Two pharmaceutical companies — GlaxoSmithKline (then known as SmithKline Beecham) and Merck & Co. Inc. — made a pledge to donate the much-needed drugs for as long as it would take to eliminate the disease.
The elimination strategy has two components: (i) to stop the spread of infection (interrupting transmission); and (ii) to alleviate the suffering of affected populations (controlling morbidity).
In order to interrupt transmission, districts in which lymphatic filariasis is endemic must be mapped and community-wide mass treatment programmes implemented to treat the entire at-risk population. Most of these programmes are based on once-yearly administration of single doses of two drugs given together. The following recommended drug regimens need to be administered once a year for at least 5 years, with a coverage of at least 65% of the total at-risk population:
- 6 mg/kg of body weight diethylcarbamazine citrate (DEC) + 400 mg albendazole; or
- 150 µg/kg of body weight ivermectin + 400 mg albendazole (in areas that are also endemic for onchocerciasis).
An alternative and equally effective community-wide regimen in endemic regions is the use of common table salt or cooking salt fortified with DEC for a period of one year.
The suffering caused by the disease can be alleviated through community education programmes to raise awareness among patients. These programmes promote the benefits of intensive local hygiene practices as well as the prevention of debilitating and painful episodes of inflammation.