections, such as hookworms, which they do not attempt to estimate but are likely to be sizable.

And the price tag for all of this work? They estimate to be roughly $200 million, excluding the price of drugs which have largely been donated by GlaxoSmithKline (but should include in country-costs). Roughly $6 per daly averted. Not a bad deal.

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