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A History of the River Blindness Campaign at the Carter Center

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A History of the River Blindness Campaign at the Carter Center Summary 2011 Program Review for The Lions-Carter Center SightFirst RIVER BLINDNESS PROGRAMS Cameroon, Ethiopia, Nigeria, OEPA, Sudan, and Uganda 21-23 February 2012 The Carter Center Atlanta, GA September 2012 Donors to The Carter Center River Blindness, Lymphatic Filariasis, and Schistosomiasis Programs Alwaleed Bin Talal Foundation Massiah Foundation, Inc. Bright Horizon Foundation Michael and Rhonda McCarthy Mr. Barry Bryant and McKenna Foundation Dr. Genevieve M. Lambert Merck Chevron Nigeria, Ltd. Merck KGaA (E-Merck)/ World Health Clarke Mosquito Control Organization Community Presbyterian Church of Mount The Mills Foundation Prospect John Moores Pierre De Villiers The OPEC Fund for Pete and Amanda Docter International Development Stanley and Wendy Drezek David and Sheila Quint Bill & Melinda Gates Foundation Audre Rapoport GlaxoSmithKline Chris Reynolds Hellgate High School The Kingdom of Saudi Arabia Drs. Donald and Ernestine Hopkins Walter Schier John C. and Karyl Kay Donald Shriber Hughes Foundation Tietz Family Foundation Izumi Foundation UNICEF Lions Clubs International Foundation And to many others, our sincere gratitude TABLE OF CONTENTS Frontispiece Figures A - H ..........................................................................................................1 Abstract and Executive Summary ...............................................................................................9 Recommendations ................................................................................. 16 Maps, Figures, Tables ............................................................................ 18 Onchocerciasis Elimination Program for the Americas .............................................................. 22 Recommendations ................................................................................. 26 Maps, Figures, Tables ............................................................................ 28 Uganda .....................................................................................................................................32 Recommendations ................................................................................. 36 Maps, Figures, Tables ............................................................................ 39 Sudan .......................................................................................................................................43 Recommendations ................................................................................. 45 Maps, Figures, Tables ............................................................................ 46 Cameroon ................................................................................................................................. 54 Recommendations ................................................................................. 56 Maps, Figures, Tables ............................................................................ 57 Nigeria ......................................................................................................................................62 Recommendations ................................................................................. 67 Maps, Figures, Tables ............................................................................ 71 Ethiopia .....................................................................................................................................79 Recommendations ................................................................................. 81 Maps, Figures, Tables ............................................................................ 83 Acronyms ..................................................................................................................................89 Annexes 1. A History of the River Blindness Campaign at The Carter Center ................. 91 2. The Carter Center RBP reporting processes and research agenda .............. 96 3. List of Program Review Participants ........................................................... 100 4. Contact List of Program Review Participants .............................................. 101 5. Program Review Agenda ........................................................................... 108 6. The Nigeria Lymphatic Filariasis (LF) Elimination Program and Schistosomiasis Control Program .............................................................. 111 7. Monitoring Sustainability and Costs after Withdrawal of Core Funding by the African Program for Onchocerciasis Control (APOC) ................................. 