WHO Revives Efforts To Eliminate Forgotten Disease: Yaws

Today, more than 500 000 are afflicted by yaws, which is caused by a spiral bacteria that penetrates through a cut in the skin resulting in bumps that burst, ulcerate and spread over the body.

In the 1950s, more than 50 million people worldwide were afflicted by the disease until WHO, in partnership with UNICEF, established a massive global control programme to eliminate it. The Global Yaws Control Programme, fully operational between 1952 and 1964, succeeded in treating 300 million people in 50 countries - reducing global levels of the disease by more than 95% and virtually eradicating yaws. However, after the programme's enormous success, sustained surveillance of yaws diminished, which has now given way to its resurgence in the 21st century.

Debilitating disease

Yaws is transmitted from person to person via skin contact or through breaks in the skin caused by injuries or bites which allow the spiral bacteria to penetrate. It is a debilitating disease whose effects in its young victims (mostly children under 15 years of age) can often cause gross deformation. Lesions develop that eat bone, cartilage, skin and soft tissue, leaving victims with gaping holes where their lips or noses should be.

"The persistence of yaws in the 21st century is unacceptable;" says Dr Lorenzo Savioli, WHO Director of Neglected Tropical Diseases. "There is a cost-effective approach to treating this disease." Yaws is treated by a single dose of long-acting penicillin that costs as little as 32 US cents. Experts believe that yaws can be eliminated and eventually eradicated because humans are the only reservoir of infection.

New cases of yaws appear every year. This week (24-26 January), world experts including officials from the health ministries of selected endemic countries -- Indonesia, Ghana and the Republic of Congo -- will be holding an informal consultation to develop a new global strategy for combating this disease, the second attempt of its kind.

Objectives and optimism

The consultation's objectives are three-fold:

1. to detect and treat all yaws cases and their contacts;
2. to interrupt transmission of the disease;
3. and to prevent disability.

The overall aim is to minimizing suffering and the socio-economic impact the disease has on affected populations. A recent control programme in India provides optimism that elimination can be achieved in other countries with persistent efforts and political commitment. In the south-east Asia region, the aim is to eradicate yaws by 2012.

The consultation this week will examine whether elimination is now possible in other regions of the world, signalling a possible revival of the 1950s global yaws programme as well as the development of a current global strategy to generate much needed support at global, regional and country levels to eradicate this disease once and for all.