Tag Archives: success story

The Americas is One Step Closer to Eliminating Onchocerciasis

 

Less than a year after Colombia eliminated onchocerciasis from its borders, its neighboring country, Venezuela, is making similar strides in the fight against neglected tropical diseases (NTDs). Earlier this month, we were excited to hear that Venezuela interrupted transmission of onchocerciasis in its last remaining focus area of the country – meaning Venezuela is well on its way to being certified for eliminating this painful and disfiguring disease.

Onchocerciasis is the world’s fourth leading cause of preventable blindness. As one of the seven most common NTDs, onchocerciasis primarily affects poor populations living along rivers. Infection occurs when black flies carrying the filarial parasitic worm Onchocerca volvulus bite humans. After the larvae enter the body, develop into adult worms, and eventually die, the disease progresses to cause severe skin rashes and depigmentation, visual impairment and blindness. Control efforts in the both the Latin American and African regions are focused on eliminating this NTD as a public health concern.

If you can recall, six countries in the region of the Americas were previously endemic to onchocerciasis: Brazil, Colombia, Ecuador, Guatemala, Mexico, and Venezuela. Through the concerted efforts of the ministries of health of the endemic countries and the local communities, the Onchocerciasis Elimination Program for the Americas (OEPA), the Carter Center, the Pan American Health Organization (PAHO), and Merck & Co., 11 out of the 13 foci had achieved control of this NTD by 2013. The two remaining foci are found in the border region between Venezuela and Brazil, specifically in the migrant Yanomami indigenous community.

Francisco Armada, Venezuela’s Minister of Health, announced the interruption of transmission on World Health Day last week. The People’s Ministry of Health of Venezuela (MPPS) and the PAHO country office will now begin the three-year surveillance stage. If no new cases are found during the three years, Venezuela can begin the process for certifying the elimination of onchocerciasis. Minister Armada also reaffirmed the government’s commitment to Brazil to continue working together to reach the joint goal of onchocerciasis elimination in the region.

Colombia was the first country in the Americas to receive verification of the elimination of this NTD from the World Health Organization (WHO). Ecuador has completed the three-year surveillance phase and Guatemala and Mexico are close to completing it – after this phase, they will be able to request verification of elimination from WHO. The progress demonstrated in the Latin American and Carribbean region is encouraging.

We congratulate Venezuela on this success and look forward to following the country’s – and the region’s – progress towards onchocerciasis elimination!

The New York Times Recognizes Tremendous Progress on NTDs

 

Photo by Olivier Asselin

Photo by Olivier Asselin

 

Shawn K. Baker, interim director of nutrition in the Global Development Program at the Bill & Melinda Gates Foundation, and former regional director for Africa at Helen Keller International, has seen amazingly effective public health campaigns in action. In a recent article posted on New York Times Columnist Nick Kristof’s blog, Shawn highlights some of the most important success stories he’s witnessed.

“I have had the privilege of seeing first-hand how much good development assistance can do and the level of commitment and leadership that can be found on the ground,” Shawn writes.

One of Shawn’s success stories highlights the rapid progress made towards controlling neglected tropical diseases (NTDs) in Africa.

When speaking of these debilitating diseases, Shawn states, “These are not the headline diseases such as HIV or malaria, and have tongue-twisting names such as onchocerciasis, geohelmintiasis, schistosomiasis, lymphatic filariasis and trachoma.”

While NTDs do lack the attention given to other diseases like HIV/AIDS or malaria, the international community, NGOs, pharmaceutical companies and national governments are making tremendous progress in developing integrated plans to eliminate NTDs – and they’re succeeding.

According to Shawn, “In 2012 the five national programs in Burkina Faso, Cameroon, Mali, Niger and Sierra Leone treated over 90 million people, while other countries, such as Ghana and Uganda, and now Guinea are showing similarly impressive results. There is real hope that these diseases can be eliminated in our lifetimes.”

Shawn ends his piece by stating that complacency is not an option when it comes to eliminating NTDs, and that much still needs to be done for patients who have already reached the blinding stage of trachoma – one of the NTDs targeted by Helen Keller International.

To read the full post, click here.  

How a Nigerian General Became an Advocate for Stopping River Blindness

Lieutenant General (Ret.) Theophilus Yakubu (TY) Danjuma knows river blindness firsthand. As a Nigerian who grew up in a country with one of the highest rates of river blindness (also known as onchocerciasis) infection in the world, he has not only witnessed the devastation this disease can bring to families and communities, but has also suffered from the disease himself.

River blindness produces rashes, skin lesions and severe skin inflammation that can make the skin change color and lose elasticity. People suffering from the disease often face daily social humiliation and isolation, and infected children struggle to pay attention in school because of intense itching. River blindness, however, is aptly named. Its most debilitating symptoms are severe visual impairment and irreversible blindness.

