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Africa’s populous country, Nigeria, contains or contained more cases of dracunculiasis, onchocerciasis, lymphatic filariasis, and schistosomiasis than any other African nation and ranks or ranked first (dracunculiasis, onchocerciasis, schistosomiasis) or third (lymphatic filariasis) in the world for the same diseases. After beginning village-based interventions against dracunculiasis 20 years ago and confronting onchocerciasis a few years later, Nigeria has nearly eliminated dracunculiasis and has provided annual mass drug administration for onchocerciasis to over three quarters of that at-risk population for 7 years. With assistance from The Carter Center, Nigeria began treating lymphatic filariasis and schistosomiasis in two and three states, respectively, over the past decade, while conducting pioneering operational research as a basis for scaling up interventions against those diseases, for which much more remains to be done. This paper describes the status of Nigeria’s struggles against these four neglected tropical diseases and discusses challenges and plans for the future.
Received November 14, 2008. Accepted for publication January 21, 2009.
Acknowledgments: The authors thank Shandal Sullivan, Renn McClintic-Doyle, and Lauri Hudson-Davis for assistance in preparing this manuscript. We are deeply grateful for the support provided by Past President and Mrs. Jimmy Carter, and by General Dr. Yakubu Gowon in the work described here. We also acknowledge the work of Dr. Munirah Y. Jinadu, former national coordinator for schistosomiasis control and LF elimination.
Financial support: Major external support for the dracunculiasis eradication program was provided by The Carter Center, the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), Centers for Disease Control and Prevention (CDC), and many other donors. The Japan International Cooperation Agency (JICA) and UNICEF helped support safe water sources in some dracunculiasis-endemic villages. Nigeria appreciates the support and partnership with Lions Clubs, UNICEF, Africare, the River Blindness Foundation, Helen Keller Worldwide, Christoffel Blindenmission, SightSavers International, MITOSATH, IFESH, and The Carter Center for Nigeria’s onchocerciasis activities. Additional support for the onchocerciasis activities is provided by the African Program for Onchocerciasis Control, with Mectizan donated by Merck. Albendazole was donated by GlaxoSmithKline, and praziquantel was donated by E-Merck (Germany) through WHO. GlaxoSmithKline also provided financial support for LF work in Plateau and Nasarawa States. The Izumi Foundation provided some support for schistosomiasis control in Plateau, Nasarawa and Delta States. The Bill and Melinda Gates Foundation has provided some support for all four programs. WHO’s Regional Office for Africa, the Mectizan Donation Program, the Liverpool Lymphatic Filariasis Support Center, and The Carter Center are helping to support mapping of LF.
* Address correspondence to Donald R. Hopkins, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307. E-mail: sdsulli{at}emory.edu
Authors’ addresses: Ngozi Njepuome, HIV/AIDS/TB, Federal Ministry of Health, Federal Secretariat, Abuja, Nigeria, Tel: 234-805-601-0207, Fax: 234-9-523-7475, E-mail: ngonjep{at}yahoo.com. Donald R. Hopkins, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, Tel: 404-420-3837, Fax: 404-874-5515, E-mail: sdsulli{at}emory.edu. Frank Richards, River Blindness Control Program (including Lymphatic Filariasis Control and Schistosomiasis Elimination), Malaria Control Program, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, Tel: 770-488-4511, Fax: 770-488-4521, E-mail: fxr1{at}cdc.gov. Ifeoma N. Anagbogu, National Guinea Worm Eradication Program, Federal Ministry of Health, Abuja, Nigeria, E-mail: ifechuba{at}yahoo.co.uk. Patricia Ogbu Pearce, National Onchocerciasis Control Program and Lymphatic Filariasis Elimination Program, Federal Ministry of Health, Abuja, Nigeria, E-mail: peje2004{at}yahoo.com. Mustapha Muhammed Jibril, Schistosomiasis and Soil Transmitted Helminth Control Program, Federal Ministry of Health, Abuja, Nigeria, E-mail: mjt0202{at}yahoo.com. Chukwu Okoronkwo, National Onchocerciasis Control Program, Federal Ministry of Health, Abuja, Nigeria, E-mail: chukoro_christ{at}yahoo.co.uk. Olayemi T. Sofola, National Malaria Control Program, Federal Ministry of Health, Abuja, Nigeria, E-mail: tsofola{at}yahoo.com. P. Craig Withers Jr, Health Programs, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, Tel: 404-420-3851, Fax: 404-874-5515, E-mail: cwither{at}emory.edu. Ernesto Ruiz-Tiben, Guinea Worm Eradication Program, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, Tel: 770-488-4509, Fax: 770-488-4532, E-mail: exr1{at}cdc.gov. Emmanuel Miri, Country Representative, The Carter Center, 1 Jeka Kadima Street, Off Tudun Wada Ring Road, PO Box 7772, Jos, Nigeria, Tel: 234-73-461-861 or -463-870, Fax: 234-73-460-097, E-mail: cartercenterng{at}yahoo.com. Abel Eigege, Nasarawa Integrated Programs, The Carter Center, 1 Jeka Kadima Street, Off Tudun Wada Ring Road, PO Box 7772, Jos, Nigeria, Tel: 73-461-861 or -463-870, Fax: 73-460-097, E-mail: cartercenterng{at}yahoo.com. Emmanuel Emukah, Southeast Programs, The Carter Center, 1 Jeka Kadima Street, Off Tudun Wada Ring Road, PO Box 7772, Jos, Nigeria, Tel: 73-461-861 or -463-870, Fax: 73-460-097, E-mail: emukahe{at}yahoo.com. Ben C. Nwobi, Control of Neglected Tropical Diseases, Federal Ministry of Health, Abuja, Nigeria, E-mail: emekanwobi{at}hotmail.com. Jonathan Y. Jiya, Federal Ministry of Health, Abuja, Nigeria, E-mail: jiyajy{at}yahoo.com.
Reprint requests: Donald R. Hopkins, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307.
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