By Simon Bush,
“The neglected tropical disease (NTD) agenda would not have been feasible without the Community Directed Treatment with Ivermectin (CDTI) framework.
This is the conclusion of a recent paper commissioned by Sightsavers on combating onchocerciasis – or river blindness. What it means in less formal terms is that involving communities in the distribution of river blindness treatments has proven to be effective, sustainable and a method that can be used to combat other diseases. What it also means is the role played by non-governmental development organisations (NGDOs), such as Sightsavers, is fundamental to tackling, and ultimately eliminating, NTDs.
The river blindness tale has been told many times before, and readers of this blog may well be familiar with its treatment, Mectizan® (ivermectin*), which is donated for mass distribution by global pharmaceutical company Merck & Co. Inc. (known as MSD in the UK). But at Sightsavers we wanted to show another side of the story. After nearly 60 years of working in Africa to alleviate river blindness, we felt it was time to take stock of how NGDOs have performed, and ensure that by looking back, we are heading in the right direction in the future – especially as the scientific evidence shows that we have moved from the control of the disease to the elimination of its transmission.
The paper, ’Empowering communities in combating blindness and the role of NGOs’, reviews published literature and previously unpublished documents relating to approaches to river blindness in Africa during the early 1990s. Through four case studies, it describes the challenges organisations have faced when trying to encourage affected communities to manage their own treatment programmes. This was the only way those trying to tackle river blindness felt ongoing action could be sustained for 20 years or more – eventually leading to elimination. Read more: Success in combating NTDs means community ownership