Humma (onchocerciasis) is a disease caused by the parasite Onchocerca volvulus and transmitted by the bites of blackflies (Simulium species). Adult worms live in subcutaneous nodules; females release millions of microfilariae (first-stage larvae, L1) and these larvae cause severe itching, disfiguring skin diseases, and long-term exposure leads to vision loss and irreversible blindness. Early childhood exposure to humma has also been associated with epilepsy. The mosquito that feeds on the microfilariae during its lefting process develops the larvae from L2 to the infectious L3 stage within 6–12 days and transmits them to another person with the next bite. Over 99% of the people requiring treatment live in 26 countries in Africa; the rest live in Brazil, Venezuela, the Bolivarian Republic of Venezuela, and Yemen.
Coverage was low in countries such as Cameroon (17.1%), Togo (21.9%) and Yemen (24.4%). The low coverage in Cameroon reflects the consequences of sudden changes in external financing: the MDA was planned at 123 IU with support from external donors, but this support was suspended in January 2025 after the annual plans were approved. The government adopted a reduction plan, and national funds were only released in October 2025; this was too late to organize treatment before the end of the year, and the ivermectin shipment was delayed until financing uncertainty was resolved. The MDA could only be implemented at 21 IU, with support from other partners.
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