Onchocerciasis (also known as river blindness) is a disease caused by infection with a parasitic worm transmitted by black flies, which breed in fast-flowing streams and rivers.

Onchocerciasis endemicity status (2016)

Preventive chemotherapy The coverage figure is lower than in previous years, partly because the total number of treatments required has increased with the addition of formerly untreated hypo-endemic areas to the treatment area.

WHO roadmap target:

Elimination by 2020

  • Latin America by 2015
  • Selected African countries by 2020
  • Yemen by 2015

The onchocerciasis control programme achieved good coverage through the African Programme for Onchocerciasis Control (APOC) until its closure in 2015.

198 million people were estimated to require MDA in 2016 67.1% coverage

Despite the closure of APOC, a greater number of people were reached and coverage increased to 67.1% of the estimated 198 million people in need of MDA. This was the highest coverage of all the PC NTDs in 2016. The impact on disease prevalence is difficult to measure, as operational guidance for impact evaluation is not yet available. Building on the strong control programme, the recent global strategy outlines a shift in programmatic focus from control to elimination. This introduces new demands such as defining the number of additional areas that will require treatment and appropriate criteria for stopping interventions.

Although many additional districts in a significant number of countries will require MDA, they will theoretically have a lower prevalence and therefore not require long-term treatment. The drug supply is currently meeting demand but will have to increase to meet the elimination goals. The research agenda should be realigned with the elimination targets, focusing on alternative treatment strategies and new tools for use at points of care. It will have to be translated into guidelines, in particular to address treatment in settings co-endemic for loaisis.

The operational details of the strategy should be finalized urgently, accompanied by resource mobilization to extend programme capacity and launch interventions coordinated with those for LF.

Encouraging developments since the last report include the creation of national elimination expert committees in Africa and the launch of the Expanded Special Project for Elimination of NTDs in Africa (ESPEN). Technical support to programmes and funding for scaling up treatment are, however, lacking.

This is part of Reaching a Billion, the fifth progress report of the London Declaration on NTDs. Read the full report.