Progress under pressure: Countries advance dossiers as schistosomiasis landscape evolves

Schistosomiasis remains endemic in 79 countries. Transmission of Schistosoma haematobium was newly confirmed in Cabo Verde, expanding the endemic map and underscoring surveillance needs in coastal/island settings.

Preventive chemotherapy (PC) for schistosomiasis was required in 50 countries, with 134.8 million school-aged children (SAC) and 118.9 million adults in need of treatment.

Coverage and treatments delivered

Global SCH treatment in 2024: 100.5 million people received PC (83.1 million SAC; 17.4 million adults), corresponding to 39.6% global coverage (SAC 61.7%; adults 14.6%). Three countries reported treating 403,986 preschool-aged children (pre-SAC) with praziquantel: The Gambia (61,281), United Republic of Tanzania—Zanzibar (109,764), and the Philippines (232,941).

Regional SCH coverage:

• African Region: 82.6 million SAC and 15.6 million adults treated; coverage 41.4% overall (SAC 66.0%; adults 13.9%).
• Americas: No PC was reported in Brazil and Venezuela, despite need.
• Eastern Mediterranean: No PC reported in Somalia, Sudan, Yemen; Egypt’s long-term efforts reduced prevalence to a level below EPHP, dossier has been submitted and pending independent review processes.
• South-East Asia: Indonesia (two endemic districts) treated 12,006 people.
• Western Pacific: Cambodia, Lao PDR, and the Philippines treated a combined 2.3 million people (regional coverage ~65.5%).

High-performing countries: 19 of 35 countries that implemented SCH PC achieved at least 75% national coverage among SAC—meeting WHO’s effective coverage benchmark.

Countries with gaps in PC: 15 countries requiring PC for schistosomiasis did not carry out MDA in 2024. Of these 10 are in the African region, 2 in the Americas and 3 in the Eastern Mediterranean regions. Three of these countries have a high schisto buden, with a large population in need of PC: Mozambique, Sudan and Yemen.

Progress towards 2030 NTD roadmap targets

Elimination as a public health problem: WHO guidance emphasizes verification after 5 years of ≥75% effective coverage and provides new manuals for analyzing routine health facility data to support impact tracking and strategy revision. Egypt has submitted its dossier for elimination of schistosomiasis as a public health problem; a WHO review committee has been convened.

Transmission interruption (verification prep): Countries preparing dossiers after ≥10 years without autochthonous cases include Mauritius (Africa); Antigua and Barbuda, Dominican Republic, Guadeloupe, Martinique, Montserrat, Puerto Rico, Saint Lucia, Suriname (Americas); Djibouti, Iran, Iraq, Jordan, Morocco, Tunisia (Eastern Mediterranean).

Key findings and gaps for GSA stakeholders

Adult coverage remains low: Adult SCH coverage is 14.6% globally, despite adult morbidity burden and ongoing transmission risk in high-exposure communities. Scaling adult treatment during PC rounds is essential for equitable morbidity reduction and transmission control.

Pre-SAC treatment underreported: While integrated child health campaigns deworm many children under five, data often do not reach NTD programmes—masking true coverage and complicating resource allocation and cross-sector coordination. Strengthening data sharing between Maternal and Child Health (MCH) and NTD platforms is a critical systems fix.

Operational disparities: Entire regions with high need (e.g., parts of Africa, EMR) report limited or no PC rounds. Financing constraints and instability are key barriers—yet countries achieving ≥75% SAC coverage show that effective PC remains feasible with strong coordination and supply chains.

New and emerging foci: Cabo Verde’s confirmed S. haematobium transmission signals the importance of continuous surveillance, rapid investigation, and context-specific responses in newly affected areas.

Implications and recommended actions

• Integrate schistosomiasis into routine PHC: Embed praziquantel delivery in school health, antenatal care, child health days, and community platforms to stabilize coverage, reduce costs, and strengthen trust—especially for adults and pre-SAC.
• Close the data gap: Standardize and enforce data integration between MCH, school health, and NTD programmes to capture pre-SAC treatment and monitor equity across age and gender cohorts.
• Prioritize adult treatment in high-risk areas: Expand adult PC in communities with sustained water contact and high infection intensity to reduce morbidity and reduce transmission.
• Support verification pathways: Back country dossier preparation for elimination as a public health problem and for transmission interruption, leveraging WHO’s updated manuals and regional platforms (e.g., ESPEN).
• Sustain high coverage where feasible: Protect gains in countries reaching ≥75% SAC coverage with continued drug supply, microplanning, and community engagement, while addressing bottlenecks in underperforming settings.

Read the full report in English and French here.