114 8. Publications Authored or Coauthored by RBP Personnel ........................... 116 9. Acknowledgements .................................................................................... 125 Figure A Carter Center-Assisted Programs: Annual Mectizan® Treatments, 1996 – 2011 16,000,000 14,604,327 14,115,910 14,355,547 14,000,000 13,499,414 12,985,296 12,000,000 11,109,611 11,301,304 10,798,434 10,000,000 9,658,793 8,964,429 8,019,378 8,000,000 7,229,829 6,684,146 Treatments 6,000,000 5,626,767 5,090,511 3,873,425 4,000,000 2,000,000 0 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Year Figure B Carter Center-Assisted Programs: Cumulative Mectizan® Treatments, 1996 – 2011 157,916,978157,916,978 160,000,000 143,561,574 140,000,000 128,957,247 114,841,337 120,000,000 101,341,923 100,000,000 88,356,627 77,055,323 80,000,000 Treatments 66,256,889 60,000,000 55,147,278 45,488,485 40,000,000 36,524,056 28,504,678 21,274,849 20,000,000 14,590,703 8,963,936 3,873,425 0 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Year 2 Figure C 2011 River Blindness Program Review Participants Figure D Geographic Distribution and Transmission Status of Onchocerciasis in the Americas, December 2011 1 Oaxaca 44,919 2 North Chiapas Transmission status % Pop. 7,125 ELIMINATED 29% 4 Huehuetenango 30,239 INTERRUPTED 50% SUPPRESSED 17% 3 South Chiapas* 114,024 ONGOING 4% 5 Central 124,498 8 Northcentral 9 Northeast 6 Escuintla 14,385 93,239 62,590 7 Santa Rosa 12,208 10 South 9,168 12 Colombia COLOMBIA 1,366 10 12 13 Esmeraldas 25,863 11 Amazonas 12,563 4 Figure E Uganda: Carter Center-Assisted Districts, 2011 Figure F Uganda Districts where Onchocerciasis Elimination Policy is being Implemented 6 Figure G Uganda declares interruption of transmission in Itwara, Wadelai and Mt. Elgon in 2011 Uganda Daily Newspaper: New Vision, Friday, February 17, 2012 Figure H Impact of MDA and LLINs on Lymphatic Filariasis Transmission in Nigeria Panel A Panel B In 2011, for the first time, no infective (L3) mosquitoes were detected MDA – Mass Drug Administration with Mectizan® and Albendazole LLIN – Long Lasting Insecticidal Nets 8 ABSTRACT 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) through programs whose goals are either to control or eliminate onchocerciasis. Most of these activities are undertaken in collaboration with Lions Club International Foundation (LCIF) under the Lions-Carter Center SightFirst Initiative. In 2011, the RBP and its partners provided more than 14.3 million Mectizan® treatments (Frontispiece Figure A). Cumulative RBP-assisted Mectizan® treatments since 1996 exceeded 150 million (Frontispiece B) in 2011, and this milestone was commemorated by a special “150” medal (see inset). The RBP also helps countries integrate river blindness efforts with lymphatic filariasis, malaria, schistosomiasis, trachoma, and Vitamin A supplementation when feasible. In 2012, the RBP plans to undertake a paradigm shift by focusing all of its efforts on eliminating RB transmission. RBP will continue its elimination efforts in A commemorative medal was the Americas and Uganda, enhance its work in areas distributed at the Program Review, celebrating over 150 million currently assisted in Nigeria and Ethiopia, wind down its cumulative Mectizan treatments programs in Sudan, and end its support to Cameroon. delivered by Carter Center (RBP)- assisted programs from 1996 – 2011. BACKGROUND Design by Sherri Richards. Human onchocerciasis, an infection caused by the parasitic worm Onchocerca volvulus, causes chronic skin disease and severe itching, as well as eye lesions that can progress to visual loss or complete blindness. The worms live in fibrous ‘nodules’ that often can be felt just under the skin. Onchocerciasis is transmitted by small black flies that breed in rapidly flowing rivers and streams, thus leading to the common name for the disease, “river blindness” (RB). The World Health Organization (WHO) estimates that approximately 37.2 million people are infected and 770,000 are blinded or severely visually impaired in 38 endemic countries. Approximately 123 million people live in endemic areas worldwide and are therefore at risk of infection; more than 99% of those at risk reside in Africa. Periodic mass treatment with Mectizan® prevents eye and skin disease caused by O. volvulus and may also be used to reduce or even interrupt transmission of the disease depending on the duration and frequency of treatment per year and the geographic extent of the distribution programs. (See Annex 1 and 2 for further details.) The Carter Center’s RBP is dedicated to safe and sustainable mass distribution of Mectizan® with health education to control or eliminate onchocerciasis. The distinction between control and elimination is important.
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