The debilitating effects of lymphatic filariasis (LF) were once a constant threat for the people living on Kenya’s Lamu coast. Lymphedema, a painful and disabling swelling of the limbs caused by advanced LF, is the most visible effect of the disease. Today, it is estimated that 4.3 million people still require treatment for the disease, but the threat of irreversible swelling has been reduced dramatically.
Kenya began a mass drug administration (MDA) program against LF in 2000, but lacked funding to complete enough annual rounds to eliminate the disease. “We started with high hopes, but the funds lasted just two years,” said Dr. Dunstan Mukoko, former director of the NTD Unit of the Kenyan Ministry of Health (MoH). MDA was carried out only when funding was available, until it was halted altogether after a decade.
In 2016, the END Fund, Evidence Action, and the MoH began a partnership that would transform the country’s LF elimination program. The END Fund provided consistent funding to restart MDA in the coastal region, and it was conducted successfully for five years in a row.
Building on this momentum, an innovative approach was piloted in 2018 to accelerate elimination by administering three drugs at once—ivermectin, diethylcarbamazine, and albendazole (IDA). This triple drug therapy has the potential to reduce the time needed to break transmission of LF from five years or more down to just two years. IDA was piloted in three coastal sub-counties that had lagged behind in lowering rates of the disease—Jomvu, Lamu East, and Lamu West. Dr. Sultani Matendechero, head of the Kenya National Public Health Institute, partnered with the END Fund to introduce the triple drug approach. “Essentially, we were the first country in the world to deliver effective rounds of IDA and to showcase that it is able to eliminate LF in two years,” he said proudly.
Use of triple drug therapy has helped the country’s elimination efforts to vault forward despite the challenges of its early years. Following two successive rounds of IDA therapy in Jomvu, Lamu East, and Lamu West, an impact assessment in 2021 confirmed that these areas had successfully interrupted