Yaws and other endemic treponematoses

Informal consultation on Yaws, 24–26 January 2007, Geneva, Switzerland

Background


The WHO Department of Control of Neglected Tropical Diseases organized a three-day (24–26 January 2007) informal consultation on yaws to revive interest (activities at headquarters) and launch a new global initiative to address the persistence and resurgence of the disease.

Objectives

The four objectives of the meeting were:

  • To review the current epidemiological situation on yaws worldwide.
  • To define what should be done at global, regional and country levels, and how.
  • To identify potential partners for yaws elimination.
  • To launch a new initiative on yaws.
Main conclusions and recommendations
  • Although tremendous achievements have been made in the past to reduce the burden of the disease, yaws has not been eliminated from certain countries, as currently believed. Indeed, it has been resurging in some previously endemic countries since the late 1970s.
  • Except in a few countries, yaws is not part of public health and surveillance activities (using available data of 1990). The current global distribution of the disease is therefore unclear.
  • In the WHO South-East Asia Region, the goal is to eradicate yaws by 2012. Targeted countries are India, Indonesia and Timor-Leste.
  • The declaration in 2006 of elimination of yaws in India provides additional impetus that elimination is possible in other countries. Strong political commitment (national health policy of India 2002 on yaws eradication), periodic reviews and close monitoring of programme activities at the highest level by a task force as well as independent appraisals have all made elimination possible.
  • In general, yaws has been eliminated from many of the 46 endemic countries based on the 1950 data.
  • Activities to control yaws should be revived, starting in countries with currently available information, and the situation evaluated in other countries based on the disease distribution in 1990.
  • WHO should establish an elimination programme for yaws in the context of neglected tropical diseases and take the lead in actively reviving interest in the disease and in engaging countries.
  • The goal should be elimination of clinical cases (zero cases) supported by active case-finding and serological surveys. No timeline for elimination has been set.
  • Revived national efforts should explore possible collaboration with existing programmes, for example, Buruli ulcer, dracunculiasis and leprosy, as well as immunization to facilitate elimination and surveillance activities, and to allow the use of existing resources of these programmes.