Director of the African Programme for Onchocerciasis Control (APOC), Dr. Uche Amazigo, has revealed how the programme intends to use community-target approach to eliminate River Blindness (onchocerciasis)in endemic African countries.
APOC’s strategy is based on preventive treatment of affected populations with a once-yearly dose of the anti-onchocerciasis drug ivermectin, according to Uche, who spoke with Hannah Brown, in an article published in Public Library Of Science (PLOS).
APOC, with the help of Amazigo, developed a strategy that has been remarkably successful in not fewer than 19 African countries. It is one that uses unpaid community workers to supplement the health system by training them to treat themselves and their neighbours and to complete record books to track drug distribution.
"All the communities want is for you to come and train their own chosen people. Once you have trained them, you send drugs to the drop-off point, and they will complete drug registers and return them," Amazigo said.
According to her, communities do the job that the health system should do, adding, "The important thing is that we do it in a way that will make communities feel very proud to be doing it, that they are able to distribute drugs themselves, and proud to serve the community."
Across 19 sub-Saharan African countries, the remarkable success achieved by APOC and its less extensive predecessor programme, Onchocerciasis Control Programme (OCP), which focused on 11 countries in West Africa, showed that Amazigo’s long-term support for this strategy is not misplaced.
APOC has enjoyed unlimited medicine donations from manufacturer, Merck & Company. This has helped it deliver treatment to communities in a sustainable and long-term manner.
"You now have countries where onchocerciasis is no longer a public health problem. In Burkina Faso, Mali, Senegal, Niger, Guinea, Togo, and Benin it is very hard to find any child going blind from onchocerciasis because they have active national surveillance which has maintained the achievements of the OCP," she said.
Amazigo said some of these countries have also started to reclaim land previously deserted due to the presence of black fly to grow cotton on a large scale.
"Some are up to the level of exporting cotton, so this is a huge economic development," she said.
As APOC’s mandate nears its pre-defined endpoint of 2015, Amazigo is now turning her attentions to a new and potentially more ambitious challenge.
Using the community-directed treatment strategy APOC has refined, she is now resolute that the programme would become a model for a more general strengthening of health systems in African countries.
"APOC’s experience shows that the system can work, successfully and sustainably, even in the most difficult environments, such as the conflict-scared and poverty-stricken Democratic Republic of Congo (DMR). What is more," Amazigo said.