Sri Lanka
Country Overview
Sri Lanka is an island nation in Southern Asia with a population of about 21.3 million. Even with an average GDP growth of 4.5% in 9 of the last 10 years, ethnic conflict has impeded economic growth over two decades. The country continues to recover from the devastating 2004 tsunami that killed tens of thousands and destroyed about $1.5 billion worth of property. The tropical monsoon climate contributes to the prevalence of various infectious diseases in the country, including malaria, dengue fever, Japanese encephalitis, lymphatic filariasis (LF), soil-transmitted helminths (STHs), and leptospirosis.
Civil strife has also aggravated Sri Lanka’s public health situation by increasing insecurity and limiting access to health care for the population in northeast Sri Lanka, with significant understaffing in the health sector. Following the recent termination of hostilities it is likely the country’s health sector will be disadvantaged by the need for Sri Lanka to deal with post-conflict humanitarian need and reconstruction efforts.
Current Effort
LF control in Sri Lanka has strong support from the national government, with assistance from international organizations. Earlier efforts during the 1950s and 1960s resulted in the elimination of the Brugian form of the disease leaving the endemic areas confined to the south west of the country. Mapping for LF was conducted in all 25 districts and approximately 10.4 million people live in the eight districts found to be endemic. All of these received a first round of mass drug administration in 2001 or 2002; the national Programme to Eliminate Lymphatic Filariasis has also developed guidelines to prevent LF-caused disability and follows them in all of these districts. Five rounds of de-worming treatment have been administered since 2002; drugs were distributed house-to-house, or at specific locations in selected highly-endemic pockets, in an effort to achieve high coverage rates. In addition, hydrocele surgeries were carried out by public and private hospitals across the country. Sri Lanka is now believed to have successfully interrupted the transmission of LF, so treatment was stopped in 2007, but surveillance continues.
The albendazole distributed in LF-endemic districts also provided effective treatment for STHs. Sri Lanka is one of the few countries that include deworming in its routine antenatal care programs, greatly minimizing the number of pregnant women who suffer from STHs and related complications, particularly anemia. Sri Lanka has also conducted vector control activities, health awareness campaigns, and distribution of mother-infant and first aid kits as well as bed nets – particularly in the northern region most affected by the conflict.
Remaining Gap
Needs assessments and health sector development must continue to avoid further deterioration of the health system during the ongoing civil unrest. Additional funding is needed to ensure the continued provision of drugs to treat STHs, as well as continued monitoring, program evaluation, and disability management regarding NTD control. To support NTD control efforts in Sri Lanka, please click here.
