A long-standing powerhouse in public health, Atlanta is now home to another public health initiative that’s been making strides in eliminating the debilitating disease lymphatic filariasis: Global Alliance for the Elimination of Lymphatic Filariasis (GAELF).
Lymphatic filariasis (LF) is a tropical parasitic infection, which is usually transmitted through mosquitoes. It is sometimes called ‘elephantiasis’ because peoples’ limbs, normally their legs, end up severely swelling from a buildup of lymphatic fluids, giving the appearance of large limbs resembling those of an elephant. Over 120 million people are at risk of the disease worldwide, according to the CDC.
The Task Force for Global Health, an international organization operating in over 150 countries that supports local health systems and leverages global expertise, regularly supports global programs to eliminate diseases like this. It moved to its current location in Decatur in 2018 and on April 29, 2025, added GAELF into its fold.
“Connect and communicate are two words that we like to use,” said Charles Mackenzie, a pathologist who has been working on eliminating Neglected Tropical Diseases (NTD) like LF for over 50 years and chair of GAELF.
GAELF has been around for 25 years, once based out of the Liverpool School of Tropical Health. Its latest home, the Task Force for Global Health, is a natural landing spot for the effort to eliminate a disease like this, Mackenzie said, due to the task force’s experience running global programs and being a central hub for scientific connections and leadership.
“After many years — say the first 20, 25 years of my career — I was looking for ways to do something. We were a very small scientific community not really getting anywhere,” Mackenzie said.
Their luck would soon change, however.
The Mectizan Donation Program (MDP) was established in 1987, named after one of the drugs that was donated by longtime alliance partner Merck & Co. to help fight the disease known as river blindness. The Mectizan anti-parasitic drug was also found to be effective against LF and helped lead the charge against that disease starting in 1988.
“The big key was the donation of a drug that we realized would, in fact, impact the infection and, through that, reduce the disease; we found a way through research, but the research needed the donation of a drug because drugs cost a fortune for treating several 100 million people.”
Since then Merck & Co. has helped facilitate over 5 billion treatments for the disease, and today the Task Force for Global Health reports that river blindness has been eliminated in Colombia, Ecuador, Guatemala, Mexico and Niger. It has also been instrumental in eliminating LF.
An invisible force for good
Today, GAELF looks back at the progress it made in eradicating LF — even if it’s not well-known.
“Good public health work is prevention,” said Andie Tucker, business strategy manager for the Task Force for Global Health. “Which means it’s sometimes invisible… often invisible,” she added.
According to the Task Force for Global Health, LF has been eliminated in Malawi, Timor-Leste, Togo and Yemen. Aside from those countries, it also reports that 305 million people no longer need treatment for LF.
The World Health Organization (WHO) noted a decrease from nearly 2.2 billion to 1.4 billion in people needing interventions against NTDs from 2010 to 2023.
“How do you get so many drugs to some of the most difficult places [to access] on Earth, and to everybody — because everybody who is in the infection area who is not a young child, old and ill or pregnant you treat,” Mackenzie said. “That’s a massive task and job, and frankly, I think it’s one of the most extraordinary successes we’ve had in medicine that still nobody really knows much about.”
In the social media age, with varying opinions on COVID, the perennial question of ‘why isn’t there a cure for cancer yet,’ vaccine skepticism and mistrust of institutions going to developing nations in the name of “doing good,” it is hard to find a public health win of this proportion without any conspiracies.
But LF may be an exception.
“There’s not a lot of conspiratorial stories you can develop with this one, because it was just countries that went out and did it… WHO organized it, drug companies gave the drug, and NGOs supported it… it just went ahead,” Mackenzie said.
Working with community partners in each local region has helped build trust within those communities and aided the effort’s effectiveness. The relatively recent memory of how widespread the debilitating disease used to be, too, helps communities stay persistent in the fight against it.
Moreover, ensuring that people hear about these public health wins is crucial to tackling diseases in the future, just as the effort to tackle river blindness helped catalyze a similar effort to eliminate LF.
“People want to invest their time, effort, attention and money in efforts that will go somewhere,” said Tucker. “We all want to have an impact, and we have shown enormous, jaw-dropping, beyond anybody’s expectations impacts in the LF space. Nobody expected that we’d be looking at 21 countries having eliminated this disease by this year and millions and millions of people no longer being at risk for LF.”
Tucker added that they anticipate an additional five countries may be able to report the elimination of the disease just this year. The goal is to ultimately eliminate the disease in all endemic countries.
The last mile
Despite its successes, the alliance is focusing efforts on reaching that “last mile,” or the hardest milestones to achieve.
At a time where public health priorities are being reshaped on a federal level — and with it, the funding for programs — the work of entities like GAELF becomes that much more important, agreed Mackenzie and Tucker.
“Operating in a more resource-constrained environment means that we need to be more effective problem solvers; we need to be more efficient with the funding that we do have,” said Tucker. “That is where GALEF comes in because GALEF holds together the community that works on LF.”
Through the alliance and the joining of the Task Force for Global Health, GAELF is optimistic it won’t have to miss a beat. It’s important to be intentional about keeping the “foot on the gas” because these wins aren’t necessarily a given, Tucker said.
“If we don’t think hard, if we don’t collaborate, if we don’t work together, if we don’t get real scrappy and smart about what comes next because of the constrained resource environment in which we’re operating now, then we might not reach that last mile,” Tucker said. “And that would be so devastating for how far we’ve come together.”
True dedication to a disease that has stayed in the shadows of malaria, TB.
Treatment which has given independence back to those who have been affected and infected.