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Disease and Mortality in Sub-Saharan Africa. 2nd edition. Washington (DC): World Bank; 2006. Chapter 15.


Over the last 30 years a large international partnership has successfully attacked onchocerciasis. This partnership has defeated the disease in 10 of the 11 countries in West Africa and is making progress in the remaining endemic countries in central Africa and East Africa. The program, spanning 30 countries across Sub-Saharan Africa, encompasses more than 107 projects to create a comprehensive approach to eliminating the disease as a public health problem. The onchocerciasis control programs have yielded the following results: 1989–90—60,000 people treated in 11 countries. 1994—2 million people treated. 2002 (end of phase 1)—40 million people protected in 11 countries; 600,000 cases of blindness prevented; 18 million children spared the risk of onchocerciasis. 2003—33 million people treated in 69,641 communities in the APOC countries; more than 162,000 community distributors and 18,000 health workers trained or retrained. 2010—a projected 102 million people and about 100,000 communities protected in 16 countries and a projected 150 million people protected in 30 countries. Prior to 2002, when the OCP closed, 25 million hectares of relatively fertile land in the river valleys were freed for resettlement and for agriculture; the socioeconomic impact of OCP is considered to be enormous. More than 40 million people in the 11 countries were considered free from infection and eye lesions. Sixteen million children born after 1974, when OCP activities began, are free of onchocerciasis; more than 1.5 million people originally infected are no longer so; and more than 200,000 cases of blindness have been prevented. The second phase of the studies to determine the impact of APOC are under way, but the program is considered to be highly cost-effective. The cost per disability-adjusted life year of APOC operations is US$6.50. A study is also being conducted to demonstrate the feasibility and cost-benefit of onchocerciasis elimination with ivermectin.

Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank.

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