02188nas a2200217 4500000000100000008004100001653003900042653003000081653001600111653001600127100001600143700001400159700001600173700001300189700001400202245009300216300001200309490000700321520162800328022001401956 2016 d10aNeglected tropical diseases (NTDs)10aLymphatic filariasis (LF)10aGuinea worm10aElimination1 aKastner R J1 aStone C M1 aSteinmann P1 aTanner M1 aTediosi F00aLessons learned from developing an eradication investment case for lymphatic filariasis. a393-4170 v943 a

In the last few years, the concepts of disease elimination and eradication have again gained consideration from the global health community, with Guinea worm disease (dracunculiasis) on track to become the first parasitic disease to be eradicated. Given the many complex and interlinking issues involved in committing to a disease eradication initiative, such commitments must be based on a solid assessment of a broad range of factors. In this chapter, we discuss the value and implications of undertaking a systematic and fact-based analysis of the overall situation prior to embarking on an elimination or eradication programme. As an example, we draw upon insights gained from a series of lymphatic filariasis (LF) studies from our research group that adopted an eradication investment case (EIC) framework. The justification for EICs, and related epidemiological, geospatial and other mathematical/operational research modelling, stems from the necessity for proper planning prior to committing to disease eradication. Across all considerations for LF eradication, including: time, treatments, level of investments necessary, health impact, cost-effectiveness, and broader economic benefits, scaling-up mass drug administration coverage to all endemic communities immediately provided the most favourable results. The coherent and consistent pursuit of eradication goals, operationally tailored to a given socioecological system and based on integrated measures of available tools will lead relatively rapidly to elimination in many parts of endemic areas and provide the cornerstone towards eradication.

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