The focus on developing integrated health programs at the local level is precisely one of the approaches that is needed as countries strive to attain universal health coverage.īut fighting infectious diseases is like riding a bicycle. This initiative will continue the fight against river blindness while targeting several other diseases for elimination, including lymphatic filariasis (also known as elephantiasis) and debilitating helminth infections, which are transmitted through soil carried by parasitic worms.Īlso, these campaigns involve a significant effort to mobilize resources that empower local communities to strengthen their primary healthcare capabilities. The success against onchocerciasis is having a profound influence on the broader effort to fight other “neglected tropical diseases.” It has prompted WHO to launch the new Expanded Special Project for Elimination of Neglected Tropical Diseases.
Several weeks ago, in Ouagadougou, Burkino Faso’s capital, I witnessed the administration of the 1-billionth tablet of ivermectin in the fight against river blindness. Mass treatment campaigns have reached well over 100 million people. It does this by breaking the cycle of infection, the passage of onchocerciasis larvae from flies to humans and from humans back to flies. Repeating mass treatment over several years can eventually eliminate the disease from an endemic region. Merck, the drug’s key manufacturer, has been donating the medication to the World Health Organization, allowing it to be deployed forcefully against river blindness in mass treatment campaigns in which everyone in an area at risk is treated regardless of symptoms. Insect control is one factor, but the most decisive intervention involves treating entire communities repeatedly with the anti-parasite medication ivermectin.
The battle against river blindness has been waged with two key weapons. An analysis published in the Journal of Infectious Diseases of Poverty found that in one large swath of disease hot spots outside West Africa, infections have plummeted to at or near zero. Now in at least 10 West African countries, it is no longer considered a public health threat. But disease experts and policymakers are now considering how 40 years of work combating onchocerciasis in Africa has made eradication a plausible scenario.īefore intensive control efforts were launched in the 1970s, 40 million people were infected with the disease and 160 million were at risk. Polio is perhaps closest to gaining entry into this club. The club of the eradicated human disease is supremely elite. Disease experts don’t use the term eradication lightly.
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