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Program Review for the Lions-Carter Center Sightfirst River Blindness

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Program Review for the Lions-Carter Center Sightfirst River Blindness Summary 2007 Program Review for The Lions-Carter Center SightFirst River Blindness Programs Cameroon, Ethiopia, Nigeria, OEPA, Sudan, and Uganda 6 – 8 February 2008 The Carter Center Atlanta, GA August 2008 Donors to The Carter Center River Blindness, Lymphatic Filariasis, and Schistosomiasis Programs Phyllis T. Albritton Mid-Continent University The Baxter International Foundation Anthony Moores Bruce and Patricia Bayuk Jennifer Moores Bryan Beck John and Becky Moores Orville and Ruth Brown Mary I. Naylor Tom and Miriam Bryan The Osprey Foundation of Maryland Warren E. Buffett The P Twenty-One Foundation Thomas Burns John and Sandra Parker Centra Industries, Inc. George Peake Mark Chandler and Christina Kenrick Steve and Robin Perez Community Presbyterian Church of Mount Prospect Edward and Anne Rand John and Claire Cross Randstad North America Janice Culpepper Nancy Ryzenman Diana, Princess of Wales Memorial Fund Felicia Sanchez Glenn and Karen Doshay Mark and Maureen Sanders Philip and Marla Doss The Kingdom of Saudi Arabia Stanley and Wendy Drezek Jeffrey A. Schneider Henry N. Easley Timothy R. Schwertfeger and Gail Waller Enterprise Middle School The Scripps Research Institute The Franklin Mint Robert and Pearl Seymour Bill & Melinda Gates Foundation Shin Poong Pharmaceutical Co., Ltd. Patricia I. Gillis Southminster Presbyterian Church GlaxoSmithKline PLC Dorcel M. Spengler Global Health Council The Starr Foundation William Heasom Julia Suddath-Ranne and Micheal Ranne Hellgate High School Paul C. Swanda The Emery C. Jr./Nancy F. Herman Fund Lawrence and Susan Taylor John C. and Karyl Kay Hughes Foundation Tinsley Foundation Izumi Foundation Earl and Marilyn Tish Mavis D. James The UPS Foundation, Inc. Christopher Jette Richard and Patricia Warren JGA, Inc. Charles and Mary Ann Wolf Michael Just Daniel Wolf Jill Keogh Washington High School Lavelle Fund for the Blind The World Bank A. G. Leventis Foundation Wyeth Lions Clubs International Foundation Vance Zavela and Jean Schiro-Zavela Arthur Lipson and Rochelle Kaplan Beryl W. Zerwer The Lumpkin Family Foundation Peter E. Matushek Merck & Co., Inc. And to many others, our sincere gratitude. Figure A The Carter Center’s River Blindness Program celebrates the delivery of more than 100 million (108) Mectizan® treatments in Africa and the Americas since the program began in 1996. President Carter has described a Mectizan tablet as “more precious than a diamond of the same size.” The milestone was achieved in a collaboration with the 11 national programs and our partners. Through a strong international coalition we are preventing blindness one person at a time. Design created by Mrs. Sherri Richards, artist and graphic designer Figure B Carter Center program staff celebrate Dr. Hopkins’ receipt of the 2007 Mectizan Award, awarded to him by Merck & Co. Left to right: Mr. Craig Withers, Dr. Frank Richards, Dr. Donald Hopkins, Ms. Lindsay Rakers, and Dr. Moses Katabarwa.. Figure C Group Photo: 2007 Program Review for The Carter Center River Blindness Program Figure D Treatments with Mectizan® in the Americas: 1989-2012 900,000 Projected data to fit new OEPA goal to end 800,000 transmission by 2012 700,000 600,000 500,000 2015 2012 Last 400,000 Last year year of of treatment post-MDA 300,000 surveil- lance 200,000 100,000 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Figure E Decreasing Skin Snip Positivity in 6 Localities in Abu Hamad Focus Elimination Effort in Sudan 40.0% 37.5% El Geref 35.0% Abu Hamad Kedji 30.0% El Ghireib Kalaseikal 25.0% Sherri Island 20.0% 17.5% 15.0% 10.0% 6.3% 5.0% 2.0% 2.0% 0.0% 0.0.0%0% 1984 2007 Figure F Nigeria: Impact on Lymphatic Filariasis* Average Lymphatic Filariasis ICT Results Average Microfilaria Prevalence in 9 in 10 Sentinel Villages, at baseline (2000) Sentinel Villages, at baseline (2002/3) and and most recent (2007) most recent (2007) a n n 60% 12% o o ari 9.8% 50% 46% 10% fecti fecti crofil n i n I I 40% 8% to to i i u u 30% 6% sq sq 83% 80% o o t Positive ICTs sitive for m n 20% 4% t M t M 8% t po n en 2% 0.7% 10% cen c Perce Per 0% Per 0% Perce 2000 2007 2002/3 2007 n = 500 n = 2,713 n = 3,430 n = 1,080 Average Mosquito Infection Rates in 9 Sentinel Villages, at baseline (2000) and most recent (2007) (n > 1,000) n 6% o 5.2% 5% fecti n I 4% to i u 3% sq 92% o 2% t M 1% 0.4% cen *In Plateau and Nasarawa States Per 0% 2000 2007 Figure G CDDs trained 100,000 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 Training ofCommunityDirectedDistributors (CDDs) 0 for LastFourYearsand Projectionfor2008 Cam 4,937 8,023 e roon 8,369 37,458 2008 Projection 2007 2006 2005 2004 32,572 25,608 