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Scabies, or mate māngeongeo riha, is a dermatological condition of significant public health concern in the Oceania region. It causes extreme itching, which can be unbearable, and can lead to debilitating sequelae, including rheumatic heart disease (RHD). In this essay, I will firstly consider scabies from a clinical perspective, before exploring the challenges this disease poses in the Pacific, Australia, and Aotearoa New Zealand. Finally, I will outline my imaginative, ambitious vision into which I would invest philanthropic funds. I believe my proposal could feasibly make substantial in-roads into control of the “seven-year itch” in seven months by harnessing synergies with coronavirus disease 2019 (COVID-19) management.