The WHO Onchocerciasis Control Programme: retrospect and prospects

Area of Science:

• Public Health
• Tropical Medicine
• Vector-Borne Disease Control

Background:

• Onchocerciasis, or river blindness, is a debilitating parasitic disease transmitted by the Simulium fly.
• The World Health Organization's Onchocerciasis Control Programme in West Africa (OCP) was established to combat this disease.
• Experience from anti-locust campaigns informed the strategic planning of the OCP.

Purpose of the Study:

• To review the history and genesis of the OCP.
• To highlight the challenges faced by the OCP, including vector migration and insecticide resistance.
• To describe the management strategies and research undertaken to overcome these challenges.

Main Methods:

• Insecticide treatments targeting the breeding sites of the Simulium damnosum species complex, the vectors of onchocerciasis.
• Monitoring and management of vector migrations to prevent reinfestation of controlled areas.
• Research into insecticide resistance and development of control strategies.

Main Results:

• The OCP has achieved significant success in controlling onchocerciasis transmission in West Africa.
• Despite challenges such as fly migration and insecticide resistance, the program is largely meeting its objectives.
• Ongoing vector control and supplementary chemotherapy are projected to continue until 2004.

Conclusions:

• The OCP demonstrates the feasibility of large-scale vector control programs for tropical diseases.
• Integrated strategies combining vector control and chemotherapy are crucial for sustained onchocerciasis elimination.
• Continued vigilance and adaptive management are necessary to address evolving challenges in disease control.