Reprinted with permission from: Malaria Free Future
By: Bill Brieger
Roll Bank Malaria (RBM) was launched in 1998, but actual scale up to universal coverage is only happening in 2010. By Comparison, the African Program for Onchocerciasis Control (APOC) took off in 1996 and has been scaled up for several years in all but a few of its endemic countries. Granted, APOC has a relatively smaller target area, but it now regularly reaches over 127,000 African villages with annual doses of ivermectin.
Both programs have in common the need to sustain their scaled up for many years into the foreseeable future if disease elimination is to be achieved.
This need for a long term perspective causes concern when one reads about a threat to continued funding for APOC’s Borno State, Nigeria project, and raises speculation whether malaria efforts may face the same threat a few years down the line.
Onchocerciciasis, one of the most common neglected tropical diseases known as “river blindness”, is a major contributor to visual impairment and blindness in sub-Saharan Africa. Onchocerciasis also causes lesions, skin depigmentation, and debilitating itching, all of which foster stigmatization and social isolation. Beyond its health impacts, onchocerciasis has also instilled a fear of blindness in affected communities, prompting them to abandon fertile river valleys in Africa, thereby reducing agricultural productivity and increasing poverty.
Approximately 37 million people around the world are infected with onchocerciasis; over 102 million people are at risk for the disease in 19 countries. 500,000 of those infected with onchocerciasis are severely visually impaired, and another 270,000 have been rendered permanently blind from the disease.
Fortunately, there are African-led efforts underway to control and eliminate this disease that can serve as a model for community-led health interventions and health systems strengthening efforts around the developing world. The African Programme for Onchocerciasis Control (APOC) was established in 1995 to eliminate onchocerciasis as a disease of public health importance in Africa. At the core of APOC’s strategy to eliminate the disease is community-directed treatment with ivermectin (CDTI), a strategy largely pioneered by APOC’s dynamic director, Dr. Uche Amazigo.
In 1997, APOC formally adopted the CDTI strategy to deliver ivermectin to infected and at-risk communities, and in the years since it has rapidly scaled up and expanded its efforts. Over 600,165 trained CDDs have been trained and engaged in CDTI projects since APOC’s inception, and they have delivered nearly (965,000,000) ivermectin tablets in 11 years (1997-2007). Millions more have benefitted from other health interventions implemented simultaneously with CDTI, including home-based management of malaria, distribution of insecticide treated bed nets, Vitamin A supplementation, and management of HIV/AIDS as well as awareness campaigns involving the support of CDDs.
Tonights episode of the NewsHour with Jim Lehrer focuses on a community-based program to eliminate onchocerciasis (river blindness), one of the seven most common neglected tropical diseases, in Tanzania. Watch this video for a preview of tonights show.
The episode will include an interview with Dr. Uche Amazigo, and will highlight the community drug distribution program she has championed through the African Programme for Onchocerciasis Control (APOC). APOC has become a successful model of how effective public-private partnerships can leverage local community members to support the health needs of their friends, families and neighbors.
Talea Miller with the NewsHour team also put together a great slideshow of her photos from the Tanzanian trip, available on Flickr.
- The Global Network for Neglected Tropical Diseases is a major advocacy and resource mobilization initiative of the Sabin Vaccine Institute dedicated to raising the awareness, political will, and funding necessary to control and eliminate the most common neglected tropical diseases (NTDs)--a group of disabling, disfiguring, and deadly diseases affecting more than 1.4 billion people worldwide living on less than $1.25 a day.
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