Category Archives: Onchocerciasis

New World Bank Video Shows an Amazing River Blindness Success Story

 

APOC

To celebrate the remarkable progress made against river blindness (onchocerciasis) in Africa since the formation of a tremendous public-private partnership to combat the disease forty years ago, global partners recently gathered at World Bank headquarters in Washington, DC. Leaders poignantly spoke about how this country-owned, community driven effort — the World Bank’s first health project — carried out through the Onchocerciasis Control Programme (OCP) between 1974-2005, and the African Programme for Onchocerciasis Control (APOC) between 2005-present, is now reaching 100 million people in 31 countries annually thanks to bold visions, clear strategies and the collaboration of partners.

To coincide with OCP/APOC’s 40th anniversary, a new World Bank video narrates the unlikely story of how insecticide and Mectizan (ivermectin) — a pill donated by Merck for free for as long as needed — have transformed the lives of millions of people. Generating blindness, impaired vision and severe itching, among other effects, river blindness once devastated entire communities. The disease left people unable to farm for sustenance and a living, inhabit land in river valleys and take care of their families.

But, with insecticide sprayed by helicopters, and eventually the distribution of ivermectin in all affected countries, some areas are free of the disease. 25 million hectares of arable land — enough to feed 17 million people — are now freed up for use.

By 2025, we can eliminate river blindness in Africa and end the cycle of poverty caused by this horrific disease. But, we must continue to mobilize and pool resources, increase country leadership and integrate efforts to accomplish this goal.

Congratulations to all of the APOC partners fighting for a brighter, healthier future!

Make sure to watch the full video:

The World Bank and Partners Celebrate 40 Years of Success in Controlling River Blindness

 

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This Friday, the World Bank, the World Health Organization (WHO), Merck and other partners will celebrate 40 years of success in controlling river blindness in Africa. The African Programme for Onchocerciasis Control (APOC) is recognized as one of the most successful public-private health partnerships in Africa – treating 100 million people a year in 31 African countries with free medicines donated by Merck & Co.

The World Bank has a long-established history of fighting neglected tropical diseases (NTDs). In fact, the 1974 agreement by then World Bank President McNamara to establish a partnership to Control River Blindness was arguably the first World Bank health project.

To celebrate APOC’s 40 years of success, the World Bank will host a 40th anniversary learning event and summit this Friday, June 20 at the World Bank Headquarters in Washington, DC.

Friday’s event will highlight lessons learned from APOC’s 40 years of efforts to control onchocerciasis, the history of this historic partnership, and the impact of its programs and the future of NTD control and elimination. The day’s panels will be filled with distinguished experts in global health, nutrition and NTDs.

The learning panels will conclude with a celebratory summit and reception launched by World Bank President Dr. Jim Yong Kim. Her Royal Highness Princess Alexandra will also be in attendance as a guest of honor. Panelists at the summit will celebrate the history and future of APOC from the continental perspective.

We hope you’ll join the World Bank and its partners for this celebration. You may find more information about the event here. RSVP to rbsummit2014@gmail.com.

The day-long event will take place at 1818 H St. NW, Washington DC in the World Bank’s Preston Auditorium and Wolfenshon Auditorium – beginning at 9am and ending at 8pm.

For more information, and to view the live stream, click here. Be a part of the conversation by following #WBlive and #NTDs on Twitter. 

What Can the Experiences of Sierra Leone and Cambodia Tell Us about How to Fight NTDs?

 

By Romina Rodríguez Pose, independent consultant on international development and lead author for the Health Dimension case studies, Development Progress Project.

Image from Sierra Leone 15

Neglected tropical diseases (NTDs) affect the poorest billion people in the world. They cause number of chronic health conditions that largely limit people’s ability to study and work and consequently have a healthy and productive life. The stigma attached to them can also lead to isolation and fear for those who suffer.

Although they have been long ignored within international and national agendas, in the last decades, there has been an increasing awareness of how NTDs can impede endemic countries from achieving broader development goals. This led to the emergence of global public-private partnerships involving major drug donations from key pharmaceutical companies, the development of inexpensive control strategies and a growing number of donors earmarking funding for integrated NTD control.

These readily available solutions have enabled some endemic countries to fight the five NTDs that bear 90 percent of the global burden: onchocerciasis, also known as river blindness; schistosomiasis, also known as snail fever; lymphatic filariasis, also known as elephantiasis; soil transmitted helminths, also known as intestinal worms; and trachoma.

Image from Cambodia 8To better understand the drivers of progress, ODI’s Development Progress project has taken a closer look at two of the leading performers: Sierra Leone in Africa and Cambodia in Asia. In spite of their different contexts and epidemiological profiles, three drivers have emerged in both case studies:

1. Advances in the fight against NTDs have been driven by the availability of earmarked funds and donated drugs. These have been crucial for both resource-constrained countries, since most endemic countries are faced with several competing, and perhaps more urgent, health issues (such as high mortality rates for mothers and children in Sierra Leone and dengue outbreaks in Cambodia). As a counterpart, political will and local engagement to take advantage of global initiatives have been crucial in bringing NTDs within the national agenda. Both governments, through their Ministries of Health, have proactively looked for partners, secured funds and drugs donations and made important efforts to develop local capacity.

