Haiti National Program for the Elimination of Lymphatic Filariasis—A Model of Success in the Face of Adversity

Abstract

Lymphatic filariasis (LF) is a mosquitoborne parasitic infection that causes lymphedema, elephantiasis, and hydrocele. Haiti is one of only four countries left in the Americas where transmission of lymphatic filariasis still occurs. The National Program to Eliminate LF (NPELF) was started in Haiti in 2000, and by 2005 a population of 1.6 million people in 24 communes, including the majority of high-prevalence communes, was targeted at least once for mass drug administration (MDA). An interruption in external funding at the end of 2005 paralyzed the program, but with new donor support the NPELF was able to scale up to achieve full geographic coverage, reaching more than 8 million people in 2012. The LF program in Haiti has faced many challenges, including political crises, hurricanes, a devastating earthquake, and a deadly cholera outbreak in the earthquake's aftermath. Despite these challenges, the NPELF and partners have persisted, and now the program is integrated with soiltransmitted helminth (STH) control, is national in scope, and provides appropriate supportive care for persons suffering from LF morbidity. Haiti serves as a model for successful program implementation in countries affected by political and social challenges and natural disasters.