Unlike clinic-based distribution systems, APOC’s strategy of community-directed treatment with ivermectin (CDTI) promotes active community participation and community ownership from the outset. Communities collectively plan their own distribution systems, decide who distributes the ivermectin, and decide where and when the ivermectin is distributed. Communities are also encouraged to monitor their own progress and make modifications as necessary.
In this way, communities take charge of the whole CDTI process. The role of ministries of health and non-governmental development organizations (NGDOs) is to support and empower the communities rather than dominate and impose on them.
By definition, the CDTI process is in the hands of the communities affected by onchocerciasis. The success or failure of APOC to reach its ultimate goal will depend greatly on the degree to which communities are empowered to take ownership and responsibility for their ivermectin distribution.