Health care at the end of the road: opportunities from 20 years of partnership in onchocerciasis control

Abstract

The unprecedented decision of Merck & Co., Inc., to donate ivermectin through the Mectizan® Donation Program, has catalysed an exemplary partnership, to distribute the drug to the communities at risk of onchocerciasis, and empower them to take charge of the drug distribution themselves. Integration with other activities has always been part of the plan, but has been accelerated in recent years because of the need to strengthen primary health care, and to meet the challenges of integrating the rapid impact of Neglected Tropical Disease programmes. Activities that have been integrated include provision of vitamin A capsules, elimination of lymphatic filariasis, the distribution of insecticide-treated nets, and comprehensive eye health. Although these integrated activities show promising results for all programmes involved, challenges still remain. The risk of overburdening communities with multiple activities, and the problem of remuneration at the community level, are the major concerns, as is the need for effective coordination. The expanded onchocerciasis control partnership is a model of translating the eighth Millennium Development Goal (MDG), namely ‘develop a global partnership for development’, into action and also addresses other key MDGs. In 2006, the partnership provided more than 62 million treatments for onchocerciasis control, and offers a firm foundation from which to deliver other needed health interventions while safeguarding the achievements of onchocerciasis control thus far.

Keywords:

• Millennium development goals
• primary health care
• neglected tropical diseases
• partnership
• onchocerciasis
• community-directed interventions

Acknowledgements

We acknowledge the contribution of the following persons to the NGDO Coordination Group for Onchocerciasis Control: Philip Albano, Uche Amazigo, Nichole Brown, Jean-François Ceccon, Paul Derstine, Charles Franzén, Ken Gustavsen, Agnes Hauser, Moses Katabarwa, Franca Olamiju, Serge Resnikoff, and Daniel Shungu. This Group consists of the following NGDOs: Charitable Society for Social Welfare, Christoffel-Blindenmission, Helen Keller International, IMA Worldhealth, Light for the World, Lions Club International Foundation (SightFirst Programme), Mectizan® Donation Program, Mission to Save the Helpless (MITOSATH), Organisation pour la Prévention de la Cécité, Sightsavers International, The Carter Center, United Front Against Riverblindness, and US Fund for UNICEF. The Lymphatic filariasis support centre at the Liverpool School for Tropical Medicine and Hygiene and Merck & Co., Inc. are associated partners of the Group. We would like to thank Jennifer Nielsen and Tony Ukety for their comments on the manuscript.