2013 Program Review for the Lions-Carter
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Summary 2013 Program Review for The Lions-Carter Center SightFirst RIVER BLINDNESS ELIMINATION PROGRAMS Ethiopia, Nigeria, OEPA, Sudan, and Uganda 3-5 March 2014 The Carter Center Atlanta, GA October 2014 Donors to The Carter Center River Blindness, Lymphatic Filariasis, and Schistosomiasis Programs* Alwaleed Bin Talal Foundation Michael and Rhonda McCarthy BASF Corporation Wilma and Van McConnon Mark E. Battjes Richard Menzel Beacon Charitable Foundation Merck and the Mectizan Donation Program Suzanna and John Black Merck KGaA (E-Merck)/World Health Mr. Barry Bryant and Organization Dr. Genevieve M. Lambert The Mills Foundation Chevron Nigeria, Ltd. Gerri and Brian Monaghan Clarke Mosquito Control John Moores U.S. Centers for Disease Control and Prevention Government of Nigeria Community Presbyterian Church of Mount The Sir Emeka Offor Foundation Prospect The OPEC Fund for Reeshad Dalal International Development Pierre De Villiers Thomas O’Riordan and Caroline Stamato Simon Dibley and Nicole Cohen Jayoung Pak Stanley and Wendy Drezek The ENVISION project, led by RTI International Roiston Dsouza Skoll Foundation Environmental Systems Research Institute St. Thomas Aquinas Parish Mohamed S. Farsi Foundation Sudan Federal Ministry of Health Jose Galvan Susan and Lawrence Taylor Bill & Melinda Gates Foundation Rudolph Thomas GlaxoSmithKline Estate of Mr. Gordon Toft Hellgate High School Laurie and Glenn Turner Jennifer and Sergio Hernandez U.S. Agency for Caryn Hobbs International Development Drs. Donald and Ernestine Hopkins Ruth Wagoner Jaymini and Andre Tremayne Mr. Eric Wepsic and Izumi Foundation Mrs. Patricia Pacelli Michael Just Vestergaard Elenor Lange The JV Schiro Zavela Foundation A. G. Leventis Foundation Lions Clubs International Foundation And to many others, our sincere gratitude. *We appreciate the support of the donors listed here, whose funding was utilized in 2013 for the activities described in these proceedings. TABLE OF CONTENTS Frontispiece Figures A - L ...........................................................................................................1 Abstract and Executive Summary ............................................................................................. 13 Recommendations ................................................................................. 21 Maps, Figures, Tables ............................................................................ 23 Onchocerciasis Elimination Program for the Americas .............................................................. 28 Recommendations ................................................................................. 33 Maps, Figures, Tables ............................................................................ 35 Uganda .....................................................................................................................................40 Recommendations ................................................................................. 45 Maps, Figures, Tables ............................................................................ 47 Sudan .......................................................................................................................................53 Recommendations ................................................................................. 55 Maps, Figures, Tables ............................................................................ 56 Nigeria ......................................................................................................................................60 Recommendations ................................................................................. 65 Maps, Figures, Tables ............................................................................ 68 Ethiopia .....................................................................................................................................76 Recommendations ................................................................................. 79 Maps, Figures, Tables ............................................................................ 81 Acronyms ..................................................................................................................................88 Annexes 1. A History of the River Blindness Campaign at The Carter Center ................. 90 2. The Carter Center RBEP Reporting Processes and Research Agenda ........ 97 3. List of Program Review Participants ........................................................... 101 4. Contact List of Program Review Participants .............................................. 102 5. Program Review Agenda ........................................................................... 