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espite running late in eradicating filariasis, the government says it will rid the country of the tropical disease by 2025.

The Health Ministry said 32 of 236 formerly lymphatic filariasis-endemic regencies across Indonesia were now free from the infectious parasitic disease, known as kaki gajah (elephant foot), including Bandung in West Java, Rote islands in East Nusa Tenggara (NTT) and Merauke in Papua.

More regencies are expected to be declared free of filariasis this year, as 73 regencies have finished their five-year compulsory mass drug program and are currently being assessed by the government’s filariasis elimination task force.

The 2025 target is five years later than a goal set by World Health Organization, which aims for the worldwide elimination of lymphatic filariasis as a public health problem by 2020.

“It is impossible to eliminate it by 2020, because we just started the October National Filariasis Elimination Month program in 2015. […] But we are optimistic that with this program we can eliminate it entirely by 2025,” the ministry’s director of prevention and control of vector and zoonotic infectious diseases, Jane Supardi, said on Tuesday.

Eliminating filariasis is an important task, as the disease, which occurs when filarial parasites are transmitted to humans through mosquitoes, can cause permanent disability.

Therefore, the decreasing prevalence is good news for a nation that has declared eliminating lymphatic filariasis a national priority since 2004.

According to ministry data, there were 13,039 cases of chronic filariasis in 2017. Papua, NTT and West Papua have the highest number of cases, with 3,000, 2,700 and 1,300, respectively.

Jane said the disease had been the target of worldwide efforts for dozens of years, but it was only in 2015 that the Health Ministry officially launched a more integrated program called the October National Filariasis Elimination Month (Belkaga) to eradicate the disease.

This year, therefore, marks the fourth time for the Health Ministry to hold the nationwide mass drug administration (POMP) for lymphatic filariasis. This October, the drug against the disease will be given to around 36.5 million people in 131 affected regencies.

The Belkaga program has been scheduled for every October from 2015 until 2020, and it is compulsory for all people from 2 to 70 years of age in the endemic regencies to take the medicine simultaneously to prevent the disease and focuses on decreasing microfilaria, the larval stages of the filarial worm, in blood.

After the nationwide mass drug administration is completed, there will be a thorough evaluation by the task force, and only regions with incidence rates below 1 percent will get the filariasis elimination certificate from the ministry.

However, Taniawati Supali, the head of the filariasis task force, said the nationwide mass drug administration program was challenging, because some of the people, claiming that they are not sick, rejected the medicine to avoid side effects.

“Some people experience side effects like nausea and headache, but that is a good thing, because it means the medicine is trying to kill the microfilaria inside the blood. Many are concerned about these effects and also tell others not to take the drugs,” Taniawati said.

Alor regency in NTT, for example, which once had one of the highest rates of chronic cases, has decreased the prevalence of filariasis from around 20 percent of the population in 2002 to below 1 percent in 2007, after its people took the medicine religiously for six years.

“It is possible for us to eliminate the disease, but to reach that goal, it is important that everyone takes the medicine, especially the healthy people. Everyone must participate so that we can create herd immunity,” she said.