HEALTH: Success Against River Blindness Can Be AIDS Model – U.N.

By Haider Rizvi Reprint | | Print |

Haider Rizvi

UNITED NATIONS, Nov 7 2002 (IPS) - Millions of lives could be saved from deadly diseases like AIDS, malaria and tuberculosis if the world learned from the success of efforts to eradicate oncoceriasis – or river blindness – from Africa, say United Nations officials and public health advocacy groups.

The key to overcoming the disease, they say, was to put communities at the centre of the fight, supporting them with a team of donors, health groups and private-sector contributors.

About 30 years ago, U.N. officials heard for the first time the horror stories of thousands of men, women and children going blind in rural western Africa. They began an initiative to fight the disease in the region, unsure if the programme would succeed because of their scarce resources.

But within a few years, the Oncoceriasis Control Programme (OCP) not only started producing meaningful results, but also drew support from a number of governments, international donors and the World Bank.

"It has proved to be highly successful," says Lamin Manneh, a regional advisor at the United Nations Development Programme (UNDP), which, along with the World Health Organization (WHO) initiated the programme.

"Right from the beginning, the approach that was taken against this disease was taken in the context of public health, with an emphasis on the involvement of national authorities and local governments."

UNDP and the World Bank claim that the OCP has protected 600,000 people in western Africa who could have fallen prey to the disease.

Public health experts say river blindness is the leading infectious cause of blindness in the world. The disease is caused by the bite of a small, black fly that breeds near rivers and streams along the most fertile banks in Africa and some parts of Latin America. Africa accounts for 99 percent of infectious cases.

Impressed with the programme’s success, a number of donors who recently met at a conference in Luxembourg pledged more than 13 million U.S. dollars to treat the last pockets of river blindness in Ghana, Benin, Togo, Guinea, and Sierra Leone over the next four years.

They project that by the end of 2007, the 28-year old effort will have protected more than 40 million people in 11 countries. At the conference, donors also pledged nearly 60 million dollars for the African Programme for Oncoceriasis Control (APOC), a plan created in 1995 for the entire continent.

Why? "Because, a lot of progress has been made," says Frank Richards, a public health physician with the Carter Center, a public health advocacy group founded by former U.S. president Jimmy Carter, who became involved in global efforts to eliminate river blindness in Africa in 1987.

"The success of this programme is primarily based on the community development initiative and distribution system," Richards adds.

According to U.S. drug-maker Merck, which has been supplying free doses of Mectizan to fight the disease since 1987, more than 60,000 rural communities and over 100,000 distributors in sub-Saharan Africa alone are involved in managing and distributing the drug.

Merck is among the private companies, U.N. agencies, 26 donors, 30 African countries, rural communities and about 40 non-governmental organisations (NGOs) in the partnership to fight river blindness.

Those closely monitoring the initiatives in the region say the nearly successful eradication of the disease offers a number of lessons for the fight against HIV/AIDS and other deadly diseases in Africa and elsewhere in the world.

"If you look at the facts about malaria, you must look into the context of poverty. We are talking about countries where people can’t afford to spray," says Manneh. "You look at HIV/AIDS – people can’t buy drugs.”

”The lesson for the international community is that you have to involve the national authorities and local communities, but then there is a lesson for the donors too."

Manneh and others say they appreciate the role that Merck has played.

"Merck is one of the factors behind this success. They know that people in the region have no money," says Richards who would like to see other pharmaceutical corporations follow Merck’s model and donate drugs to people in the region, whether they suffer from river blindness, AIDS, malaria or any other life-threatening disease.

"They have made a tremendous contribution," adds Alan Alemian, a biologist who works with Africare, a U.S.-based development group that has been involved in the river blindness programmes for years. Africare says it is trying to persuade other pharmaceutical firms to donate drugs to the region.

Merck claims that more than 30 million people worldwide receive Mectizan annually to treat river blindness.

"Fifteen years ago Merck decided to donate Mectizan because we felt an especially strong obligation to make it available to the people who needed it, but also were the least able to pay for it," says Raymond Gilmartin, chairman of Merck Inc.

"We are pleased to see that it (the Mectizan donation programme) has served as a model for other global health initiatives."

U.N. officials say about 70 international businesses are currently involved in the global fight against HIV/AIDS, but their contributions account for much less than what the is needed in Africa.

Last year, AIDS killed 300 million people. The year before, both malaria and tuberculosis took the lives of about two million people, mostly children in Africa.

Richards says "it’s easy to get paralysed by the AIDS epidemic," but believes that the disease can be effectively controlled if the right approach is adopted by political leaders, the drugs industry, international health organisations, and NGOs.

The OCP "is a model for community empowerment”, he says. "That model you need for any kind of health delivery system in developing countries."