A world-first scabies control program has drastically reduced cases of the highly contagious parasitic skin disease in Solomon Islands and Fiji, according to a new study.
The research, led by the World Scabies Program (WSP) at Murdoch Children’s Research Institute (MCRI) and published in Nature Health , found the first national mass drug administration (MDA) program of its kind has led to substantial and sustained decreases in scabies and associated skin infections across the Pacific nations. The MDA involved ivermectin, a safe and widely used antiparasitic treatment for neglected tropical diseases.
MCRI Dr Susanna Lake said the results showed that scabies could be controlled through coordinated national action.
“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.
The MDA was implemented by the Ministries of Health and Medical Services in Solomon Islands and Fiji with support from the WSP, an initiative of MCRI and including researchers from the Kirby Institute based at UNSW Sydney.
WSP was established in 2019 with the aim of translating research evidence into public health action for scabies control after successfully securing $10 million in support from the Macquarie Group Foundation . The Australian Government also provided further funding.
The study found after two annual rounds of MDA delivered to the entire population of Solomon Islands, scabies prevalence fell from 23.2 per cent to 3.9 per cent. Rates of impetigo, a skin infection, declined from 9.2 per cent to 1.6 per cent during the same period.
In Fiji, where one round of MDA was rolled out nationwide, scabies prevalence almost halved from 6.2 per cent to 3.4 per cent, while impetigo rates dropped from 4.3 per cent to 1.2 per cent within 12 months of treatment.
Remarkably, more than 2.5 million doses of ivermectin were provided under the MDA program. Scabies and impetigo decreased across all age groups in both countries, including young children, who experience the highest burden of disease. The prevalence of moderate‑to‑severe scabies also declined substantially.
Scabies, an endemic disease in Pacific Island countries, causes intense itching and skin damage. It can lead to secondary skin infections caused by Strep A bacteria and is linked to serious long‑term complications including kidney and potentially rheumatic heart disease.
Causing more than 600 million cases globally each year, scabies was recognised by the World Health Organization (WHO) as a neglected tropical disease in 2017, prompting increased global focus on effective control strategies.
MCRI Professor Andrew Steer said the findings were particularly important for countries with high scabies cases and limited health system resources.
“Scabies has long been neglected, despite its links to serious infections and long‑term disease,” he said. “Our research provides critical evidence to inform national and international policy and supports the broader integration of scabies control into public health and neglected tropical disease programs.”
Professor Steer said achieving high coverage in urban areas required multiple strategies to improve access, including delivering MDA through workplaces, schools and community gatherings.
He said further measures were needed to address the ongoing burden of scabies in young children, with prevalence still above 10 per cent among those aged under five despite MDA treatment.
The results come as a scabies control guide produced by the WHO , which includes contributions from Dr Lake, Professor Steer and Dr Daniel Engelman, has been published.
The guide outlines how to implement scabies control programs, including how to estimate disease burden, deliver control measures and establish effective monitoring and evaluation systems.
Publication: Hannah Andrews, Susanna Lake, Sarah Andersson, Aminiasi Tavui, Kelera Matavesi, Aminiasi Koroivueta, Josefa Koroivueta, Rejieli Vuniduvu, Mareta Vuki, Varanisese Rosa, Julie Zinihite, June Tavalia, Ayleen Sosopu, Johnina Huniehu, Sanira Ghemu, Donald Rotu, Matthew Parnaby, Tessa Hughes, Anneke Grobler, Daniel Engelman, Lucia Romani, Meciusela Tuicakau, Mike Kama, John Kaldor, Aalisha Sahukhan, Oliver Sokana and Andrew Steer. ‘Impact of the first national mass drug administration programs for scabies control,’ Nature Health . DOI: 10.1038/s44360-026-00162-6
Nature Health
Observational study
People
Impact of the first national mass drug administration programs for scabies control
29-Jul-2026