River blindness: protection for 54 cents a year.

• Author: Vieta, Frances
• Position: Onchocerciasis Control Program

The United Nations battle against river blindness has made outstanding progress at best. It is an example of inter-agency partnership and international cooperation against a major health and socio-economic development problem.

On 27 June 1997, the Heads of the Food and Agriculture Organization of the United Nations (FAO), the United Nations Development Programme (UNDP), the World Bank, the World Health Organization (WHO) and other development partners issued a declaration calling for the elimination of river blindness or onchocerciasis throughout Africa by the year 2007. The declaration was signed on the occasion of the unveiling of a statue depicting a blind African man being led by a child (see photo).

Onchocerciasis is a debilitating and often blinding disease endemic to tropical areas of Africa, as well as of Central and South America. Also known as river blindness and "the lions stare", it is caused by a parasitic worm (onchocerca volvulus), which lives and reproduces for up to 14 years in the human body. It is transmitted to infected individuals by the bite of the blackfly which breeds in fast flowing rivers, hence the name river blindness. The adult worm produces millions of infant worms which cause unbearable itching, loss of skin color, rapid aging and unsightly skin disease. Victims are often blind by the time they reach their mid-thirties.

It is the third leading cause of blindness in Africa, where 80 million people are at risk and 18 million actually affected. About 400 thousand have been blinded by the disease. It is most prevalent in the savannahs of West Africa - that area of grasslands, shrubs and trees between where the Sahara stops and the coastal rainforests begin. Here the basin of the Volta River provides the blackfly with ideal places to lay its eggs. Once they hatch, the blackflies can carry the disease flying over distances of up to 400 kilometres.

The endemic health aspects in this Sahel area have lead to adverse social and economic consequences as entire communities often abandon these fertile riverside areas to move to less productive areas away from blackly infestations. In the past, this has lead to severe food shortages, the disintegration of community life and additional burdens on already impoverished populations.

The Onchocerciasis Control Program (OCP)

In 1972, two French scientists working in the area of Bobo Dioulasso in western Burkina Faso (then Upper Volta) decided that a possible solution for the...