Elimination of onchocerciasis in the WHO Region of the Americas: Ecuador’s progress towards verification of elimination

Overview

 The Onchocerciasis Elimination Program for the Americas (OEPA) is a regional partnership, the goal of which is to interrupt onchocerciasis transmission in the Americas by 2015. The OEPA strategy is the provision of MDA with ivermectin tablets ≥ 2 times each year to all communities in endemic foci, reaching ≥85% treatment coverage of eligible populations. The OEPA partnership includes the governments of countries where the disease is endemic, The Carter Center, PAHO, the United States Agency for International Development (USAID), Lions Clubs International Foundation (LCIF) and local Lions Clubs, the United States Centers for Disease Control and Prevention (CDC), the Bill & Melinda Gates Foundation, the Carlos Slim Foundation, several universities/institutes, and Merck/Mectizan Donation Programme.

At the initiation of the OEPA in 1992, the Esmeraldas Focus of Ecuador was considered to represent one of the greatest challenges in the region to proving that transmission of onchocerciasis could be interrupted using a strategy of twice yearly ivermectin MDA. This was due to the fact that the main vector in Ecuador, S. exiguum, is highly efficient and comparable to those in Africa. Details of the initial success of the Ecuador MDA program were reported in the WHO Weekly Epidemiological Record. MDA was halted in Ecuador in 2010, and PTS was successfully completed in 2012. In October 2012, OEPA’s steering committee (the Program Coordinating Committee – PCC) recommended that the Ministry of Health of Ecuador files a request to WHO for an IVT visit. The 23rd annual InterAmerican Conference on Onchocerciasis (IACO 2013) was held in Quito, Ecuador in November 2013 to celebrate the occasion of Ecuador’s filing its formal request to PAHO/WHO for verification of elimination. The IVT visited Ecuador in May 2014 and its report is currently being reviewed by WHO.