Thanks to the efforts of the Onchocerciaisis Control Program (OCP), a now completed partnership of the WHO/AFRO, the World Bank, and its partners, onchocerciasis – or River Blindness as it is also known – has largely been controlled throughout West Africa. The program was based largely on a strategy of vector control – an expensive but highly effective strategy. The program has been heralded, deservedly, as one of the most effective public health programs of our time.

Since the closure of the OCP program, regular monitoring of the epidemiological and entomological situation has been recommended and been carried out by the new African Programme for Onchocerciasis Control (APOC), one of the hardest working and most impressive public health groups in Africa (in my opinion, at least). Paul Chinnock, on his excellent TropIKA website, has reported that onchocerciasis may be on the return in Cote D’Ivoire.

What I think this example show us is that there will be a continual need for ongoing monitoring and evaluation and the political power and flexibility to intervene as-needed on a case by case basis. In this case, community directed treatment with ivermectin will likely be recommended. The program needs to be prioritized immediately and put in place with no delay. These little black flies can travel long distances and could lead to the spread of the disease throughout the entire region. It also means that donors will need to ensure long-term support for this program, by long term I mean continuous.

This is largely the conclusion that an advisory group, of which I was a participant, recently recommended and was adopted by the governing bodies of the APOC program. Now let’s see some action.

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