The WHO Onchocerciasis Technical Advisory Subgroup (OTS) convened its eighth meeting to review progress and challenges in the global effort to eliminate onchocerciasis. Key topics included alternative treatment strategies, new medicines, monitoring and evaluation (M&E), and addressing complexities in Loa loa co-endemic regions. The group assessed the efficacy of treatments such as moxidectin, ivermectin, and doxycycline under the PICO framework and called for expanded safety evaluations in children and standardized outcome measures. Sustainability concerns prompted calls for new drug supply models beyond donations. The group recommended developing target product profiles (TPPs) for future treatments. The iTAS manual was updated to better integrate onchocerciasis and lymphatic filariasis surveillance. OTS emphasized refining M&E algorithms, enhancing post-treatment and post-elimination surveillance, and incorporating entomological and serological assessments. Data modeling was employed to inform programmatic decisions on stopping mass drug administration (MDA). Concerns were raised about undetected transmission, survey sizes, and diagnostic gaps. OTS endorsed the test-and-not-treat (TaNT) approach using the LoaScope for safe treatment in Loa loa-endemic areas and supported expanded access and operational research. Advances in diagnostics, including new rapid diagnostic tests and PCR methods, were highlighted. The group stressed collaboration between diagnostic and treatment initiatives to drive progress toward elimination.