The Lawa Model: An Integrated Liver Fluke Control Program Using the EcoHealth/One Health Approach

Human liver fluke infections caused by Opisthorchis viverrini and Clonorchis sinensis are significant public health problems in Southeast Asia, affecting over 30 million people and linked to the development of cholangiocarcinoma (CCA), a deadly bile duct cancer. Traditional control methods have faced challenges due to the parasite’s complex life cycle, which involves multiple hosts and environmental reservoirs. The Lawa model, developed in the highly O. viverrini endemic Lawa Lake area of Khon Kaen, Thailand, presents a new integrated strategy using the EcoHealth/One Health approach. This model combines novel human health interventions (anthelmintic treatments and intensive school- and community-based education), animal reservoir management, and environmental modifications. Over 15 years (2008–2022), the Lawa model has reduced human liver fluke infection rates from 60% to less than 5% in surrounding villages. Infection in fish hosts has dropped to 0%, and liver fluke cercariae are no longer detected in local Bithynia snails. This model has gained national and international recognition, being integrated into Thailand’s national agenda against liver flukes and CCA and serving as a global training site for health personnel. The Lawa model demonstrates how One Health collaboration across human, animal, and environmental sectors can effectively control zoonotic diseases, providing a model for other regions facing similar public health challenges.