The Global Network for Neglected Tropical Diseases would like to congratulate Colombia on becoming the first country in the Americas to eliminate onchocerciasis. This Monday, July 29, Colombia received verification of the elimination of onchocerciasis from the World Health Organization (WHO). This is a great achievement in the field of neglected tropical diseases (NTDs) and global health!
Onchocerciasis, also known as river blindness, is an NTD caused by a parasitic worm and is transmitted by the bite of Simulium black flies. This NTD causes disfiguring and painful skin infections and eye lesions, and is the second leading infectious cause of blindness globally. Control and elimination efforts began in the region of the Americas in the early 1990s, primarily with the formation of the Onchocerciasis Elimination Program for the Americas (OEPA). OEPA, which is sponsored by the Carter Center, was launched in 1993 in response to the Pan American Health Organization’s (PAHO) resolution CD35.R14, which calls for the elimination of onchocerciasis from the Americas. At the time of the resolution, 500,000 people were at risk for onchocerciasis in the region and the NTD was endemic in 13 foci found in 6 countries: Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela.
The recent success in Colombia is a result of close collaboration between Colombia’s Ministry of Health and Social Protection, Colombia’s National Institute of Health and its partners, which include The Carter Center and OEPA, PAHO, Merck and many others. In countries endemic for onchocerciasis, people were treated with ivermectin (Mectizan) through mass drug administration campaigns two to four times a year. The hard work and dedication demonstrated by the local health workers and community leaders in distributing the treatment and educational information was essential for achieving the goal to eliminate transmission of the disease. Ivermectin is donated by Merck & Co through the Mectizan Donation Program.
Ecuador may be the next country in the region to apply for verification of elimination, following the 3-year post-treatment surveillance phase established by the World Health Organization (WHO). Guatemala and Mexico will complete the 3-year post-treatment surveillance phase in 2014 and could then request verification from the WHO. The remaining two foci in the region are in southern Venezuela and northern Brazil, among the Yanomami indigenous community. A key to the elimination of onchocerciasis in the Yanomami area is an integration of activities to address other determinants of health and NTDs, such as strengthening primary care services, access to clean water and improved sanitation.
On the same day, energized by the announcement that Colombia received certification for the elimination of this NTD, the Colombian President Juan Manuel Santos and Minister of Health and Social Protection Alejandro Gaviria demonstrated once more their government’s commitment to the people of Colombia by launching its 5-year integrated national plan of action to address trachoma and soil-transmitted helminthes.
Colombia’s experience can help guide the efforts of other Latin American and African countries working towards elimination of this and other NTDs. Thanks to these great achievements, we are closer to seeing the end of the seven most common NTDs by 2020!
By: Alanna Shaikh
Mexico, Colombia, and Guatemala are making huge progress against river blindness, aka onchocerciasis. Colombia has eliminated river blindness from within its borders, the first country in Latin America to do so. Mexico and Guatemala have broken the cycle of transmission, and they’re ready to stop mass drug administration next year.
Elimination is a pretty clear term. It means that the disease, while still present on our planet, is down to zero in one particular region; in this case, Colombia. But what does it mean to break the cycle of transmission? Well, onchocerciasis is a tiny parasitic worm that has a pretty complicated life cycle, and one particular kind of fly is essential to the survival of the disease. Without those flies, the disease is not transmitted and dies out.
To break the cycle of transmission, you spray insecticide in the areas of fast moving rivers where the flies breed. No more flies, no more onchocerciasis. According to the World Health Organization (WHO), it takes fourteen years of spraying to totally eliminate the reservoir of adult onchocerciasis worms and therefore make sure that the disease is gone. Once you’ve reached that point, it takes three more years of close monitoring to ensure that the disease really is gone. If there really are no cases in those three years, then, like Colombia, your country can be certified as having eliminated the disease. Continue reading
By: Alanna Shaikh
I don’t know about you, but I’ve found world news to be pretty depressing this week. It seemed like a good time to remind ourselves that things do improve, and we can change global health for the better. I therefore offer you four NTD success stories:
1. Guinea Worm, aka Dracunculiasis, is on the verge of being eradicated. It is, as you may recall, one of the most wiggly and revolting NTDs, consisting of a giant worm that lives inside you and has to be removed manually and with excruciating slowness. And we’re going to make it the third disease ever to be eradicated. We’ve gone from 3.5 million cases of guinea worm in 1986 to under 5000 in 2009. How awesome is that?
2. Leprosy is being reduced in a big way. 14.5 million people have been cured of leprosy since 1985. (Yes, cured. Leprosy is a bacterial infection and doesn’t stand a chance against strong antibiotics.) It’s now a problem in only seven countries.  It’s a disease to old it was mentioned in the Bible, and we’re getting rid of it most likely within our lifetime.
3. China eliminated lymphatic filariasis in 2007. Also known as elephantiasis, lymphatic filariasis makes your limbs swell up to enormous proportions. It causes intense pain, and, obviously, disfigurement. And now it’s gone from China. Boom!
4. 2007 was a good year for NTDs.
Insofar as there is a bright side to NTDs, this is it: we can fight them and win. We’ve done it before, and we’ll do it again.
 You’re thinking it will be the second disease to be eradicated, aren’t you? Well, you’re forgetting rinderpest. Sure, rinderpest isn’t a human disease, but I think we can agree it’s a good thing if cattle don’t get diarrhea, oral erosions, and necrosis and then die.
Harshing the vibe somewhat – slightly less awesomely, this had to be achieved through changing human behavior because we still don’t have any really effective treatments for Guinea Worm disease. We’ll keep that down here in the fine print so we don’t ruin the happy. And when you consider it, behavior change on that level is pretty awesome too.
 For the record, leprosy does not actually cause limbs to fall off, although it can make them numb. We’re not talking zombies here.
 Yeah, I don’t know. Boom just seemed like a happy thing to write. The actually eradication process took years of diligent effort and was not boom-like at all. There is almost no boom in global health.
 Well, a bad year for the diseases; a good year for the people who might get them.
Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’ The views and opinions expressed by guest bloggers are not necessarily the views and opinions of the Global Network. All opinions expressed here are Alanna’s own and not those of any employer or the US government.