Four months after India launched a triple drug therapy regimen to achieve the ambitious target of eliminating lymphatic filariasis from the country by 2021, the Union Ministry of Health has put in place a policy for domestic procurement of the drug Ivermectin.
An estimated 63 crore people in the country are in need of preventive chemotherapy to avoid contracting the disease and the 53 million doses that India has received so far from an international donation programme are not enough. India needs about 100 million doses to cover the vulnerable population in endemic districts – the balance is likely to cost nearly Rs 200 crore which exceeds the budget allocated for the programme for the current year. The disease is endemic to 256 districts across the country.
Spread through mosquito bites, lymphatic filariasis – a disease in which coiled and thread-like parasitic worms infect the lymphatic system — is characterised by swollen misshapen feet, giving the disease the names Elephantiasis and Hydrocele.
Of the 1.5 billion people at risk of contracting the disease across the world, an estimated 600 million people are said to be in India. The government is banking on mass drug administration of three drugs — Ivermectin, Albendazole and Diethylcarbamazine, together known as IDA — to contain the spread of the disease.
“We have recently affected a policy change to enable domestic procurement of Ivermectin and we have ordered drugs worth about Rs 17 crore from the resources we already had this year. There was no policy earlier for domestic procurement of Ivermectin so naturally, there were no funds available. Now that the policy is in place, we are hopeful we will get some money next year, or maybe, in the revised Budget estimates for the current year,” said a senior health ministry official.
In 2019, India became the first country in the southeast Asia region to successfully pilot IDA therapy in five districts initially. Building on learnings from other campaigns (polio eradication, measles rubella elimination), the programme adopted an innovative social mobilisation strategy leading to high levels of reported community acceptance to the drugs.
Soon after, at a national symposium organised by the ministry and the World Health Organization (WHO), Union Health Minister, Dr Harsh Vardhan announced that India would learn from the pilot districts and scale-up the provision of IDA in a phased manner to further accelerate progress. By the end of 2019, IDA had been scaled up in another 11 districts of Uttar Pradesh.
Currently, Ivermectin being used by the public programme is being made available through the Mectizan Donation Programme — an international programme that supports countries in fighting the 11 Neglected Tropical Diseases.