Ethiopia 32,634 33,299 32,661 42,220 N Pr 368 orth Sudan og 67 r 900 a m 2,348 2,910 12,280 Nigeria 11,568 9,297 19,835 15,992 34,140 Uganda 10,266 21,339 52,770 87,060 TABLE OF CONTENTS Executive Summary ......................................................................................................................1 Recommendations.....................................................................................6 Maps, Figures, Tables ...............................................................................8 Onchocerciasis Elimination Program for the Americas ...............................................................12 Recommendations...................................................................................16 Maps, Figures, Tables .............................................................................17 Uganda........................................................................................................................................24 Recommendations...................................................................................29 Maps, Figures, Tables .............................................................................31 Sudan..........................................................................................................................................42 Recommendations...................................................................................44 Maps, Figures, Tables .............................................................................46 Cameroon ...................................................................................................................................50 Recommendations...................................................................................53 Maps, Figures, Tables .............................................................................55 Nigeria.........................................................................................................................................63 Recommendations...................................................................................69 Maps, Figures, Tables .............................................................................73 Ethiopia .......................................................................................................................................82 Recommendations...................................................................................85 Maps, Figures, Tables .............................................................................87 Acronyms ....................................................................................................................................97 Annexes .......................................................................................................................................... 1. The Carter Center and River Blindness.........................................................99 2. Experiences of the Post-APOC, Post-NGDO sustainability trial..................103 3. List of Program Review Participants............................................................105 4. Contact List of Program Review Participants ..............................................106 5. Program Review Agenda ............................................................................112 6. Carter Center Reporting Processes.............................................................115 7. Nigeria Lymphatic Filariasis Elimination and Urinary Schistosomiasis Control Initiative...........................................................................................117 8. Carter Center Publications...........................................................................119 9. Summaries of Special Presentations at Program Review ...........................126 10. Acknowledgements......................................................................................145 EXECUTIVE SUMMARY The River Blindness Program (RBP) of The Carter Center assists the ministries of health (MOHs) of 11 countries1 to distribute Mectizan® (ivermectin, donated by Merck & Co., Inc.) through programs whose goals are either to control or eliminate onchocerciasis. In 2007, the RBP and its partners provided over 12 million Mectizan® treatments (the greatest number since the program launched in 1996), and also reached a fantastic milestone: RBP’s 100 millionth (cumulative) Mectizan® treatment! The milestone was celebrated with a commemorative medal, a press release, a website announcement (www.cartercenter.org), and displays at the river blindness statue located at The Carter Center headquarters in Atlanta. President Carter has described a Mectizan® tablet as “more precious than a diamond of the same size” to those who suffer from river blindness. The commemorative
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