2. There is an important transitional role for development partners in providing access to strategies and guidelines on how to deal with NTDs until local capacity is fully developed. In both countries, this was achieved through bilateral, regional and global partnerships that helped build the local knowledge base for endemic countries to find their own solutions and to implement strategies according to the particular context. These dynamics between development partners and NTD programme managers have gradually led to a ‘transfer of ownership’ of the NTD programmes.

3. The integration of NTD activities within an existing government structure has been vital to set up cost-effective NTD programmes. Both countries have integrated the distribution of drugs within health and education systems. In Cambodia, given the main threat is from intestinal worms which particularly affect school-aged children, progress has been achieved by integrating the distribution of drugs into the school system and turning teachers into twice-yearly doctors/pharmacists. In Sierra Leone, given that the entire population is at risk from at least three NTDs, the main strategy involved the engagement and training of community members as drug distributors. Elected by their communities, their work is divided into catchment areas for which they are responsible, reaching the most remote corners of the country.

Image from Sierra Leone 14

Despite the increasing awareness of their importance, NTDs still loom large in the cycles of poverty, ill-health and under-development that afflict too many developing countries. Yes, as Sierra Leone and Cambodia show, progress can be achieved in the most difficult contexts and with minimal resources, stressing the importance of including NTD control and elimination targets within the post-2015 sustainable development goals.

All photos by Romina Rodríguez Pose. 

A Test For River Blindness

 

A boy helps Samuel Nicol, (age unknown) who suffers from onchocerciasis, walk through the village of Gbonjeima, Sierra Leone. Olivier Asselin, 2012.

A boy helps Samuel Nicol, (age unknown) who suffers from onchocerciasis, walk through the village of
Gbonjeima, Sierra Leone. Olivier Asselin, 2012.

Re-posted from Greg Laden’s Blog on ScienceBlogs

River blindness, also called Onchocerciasis, is the result of the infection of several different eye tissues by the nematode Onchocerca volvulus. The bacterium Wolbachia pipientis lives symbiotically in the gut of the nematode, and escapes the small roundworm to cause an inflammatory response in human tissues, which results in damage to the tissue. These infections can occur in a number of different human tissues causing a variety of effects, but when the eye tissues are involved, the result can be river blindness. It is endemic and widespread in several areas of Africa, as well as more restricted areas in South America and the Middle East.

Treatment of the disease involves killing the bacterium, which in turn kills the host nematode, using various anti-biotics. However, as we have learned over recent decades, widespread use of antibiotics can be less than ideal because this can cause selection for resistant strains so that treatment can become generally ineffective across an affected population. Ideally, there would be a reliable test for river blindness infection that would allow more targeted use of treatments.

A research team at Scripps has just published a paper in PNAS that may lead to such a treatment. The team examined urine samples from people who are known to be infected with the nematode Onchocerca volvulus and its attending Wolbachia pipientis bacterium with those who were not thought to be so infected. A massive laboratory based hunt for differences in the contents of the urine was carried out, and one molecule was identified as unique to the infected humans. This was N-acetyltyramine-O,β-glucuronide, which started out as a neurotransmitter found in the nematodes while they are young, which is then converted to N-acetyltyramine-O,β-glucuronide in the human body and eventually secreted in the urine.

The nematode has a somewhat complex lifecycle in which the very young worms infect various tissues and reproduce there, causing the damage to the tissue via the bacterium’s release. This neurotransmitter seems to be unique, or nearly unique, to these young worms. This is important because the nematode is probably widespread in humans in the endemic areas, but as relatively dormant adults found here and there throughout the body. It is only the young reproducing worms that cause the river blindness. Therefore, N-acetyltyramine-O,β-glucuronide specifically identifies individuals at risk of tissue damage to the eyes.

The test is not yet ready for prime time. There needs to be a field test that can be administered easily in conditions where there are only minimal or no clinical facilities. The test materials have to be reasonably inexpensive and not require special handling such as refrigeration. Ideally, this would consist of a urine test strip as have been developed in the past to test for blood sugar levels or pregnancy.

Another important outcome of this finding is the method itself, which the researchers have dubbed “Metabolome-mining.” (The term “metabolome” refers to the full set of metabolites to be found in a particular organism or tissue, similar to the term “genome” for the full set of genes.)

More information will be available at the Scripps Research Institution web site.

Globisch, D, Moreno, A, Hixon, M, Nunes, A., Denery, J., Specth, S., HYoerauf, A, & Jand, K (2013). Onchocerca volvulus-Neurotransmitter Tyramine is a Biomarker for River Blindness PNAS