111 6. The Lymphatic Filariasis (LF) Elimination Program .................................... 114 7. The Schistosomiasis/Soil Transmitted Helminths Control Program ............ 116 8. Monitoring Sustainability and Costs after Withdrawal of Core Funding by the African Program for Onchocerciasis Control (APOC) ................................. 119 9. Publications Authored or Coauthored by RBEP Personnel ......................... 121 10. Acknowledgements .................................................................................... 130 Frontispiece Figure A 2013 River Blindness Elimination Program Review Participants Page 1 Frontispiece Figure B Treatment for Neglected Tropical Diseases Supported by The Carter Center, 2013 Total Number of Doses Distributed 39,895,530 Total Number of Persons Treated 30,798,446 Number of Doses Distributed, River Blindness 18,993,181 Number of Doses Distributed, Trachoma 17,231,412 Number of Doses Distributed, 2,173,411 Schistosomiasis Number of Doses Distributed, Lymphatic 775,537 Filariasis Number of Doses Distributed, Soil Transmitted Helminths 721,989 0 5 10 15 20 25 30 35 40 45 Millions The Carter Center is grateful for our Ministry of Health partners and the many donors and pharmaceutical companies who have made financial and in-kind contributions to make possible these treatments. Treatment for trachoma is azithromycin (donated by Pfizer); river blindness is ivermectin (Mectizan®, donated by Merck); lymphatic filariasis is albendazole (donated by GSK) and ivermectin (Merck), and schistosomiasis is praziquantel (mostly donated by Merck KGaA) Page 2 Frontispiece Figure C 190m Cumulative Mectizan® Doses (Treatments) for RB Delivered by Carter Center RBEP-Assisted Programs 1996 – 2013* 200,000,000 180,000,000 160,000,000 191,247,812 140,000,000 172,254,488 120,000,000 157,916,978 143,561,574 100,000,000 128,957,247 80,000,000 114,841,337 101,341,923 60,000,000 88,356,627 77,055,323 66,256,889 40,000,000 28,504,678 21,274,849 55,147,278 45,488,485 20,000,000 14,590,703 8,963,936 36,524,056 3,873,425 0 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 *RB = River Blindness, RBEP = River Blindness Elimination Program Page 3 Frontispiece Figure D RBEP*: 2014 once per year, twice per year and four times per year treatment targets for 2014 16,000,000 14,404,038 14,000,000 12,000,000 10,000,000 8,814,178 8,000,000 6,000,000 4,000,000 # ofTreatments 2,000,000 51,211 - Treatment target: Treatment target: Treatment target: once per year twice per year four times per year *Carter Center River Blindness Elimination Program Page 4 Frontispiece Figure E Phases of the Elimination of Onchocerciasis (Based on WHO’s* certification/verification guidelines 2001) Transmission/ parasite Transmission Transmission eliminated suppressed interrupted Open system Closed system Adult worm population PTS % baseline % Field Field Evaluation Evaluation ATP Transmission Transmission Transmission Transmission Eliminated ongoing suppressed Interrupted Verification applied/granted** Treatment 3-year PTS phase *WHO Report, (2001). Certification of elimination of human onchocerciasis: Criteria and procedures. Following a WHO meeting on “Criteria for Certification of interruption of transmission/elimination of human onchocerciasis” (document WHO/CDS/CPE/CEE/2001.18a). Geneva, World Health Organization. **Once transmission has been eliminated in all foci in a single country, final verification can be requested to PAHO/WHO ***Post Treatment Surveillance Page 5 Frontispiece Geographic distribution of onchocerciasis Figure F and transmission status in the Americas, 2013 1 Oaxaca 2 North Chiapas Transmission status % pop. 3 South Chiapas ELIMINATED 32.6% 4 Huehuetenango * INTERRUPTED 62.7% ONGOING 4.7% 5 Central 8 North-Central 6 Escuintla 9 Northeast 7 Santa Rosa Regional population still at risk: 10 South 12 Colombia 10 380,886 Regional population no longer at risk: 13 Esmeraldas 11 Amazonas 184,310 Country has been verified by WHO free of onchocerciasis. Colombia is the only country in the world that has this recognition * Still in Post Treatment Surveillance Updated: February 2014 Page 6 Frontispiece Figure G Verification of elimination in Colombia by WHO Bogota, July 2013 President Carter and Colombian Minister of Health Dr. Uribe watch President Santos receive the onchocerciasis elimination verification certificate. Credit: The Carter Center. Page 7 Frontispiece Figure H Uganda: Increasing Carter Center-assisted Mectizan® treatments under elimination strategy 4,500,000 4,000,000 Elimination policy launched, 3,500,000 semiannual treatments begin 3,000,000 2,500,000 2,000,000 No. of Treatments of No. 1,500,000 1,000,000 500,000 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005