Yaws (framboesia) is a chronic skin disease caused by the bacterium Treponema pallidum. Almost 75% of the cases are children under 15 years old and it occurs primarily in deprived communities in warm, humid and tropical forest areas of Africa, Asia, Latin America and the Pacific. In these areas, overpopulation, poor hygiene and socioeconomic conditions facilitate the spread of the yaws. Transmission takes place through direct, non-sexual skin contact with an infected person. After 2-4 weeks, a single skin lesion appears that may multiply and spread all over the body when left untreated with antibiotics. Although rarely fatal, yaws can lead to chronic disfigurement and disability - deformities of the nose and legs - after 5 years. These complications may result in stigma, social exclusion, school absenteeism and restricted participation in the community. Unfortunately, there is no vaccine for yaws. Prevention therefore is based on the interruption of transmission by (targeted) mass drug treatment of communities, early diagnosis, health education and improvement in personal hygiene.  

Towards eradication

Past experience has shown that elimination is possible in many countries. In 2012, the WHO developed the Morges Strategy for yaws eradication by 2020. This strategy focus on delivering mass treatment to entire endemic communities and targeted treatment to all active cases and their contacts. Recently, India eliminated yaws with no new cases since 2004.