Yaws: Freeing Young Children in India from an Old Scourge

Abstract

In 2016, India became the first endemic country in the world to have been verified by the World Health Organization (WHO) as having eliminated yaws. Yaws was first reported in India in 1887, more than 125 years ago, from tea gardens in the state of Assam. It spread in central and central-eastern parts of India. However, by the late 1960s it declined dramatically worldwide including in India, where it was confined to 51 districts across 11 states of the country. The establishment of the anti-yaws campaign in 1952 and the launch of a restructured yaws elimination strategy in 1996 were game-changing moments in India’s successful effort to eliminate yaws. The Government of India’s enduring commitment to eliminate yaws had a determinative impact. Even after the disappointing re-emergence of yaws in the 1970s, a national commitment was sustained. Yaws elimination in India was built on a technically sound approach and on robust surveillance that enabled the programme to target high-priority settings and communities and verify the lack of transmission. Locally tailored strategies were undertaken to raise awareness of yaws in marginalized communities. Extensive training enabled medical officers, health workers and community functionaries from diverse departments to promote yaws identification, treatment and health education. Mobilization of financial resources also played a pivotal role in yaws elimination. India’s successful decades-long push to become yaws-free offers important lessons for other endemic countries in the WHO South-East Asia Region, including Indonesia and Timor-Leste. Simpler treatment regimens should encourage other endemic countries that elimination of yaws is feasible.