General Danjuma’s experience with this disease began in the 1960s. While leading a company of soldiers in Nigeria, he was bitten by the Simulium black fly that transmits the worm larvae that cause river blindness. For two years, the larvae spread throughout his body, maturing into adult worms and releasing bacteria that eventually trigger an immune system response. He awoke one morning with swollen eyes and itchy, inflamed skin. General Danjuma successfully underwent two weeks of treatment and experienced no lasting symptoms, but says he has never forgotten the sight of his own skin sample under the microscope at the local clinic. He still shivers at the memory of tiny worms swimming in and out of view under the lens.

General Danjuma is the Grand Patron of an important NGO based in Jos, in Northern Nigeria. The NGO, The Mission to Save the Helpless, better known by its acronym MITOSATH” is well known to the health team in the Africa Region as an important partner of African Programme for Onchocerciasis Control (APOC). MITOSATH is also among the most active NGOs in Nigeria contributing to the control of river blindness other neglected tropical diseases.

Controlling River Blindness in Africa: Setting an Example

A young boy leads a man impacted by river blindness. Photo by Olivier Asselin.

 

 

 

 

 

 

 

 

 

 

 

 

 

When river blindness control programs were first implemented in the 1970s, up to half of all adults in some hard-hit communities had gone blind from the disease. This tragedy caused many Africans to abandon their ancestral homes and livelihoods; the economic losses were estimated at US$30 million. The first Onchocerciasis Control Programme focused primarily on spraying insecticide over infected areas in order to minimize the prevalence of the black fly, preventing transmission of the parasitic worms from person to person, and eventually incorporated treatment with Ivermectin, the drug that treats river blindness, when it became available.

With the help of the World Health Organization and the World Bank in 1995, this program was expanded and renamed the African Programme for Onchocerciasis Control (APOC). Rather than attempting to control the black fly population, APOC sought to control the parasitic worms in humans through community-directed treatment with Ivermectin in 19 countries. Treatment with Ivermectin successfully kills the worms in the people who have them, thereby disrupting transmission of the disease.

Merck & Co. donates Ivermectin to Nigeria (and other countries in need), and APOC trains volunteers to distribute the drug in communities. Today, APOC provides Ivermectin to more than 96 percent of endemic communities in Nigeria, reaching more than 23 million people. Until everyone is treated, however, the risks of re-infection and new outbreaks remain. River blindness is still present in most Nigerian states, including Taraba state where General Danjuma was born. The disease continues to deeply impact communities and the lifetime productivity of the 31 million Nigerians at risk.

Now a successful businessman and politician, General Danjuma’s personal experience with river blindness and the success of MITOSATH and APOC motivated him to donate US$1 million to the program in 2010. With his donation, he hopes to invigorate interest in public health challenges in rural Africa. General Danjuma noted that, “these are not the neglected diseases of tropical Africa, but rather the diseases of neglected people.”

General Danjuma’s crusade to raise the profile of rural health issues has already gained momentum. Following his example, in 2011, the government of Nigeria pledged an additional US$5 million to APOC to assist with its control efforts. General Danjuma hopes that other countries and the private sector will join the movement to eliminate this debilitating disease once and for all.

 

In March 2012, General Danjuma participated in a panel discussion at the Center for Strategic and International Studies. Read our blog post on that event here.

 

Ownership of Treatment Efforts for NTDs in Mali

Community drug distributors in Cinzana, Mali prepare for mass drug distribution. Photo ©HKI.

As it takes a village to raise a child, it takes a community to control and eliminate NTDs. In Mali’s Segou Region resides Cinzana, a town made of 39 villages with 15,000 inhabitants with a high number of NTD cases. Diseases suffered by the area include trachoma, schistosomiasis, soil-transmitted helminthiasis, and lymphatic filariasis. Fortunately, Mali is one of 12 countries supported by an initiative funded by USAID called the NTD Control Program. Beginning in 2007, the Program partnered with the country’s Ministry of Health to distribute drugs and treatment to control NTDs. In Cinzana, distribution is conducted by a community group comprised of volunteers. Effective delivery of drugs to each infected individual can pose as a lofty endeavor. Limited resources and poor road infrastructures act as barriers to getting drugs to individuals in the outskirts of Cinzana, and becomes an even greater obstacle during the rainy seasons.

Despite these challenges, the NTD Control Program has been highly successful. By the end of 2009, the entire area of Cinzana received treatment. Much of this success is attributed to the community’s willingness to participate and be a part of the Program’s activities. Volunteers quickly recognized that effective distribution could only be reached if there was a large number of community drug distributors (CDDs). Thus, one of Cinzana’s economic interest groups, the Association of Community Health (ASACO), garnered the support of 200 much needed CDDs. In addition to the increase of CDDs, ASACO along with Mali’s government also provided more resources conducive to effective disease control such as notebooks, pens, and dosing poles, which are wooden tools used to identify the correct drug dosage for each individual.

Through community involvement and participation, Cinzana was able to reach 100% geographic coverage rates. Cinzana pledges to continue its diligence and dedication to the work of the NTD Control Program, working toward reaching goals and controlling NTDs.

To do your part in controlling and eliminating NTDs, please visit the Global Network website to get involved.

Support for NTD control in Mali is provided by USAID through a grant to Helen Keller International. Program activities are a part of the NTD Control Program led by RTI International. For more information, please visit http://ntd.rti.org/.