Elimination of human onchocerciasis: progress report, 2024–2025

Overview

Onchocerciasis, or river blindness, remains a major public health challenge despite decades of sustained efforts. More than 99% of population requiring preventive chemotherapy (PC) for onchocerciasis live in 26 countries in Africa, and about 1% living outside the continent in Brazil, Bolivarian Republic of Venezuela and Yemen. Gabon remains the only endemic country globally not implementing ivermectin treatment due to challenges associated with Loa loa co-endemicity and the risk of severe adverse events with ivermectin, particularly when introduced for the first time. Sudan did not implement MDA for onchocerciasis in 2024 and Yemen has not submitted its report yet. In 2024, Bolivarian Republic of Venezuela and Brazil implemented 2 rounds of treatment with ivermectin, providing 22 952 and 13 044 treatments respectively. For more details on progress achieved by the endemic countries in the Americas see the Onchocerciasis Elimination Program for the Americas (OEPA) report published in this issue. Data from the country reports for 2024 that had not been received at the time of publication will be made available on the PC data portal.

By the end of 2024, 25.5 million people were living in areas no longer requiring ivermectin treatment, with Nigeria accounting for more than 16.6 million of these. An additional 13.1 million people in 124 implementation units (IUs) across 4 countries are awaiting post-treatment surveillance to confirm cessation of PC. In 2024, 26 countries reported treatment against onchocerciasis reaching 171.6 million people worldwide. Global coverage achieved in 2024 was 68%. Ivermectin was distributed in 84.0% of known endemic IUs for onchocerciasis, of which 88% achieved effective coverage

A mid-term review of the NTD road map

The year 2025 represents a pivotal moment of transition and reflection, marking the midpoint of the NTD road map. The roadmap highlights the importance of stronger country ownership and leadership, while underscoring the integration of NTD delivery programmes into health systems and existing national platforms. Countries are encouraged to conduct a midterm review to assess progress toward targets, identify challenges and opportunities, and develop acceleration plans toward 2030 that prioritize sustainability, country ownership, and equitable partnerships that provide catalytic support under national leadership. Table 2 reflects progress made against the NTD road map targets by 2024.

For onchocerciasis elimination, sustaining high treatment coverage remains critical. Any decline in coverage or interruption in treatment risks undermining decades of progress, potentially reversing gains and leading to a resurgence of transmission.