River Blindness
 Onchocerciasis,
or river blindness, is a parasitic disease transmitted
by the bites of small black flies that breed in
rapidly flowing streams and rivers. Since 1996,
The Carter Center has been a leader in the fight
against river blindness in Africa and the Americas
by working in thousands of communities in 11 countries.
The Carter Center's River Blindness Program assists
ministries of health to eradicate river blindness
in the six countries in the Americas — Brazil,
Columbia, Ecuador, Guatemala, Mexico, and Venezuela
— through the special Onchocerciasis Elimination
Program of the Americas and to control river blindness
in five African countries: Cameroon, Ethiopia, Nigeria,
Sudan, and Uganda.
River
Blindness Attacks the Poor
To contract river blindness, a person typically
must be bitten hundreds of times by infected black
flies, since only a small percentage of the flies
carry the infection. Therefore, the disease is not
common among travelers or visitors to endemic countries.
It is in fact the poorest of the poor who cannot
protect themselves or escape from the black flies
who are at greatest risk. It is estimated that in
some river blindness areas of the world such as
Ethiopia, men, women, and children are bitten by
these flies as many as 20,000 times each year. Larvae
enter the body through the fly bites and eventually
mature into adult worms.
The offspring of the worms, called microfilariae,
swarm under the skin where they can infect black
flies when they bite. The microfilariae irritate
the skin and cause intense itching, skin discoloration,
and rashes. If the microfilariae enter the eyes,
they cause inflammation and irritation, which can
cause diminished vision and potential blindness.
The disruption of family life and education resulting
from the disease directly impacts local economies
and long-term development.
Drug Treatment Fights
River Blindness
Studies in the 1980s showed that the drug Mectizan®,
made by Merck & Co. Inc., could effectively
and safely treat and prevent river blindness by
killing the microfilariae in the human body. Merck
decided in the late 1980s to donate the drug to
all who needed it for as long as needed. This donation
was an important stimulus for the current initiative
to globally control onchocerciasis using a strategy
of community-based treatment.
With the use of Mectizan and health education, experts
have concluded that it is possible to completely
eliminate river blindness from the Western Hemisphere
where it occurs. The Carter Center is the leading
organization in a coalition of partners dedicated
to this cause, called the Onchocerciasis Elimination
Program of the Americas (OEPA). In Africa, the strategy
is to control river blindness.
Center Partners Increase
Program Reach
The Carter Center's River Blindness Program works
through partnerships at all levels. The primary
partners are the people in the afflicted communities,
who organize themselves and volunteer their time
to help distribute Mectizan.
The Lions Clubs International Foundation, a longtime
partner in the fight against river blindness, has
provided The Carter Center with grants since 1996
to prevent the disease in Africa and the Americas.
The River Blindness Program supports the ministries
of health and their national onchocerciasis control
efforts executed within and through national primary
public and community health care systems. The Carter
Center also works closely with the Centers for Disease
Control and Prevention and the Mectizan Donation
Program.
The River Blindness Program partners in Africa include
the ministries of health in the five endemic countries,
the United Nations and affiliated organizations
(the World Health Organization, the World Bank,
and UNICEF), and other nongovernmental development
organizations. Another important partner is the
African Programme for Onchocerciasis Control, which
is executed by WHO and funded through a World Bank
trust fund.
In Latin America, OEPA's partnerships include the
ministries of health in the six endemic countries,
the Pan American Health Organization, the Centers
for Disease Control and Prevention, academic institutions
(such as The Scripps Research Institute), and independent
organizations.
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