For over 40 years, the World Health Organization (WHO) has worked to control river blindness (onchocerciasis), the second major infectious cause of blindness in Africa.
30 years after a major donation of medication by Merck & Co, a pharmaceutical company, and after 20 years of the success of the African Program for Onchocerciasis Control (APOC) the reduction of the disease intensity has allowed WHO to shift the goal from control to elimination.
The unprecedented donation of medication “as much as needed for as long as needed”, combined with innovative distribution mechanism from WHO was protecting more than 110 million people annually in 19 countries by 2015, when the APOC program closed. It prevented over 40,000 cases of blindness every year between 1995 and 2015.
WHO Regional Office for Africa (AFRO) is still and more than ever committed to the elimination of river blindness and other Neglected Tropical Diseases (NTDs). The distribution mechanism based on a community directed treatment with ivermectin (CDTI) has been adapted and is now broadly used to distribute medicines for NTDs through the new WHO Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN). This ambitious project is working with Member States to reach WHO 2020 targets for control and elimination of the 5 NTDs curable by regular Mass Medicine Administration (MMA).
Africa has 47% of the global burden of all NTDs. The region carries the highest global burden of disease for Buruli ulcer, Guinea worm disease, human African trypanosomiasis, river blindness and yaws. NTDs cause disability, disfigurement, stigma, poverty, and have detrimental effects on school attendance and child development, agriculture, and economic productivity.
The fight against river blindness is recognized today as a public health problem that is under control given that there are no new cases of blindness in communities under treatment and there has been a drastic reduction in skin disease caused by infection.
The remaining challenge for the ESPEN special project and the Member States is to achieve transmission interruption and complete elimination of onchocerciasis. This has been already achieved in some foci of Uganda, Senegal, Mali and it is also suspected to be eliminated in some foci in Burundi, Malawi, and Nigeria.
A complete elimination of NTDs can be within reach with a strong and sustained investment by the Member States, NGOs and partners, in the effective distribution of donated medications to community levels.