Lessons from successful disease prevention campaigns in former British Africa: The Nigerian experience with Yaws

Källarsalen Session 3: Paths towards sustained development in the global south: Historical lessons organized by Erik Green and Ellen Hillbom


Jeanne Cilliers, Jutta Bolt


Neglected tropical diseases (NTDs) are just one of several categories of diseases that have been linked to slow economic development. This group of parasitic and bacterial diseases affects around 1.65 billion people worldwide and are mostly found in low-income communities, particularly in rural areas and urban slums with limited access to clean water and poor housing conditions (WHO, 2023). Yaws is a NTD that, due to lack of attention and funding, still affects people in this 21st century. One of the earliest demonstrations of the potential of mass antibiotic treatment in controlling and eliminating NTDs in Africa was the Nigerian anti-Yaws campaign. The British colonial government, in collaboration with local health officials and traditional healers in Nigeria recognized Yaws as a significant public health problem and initiated a mass treatment program in the 1940s and 1950s using penicillin to control the disease. It is thought to have been one of the most successful mass treatment campaigns of the disease and became a model for similar campaigns that were carried out in other countries (WHO, 1988). In West Africa mobile medical units had long been used to reach sparsely populated areas evolving from, or in close association with trypanosomiasis organizations (McLetchie, 1954). From 1947, medical field units in Nigeria conducted surveys to determine the occurrence of Yaws and other endemic diseases in various remote locations. These medical field units conducted extensive research prior to the launch of the yaws campaign, which facilitated a smooth transition from the planning phase to the full-scale campaign (Zahra, 1956). As such, these units appear to have been instrumental in the rapid control and treatment of the disease (McLetchie, 1954). By the mid-1960s, Yaws was declared eradicated in Nigeria but less than a decade later West Africa saw a resurgence of the disease following a policy shift which incorporated Yaws surveillance and control into primary healthcare (Asiedu et al, 2008). This paper aims to chart the historical prevalence of Yaws in Nigeria and how it responded to mass treatment campaigns. Using Annual Medical Reports for Nigeria (1900-1960), we investigate the contribution of mobile medical services to the success of the Yaws eradication campaign in Nigeria and ask what lessons from this experience can be applied to the challenge of providing healthcare services that reach the remote rural communities where NTDs remain.


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