In the Solomon Islands, more than one in five people once carried scabies — tiny mites burrowing into the skin, causing relentless itching and painful sores. Today, that number has dropped to fewer than four in a hundred. A groundbreaking health program has turned the tide on a disease that has plagued tropical communities for centuries, offering a model that could help millions worldwide.
Researchers at the World Scabies Program, based at the Murdoch Children's Research Institute in Australia, worked with the governments of the Solomon Islands and Fiji to roll out the first national scabies control programs ever attempted. The approach was surprisingly straightforward: give everyone in the country a dose of ivermectin, a cheap and well-established antiparasitic drug already used to treat other tropical diseases.
The results were striking. In the Solomon Islands, after two yearly rounds of mass treatment, scabies prevalence plummeted from 23.2 percent to just 3.9 percent. Accompanying skin infections called impetigo fell right alongside it, dropping from 9.2 percent to 1.6 percent. In Fiji, a single round of nationwide treatment cut scabies cases nearly in half — from 6.2 percent down to 3.4 percent — with impetigo rates falling from 4.3 percent to 1.2 percent within one year.
Altogether, more than 2.5 million doses of ivermectin were handed out across both nations. Reductions were seen in every age group, including young children, who suffer the highest burden of the disease. The World Health Organization recognized scabies as a neglected tropical disease in 2017, and it currently affects more than 600 million people globally each year. The parasitic mites cause intense itching that can lead to serious secondary infections and, over time, complications affecting the kidneys and heart.
Dr. Susanna Lake of MCRI said the findings prove scabies control is possible when countries act together. "Our findings demonstrate for the first time that scabies, a disease that causes enormous suffering for children and families, can be significantly reduced when effective treatment is delivered at scale," she said. Professor Andrew Steer, also of MCRI, noted that the work provides vital evidence for countries with limited health resources to tackle a long-overlooked problem.
Still, some challenges remain. Young children under five still face scabies rates above 10 percent even after treatment, and reaching people in crowded urban areas required creative strategies like setting up clinics at workplaces, schools, and community gatherings. The WHO has since published a scabies control guide, co-authored by the Australian researchers, to help other nations launch their own programs.