Several neglected tropical diseases are targeted for ‘elimination as a public health problem’ by 2020, reducing the burden amongst the poorest populations in the world, the ‘bottom billion’. As 2020 approaches there is a drive to use new tools and adapt existing strategies to achieve the goals in as many countries as possible. Alongside these efforts there also needs to be an assessment of whether true elimination is feasible and, if not, what strategies could be used to ‘hold the line’. Using the example of lymphatic filariasis, a mosquito-borne helminth which can cause debilitating symptoms such as elephantiasis, we will discuss the use of multiple models and, more recently, geo-spatial data, to inform control strategies at the international policy level through to endemic country level.