The World Health Organization (WHO) has officially recognized Niger for successfully meeting the criteria for onchocerciasis elimination. This significant public health milestone positions Niger as the fifth country globally and the inaugural nation in Africa to be certified by the WHO for halting the transmission of the parasite Onchocerca volvulus.
“Eliminating a disease represents a monumental achievement, demanding tireless dedication,” stated Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO. “I commend Niger for its unwavering commitment to freeing its people from this stigmatizing, sight-robbing disease, which inflicts immense human suffering, particularly among the most vulnerable. This success further highlights the remarkable progress we are making in the fight against neglected tropical diseases. By demonstrating that elimination is indeed possible, it offers profound hope to other nations still grappling with onchocerciasis today.”
Onchocerciasis, widely known as river blindness, is a parasitic affliction and stands as the second leading infectious cause of blindness worldwide, trailing only trachoma. The disease spreads through the bite of an infected black fly, which predominantly thrives near fast-flowing rivers and streams. While primarily affecting rural communities in sub-Saharan Africa and Yemen, smaller endemic pockets are also found in Latin America.
Niger’s proactive strategies and collaborative success
Between 1976 and 1989, under the guidance of the WHO’s Onchocerciasis Control Programme in West Africa (OCP), Niger implemented crucial vector control measures, including targeted insecticide spraying. These efforts significantly curtailed onchocerciasis transmission levels. Subsequently, thanks to donations of ivermectin from Merck, Sharpe & Dohme (MSD), a comprehensive mass drug administration (MDA) campaign utilizing ivermectin and albendazole was rolled out from 2008 to 2019 in areas still impacted by lymphatic filariasis, which were then closely monitored. Given ivermectin’s efficacy against both conditions, and with the targeted MDA zones for lymphatic filariasis overlapping with onchocerciasis-endemic regions, this intervention also proved instrumental in interrupting the transmission of the Onchocerca volvulus parasite.
Niger initiated preliminary assessments for onchocerciasis transmission interruption in 2014, following the cessation of MDA for lymphatic filariasis in most areas. Subsequent entomological and epidemiological surveys conclusively demonstrated that the combined approach of medication and vector control had effectively eliminated onchocerciasis transmission, evidenced by a dramatic reduction in prevalence from approximately 60% to a mere 0.02%.
Beyond the direct vector control interventions and MSD’s generous drug donations, the robust partnership between the Nigerien government, the WHO, and various non-governmental organizations was pivotal to Niger’s success. This collaboration facilitated the mobilization of essential resources and technical support. Continuous monitoring of disease prevalence and its impact allowed for agile adjustments to strategies, ensuring the enduring effectiveness of all interventions.
“Onchocerciasis has long inflicted immense human suffering. It has also stifled economic development in affected communities by forcing populations away from rivers, which are often vital for their livelihoods,” explained Dr. Matshidiso Moeti, WHO Regional Director for Africa. “Niger’s success lifts this burden from its people. It also establishes Niger as a shining example for neglected tropical disease elimination across Africa. The country had already demonstrated its public health leadership in 2013 by eliminating Guinea worm disease. Today marks another historic stride.”
Global strides in disease elimination
Globally, 54 countries have successfully eliminated at least one neglected tropical disease.
Niger now joins four other nations whose onchocerciasis elimination has been certified by the WHO, all located within the Region of the Americas: Colombia (2013), Ecuador (2014), Guatemala (2016), and Mexico (2015).
Within the WHO African Region, 21 countries have eliminated at least one neglected tropical disease. Onchocerciasis is the second neglected tropical disease eradicated in Niger, following the country’s certification as free from dracunculiasis (Guinea worm disease) transmission in 2013.
