GlaxoSmithKline and the Global Alliance to Eliminate Lymphatic Filariasis

In one of the largest and most significant corporate donation programs in history, GlaxoSmithKline joined together with the World Health Organization (WHO) in 1998 to form a global alliance initiative to eliminate the devastating disease lymphatic filariasis. Now, armed with a global strategy and a coalition of more than 30 other organizations from every sector, the Global Alliance to Eliminate Lymphatic Filariasis seeks to eliminate the epidemic worldwide by the year 2020. In just two years, the initiative has overcome important hurdles and already achieved significant results.

The Problem: Lymphatic Filariasis

Lymphatic filariasis (LF)also known as elephantiasisis among the world's most debilitating and profoundly disfiguring tropical diseases. Currently affecting as many as 120 million people in more than 80 countries, LF is the world's second leading cause of long-term disability and is a significant contributor to global poverty.

LF is a parasitic disease caused by microscopic worms that infect the human lymphatic system, and is transmitted from person to person by mosquitoes. The adult worms cause extensive damage to the lymphatic system resulting in severe, painful swelling of a victim's arms, legs, breasts, or genitals. LF is most often acquired during childhood, with the most severe symptoms appearing later in adulthood. At least a third of those infected by the disease are seriously incapacitated from the disfigurement. In addition to the physical handicap associated with the disease, victims must also endure severe psychological trauma and social stigmatization as well.

The World Health Organization (WHO) estimates that there are roughly a billion people worldwide that are at risk for acquiring the disease. In 1994, the International Task Force for Disease Eradication identified LF out of more than 90 different diseases as one of only six with the potential to be eradicated.

The Solution

In 1997, the World Health Assembly adopted a resolution calling for the elimination of LF as a public health problem worldwide. The very next year multinational pharmaceutical company SmithKline Beechamnow GlaxoSmithKline (GSK) joined together with the World Health Organization (WHO) to form one of the biggest corporate philanthropic program's in history, a global alliance to eliminate LF by the year 2020. The Global Alliance for the Elimination of Lymphatic Filariasis is a bold initiative that brings together 3 multinational corporations and 32 other organizations representing the public sector, academia, non-governmental organizations (NGOs), and multilateral agencies.

The cornerstone of the program's ambitious strategy is GlaxoSmithKline's donation of as much of its antiparasitic drug albendazole as is needed to eliminate the disease over the next 20 yearsestimated to be roughly 5 billion tablets. In addition to donating almost unlimited pharmaceutical supplies to the program, GlaxoSmithKline is providing additional grant support for coalition-building, program planning, worker training and communication initiatives. The program is further buttressed by the extension of Merck & Company's successful Mectizan" Donation Program against onchocerciasis (river blindness) to include LF as part of the initiative in areas of Africa where LF and onchocerciasis co-exist. The administration of both drugs has proven highly effective in minimizing LF and other similar infections. Both companies are highly involved in the activities of the Global Alliance and work closely with the other partners in the multisector program.

The central strategy of the elimination program is to break the disease's cycle of transmission by reducing the amount of microscopic worms in the blood of the at-risk population and minimizing the effect of mosquitoes. In addition to distributing the antiparasitic drugs, the strategy calls for the development of national plans of action, close coordination with local ministries of health, and integration with other similar intervention programs, such as river blindness and malaria control. The initiative also seeks to relieve the suffering and create hope among those already infected by educating health workers and patients about hygiene and treatment techniques to minimize the disability from secondary infections.

Results

By the beginning of 2001, only two years after the initiative's inception, the results of the program have been significant:

• 15 million people at risk in 20 countries were covered by active LF elimination programs.
• 33 countries had developed a national plan of action and at least 14 countries had begun implementation of an elimination program.
• Program managers in all 80 endemic countries had been identified and mobilized to begin activities at the country level.
• Mass drug distribution had already successfully begun at the country levelas in Egypt where 95% of the 2 million targeted individuals received the necessary medication.
• GlaxoSmithKline had provided 34 million tablets of albendazole to a number of countries through WHO. By the end of 2001, production and supply of the drug will increase to meet the needs of at least 35 countries.
• Merck & Co. had provided 4.6 million tablets of ivermectin (Mectizan) to Ghana, Nigeria, United Republic of Tanzania, and Togo.
• WHO facilitated the delivery of an additional 115 million tablets of the antiparasitic drug diethylcarbamazine (DEC), also used in conjunction with albendazole.
• India, with a third of all LF cases, has begun a massive pilot program to reach 40 million people.
• In February of 2001, the Alliance received a grant of $20 million from the Bill and Melinda Gates foundations to fund the first five years of the eradication program. The funds will be channeled through a World Bank trust fund to WHO and several Alliance partners.

The Global Alliance to Eliminate Lymphatic Filariasis is an important demonstration of the synergistic potential that can result from public-private collaboration in global health. Only by forming a multisector coalition of equal stakeholders, each bringing its own tools and experience, can a public health initiative such as this maximize its reach and achieve its ambitious goals worldwide. If the program is successful in eliminating this devastating disease, LF will join the ranks of only one other epidemic to ever be eradicated, that of small pox in 1980. It is hoped that Polio will also join that list within the next several years.

For more information about GSK the Global Alliance to Eliminate Lymphatic Filariasis, contact:
Lymphatic Filarisis Programme
Global Community Partnerships
GlaxoSmithKline
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