In 2000 when the Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched it was estimated that globally 120 million people in 83 countries were infected with lymphatic filarial parasites, and it was estimated that over 1.3 billion (20% of the world's population) were at risk of acquiring infection.  More than 40 million were incapacitated or disfigured with affected limbs and occasionally breasts (lymphoedema) and genitals (hydrocele).  Endemic countries are found in the tropical and sub-tropical areas of the globe spreading from the Americas, through Africa and into Asia living in both urban and rural areas.