This month marks the 150 millionth treatment against river blindness by international development NGO Sightsavers. Since 1987 when pharmaceutical company Merck & Co., Inc. took the pioneering decision to donate Mectizan® (ivermectin), the treatment that had been shown to effectively and safely treat onchocerciasis (also called river blindness), Sightsavers has been working with its partners to tackle this neglected tropical disease (NTD) and ensure that it is eliminated as a threat to some 120 million people worldwide, 99 percent of whom live in Africa. Sir John Wilson, who founded Sightsavers 60 years ago and was himself blind, first noted the devastating effects of the disease for himself when he visited Ghana in 1947, and coined the name “river blindness” to describe it. Sightsavers was then involved in the first groundbreaking research into this NTD and has since become a world leader in this field.
Transmitted through the bite of the black simulium fly which breeds in fast-flowing water, river blindness can lead to permanent loss of vision. The onset of blindness tends to affect people in their thirties and forties, meaning that many children miss out on education because they act as full-time carers to older relatives.
New evidence from APOC (the African Programme for Onchocerciasis Control) has found that transmission of the disease can be stopped and the cycle of infection broken if Mectizan® (ivermectin) is taken annually for 15-17 years. This means that in the future this NTD could be eliminated. In the interim, the drugs donated free of charge by Merck & Co., Inc. allow the disease to be treated and controlled.
It’s estimated that as many as one million people are blind or severely visually impaired through river blindness. Another 18 million people are currently believed to be infected. In 2009, Sightsavers was able to treat almost 25 million people in Africa, focusing on Ghana, Nigeria, Sierra Leone and Mali.
Deepak Khanna, Managing Director of Merck Sharp & Dohme Limited (MSD) commented: “This amazing milestone is an opportunity to thank Sightsavers for the support and commitment it has provided to the Mectizan Donation Program. As a result of this partnership, the sight of millions of people in some of the most disadvantaged countries is being protected and the Program is recognised as a model of a successful and sustainable developing world health initiative.”
One of the main challenges in fighting this disease is getting the treatment to remote communities. Sightsavers has helped to introduce the community-based distribution system which uses trained village volunteers to hand out the drugs at a local level. This approach has been adapted to other healthcare activities all over Africa such as Vitamin A distribution, cataract identification, mosquito net distribution and management of other parasitic diseases.
Nigeria is the most endemic country in the world for river blindness, with an estimated 27 million people needing treatment. In Kaduna state, everyone understands the importance of taking the drug annually. Blessing, aged 10 from Anguwan Aku Village, is responsible for fetching water from the stream for her family, making her susceptible to the bite of the black fly that spreads river blindness. Her grandfather Kugiya has lost his sight from this disease, but Blessing is protected by taking Mectizan® (ivermectin).
Caroline Harper, Chief Executive of Sightsavers comments: “River blindness is a disease that could – and should – be consigned to medical history just like smallpox. Together with our local partners, other international organisations and the immeasurable support of Merck, we’ve come a long way since we started distributing Mectizan® 23 years ago, but we still have more to do to help eliminate river blindness as a public health threat.”
The Neglected Tropical Diseases department of the World Health Organisation identifies 13 NTDs which are believed to affect one billion of the poorest and most vulnerable people in the world. Together, many NTDs cause severe disability, resulting in billions of dollars of lost productivity. River blindness, is one of these diseases as is trachoma, another blinding condition, and Sightsavers maintains that treating such diseases is one way to help alleviate poverty in some of the world’s poorest communities.
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