Nepal strengthens lymphatic filariasis elimination efforts through innovative mass drug administration (MDA) strategies

To accelerate the elimination of lymphatic filariasis (LF) as a public health problem by 2030, Nepal launched a Mass Drug Administration (MDA) campaign in high-burden areas of Banke district, Lumbini Province.

With technical and financial support from WHO Nepal, the campaign was carried out in four municipalities of Banke from February to May 2025. It successfully reached over 70% of the targeted population in three of the four municipalities, marking a significant step forward in Nepal’s renewed commitment to ending LF.

Female Community Health Volunteers (FCHVs) provide medicines for lymphatic filariasis to students during a mass drug administration campaign in Banke district, Nepal. Photo credit: WHO Nepal

This initiative was driven by findings from the 2024 IDA Impact Survey (IIS 1), which revealed ongoing LF transmission in Nepalgunj Sub-Metropolitan City, Duduwa and Narainapur rural municipalities, and Baijanath Rural Municipality. In response, WHO Nepal recommended two additional MDA rounds to break the chain of infection in these areas.

The campaign was officially launched on 17 February 2025 in Nepalgunj Sub-Metropolitan City in the presence of Mayor Prashant Bista. The event brought together local and national leaders, including District Coordination Committee Chief Gyanendra Kumar Chaudhary, former director of Epidemiology and Disease Control Division (EDCD) Dr Yadu Chandra Ghimire, and WHO Representative to Nepal Dr Rajesh Sambhajirao Pandav.

Mr Ram Kumar Mahato, programme focal person for lymphatic filariasis at Epidemiology and Disease Control Division, Ministry of Health and Population, orients community leaders for their mobilization during the campaign. Photo credit: WHO Nepal

To build momentum and ensure community engagement, EDCD, Banke’s health office and WHO Nepal initiated an array of advocacy efforts. Public events marking World Neglected Tropical Diseases Day) engaged local leaders, health workers, religious figures, journalists and influencers, building trust and boosting campaign visibility. Planning meetings held at the municipal level in early February encouraged grassroots ownership and paved the way for effective ward-level action.

A total of 319 health workers and 247 Female Community Health Volunteers (FCHVs) were mobilized to deliver MDA medicines to around 267 000 people. Special outreach teams targeted hard-to-reach and hesitant groups. Public figures taking the medicine on camera and widespread social media coverage added momentum. Miking, selfie stations, media outreach and messaging from the National Health Education Information and Communication Center, Ministry of Health and Population (MoHP), and WHO Nepal contributed to raising public awareness.

Health workers fill up the IDA register during the house-to-house mass drug administration campaign against lymphatic filariasis in Banke district, Nepal. Photo credit: WHO Nepal

Furthermore, to ensure inclusive coverage, evening sessions were organized to accommodate mobile workers, while ward-level WhatsApp groups facilitated swift coordination among teams. Regular updates from the MoHP and high-level reviews reinforced accountability and transparency throughout the campaign. Follow-up visits conducted during cooler evening hours after Ramadan helped boost participation in previously low-response areas. Regular cross-sectoral meetings enhanced strategic planning to effectively engage hesitant and hard-to-reach communities.

"The Government of Nepal remains steadfast in its commitment to eliminate lymphatic filariasis by 2030. This campaign reflects our political will, inter-sectoral collaboration and community-driven approach. We are proud of the progress and will continue prioritizing sustained, inclusive outreach to ensure no one is left behind," said Dr Yadu Chandra Ghimire, Former EDCD Director, during the launch of the campaign.

Of the 64 endemic districts, 56 have already halted MDA, indicating Nepal is nearing its goal of LF elimination.

Dr Rajesh Sambhajirao Pandav, WHO Representative to Nepal provides lymphatic filariasis medication to a child during the launch of the Mass Drug Administration (MDA) campaign in Banke district, Nepal. Photo credit: WHO Nepal

"WHO is proud to support Nepal’s unwavering efforts to eliminate lymphatic filariasis. This campaign demonstrates what is possible when technical support, strong government leadership and community engagement come together. I am positive that with sustained commitment and action, Nepal will achieve its elimination goal," said Dr Rajesh Sambhajirao Pandav, WHO Representative to Nepal.