Elimination of human onchocerciasis: progress report, 2021

Overview

Onchocerciasis, or river blindness, is one of the diseases targeted for elimination by WHO in the group of 20 diseases known as neglected tropical diseases (NTDs). The WHO road map on neglected tropical diseases, 2021–2030, developed with extensive global consultation, sets ambitious targets to be attained through 3 strategic shifts. The first is stronger accountability, by shifting from process to impact indicators and accelerating programmatic action. The second is a shift from vertical programming to intensified cross-cutting approaches. The third shift, and potentially the most significant, is a move away from partner-led to country-driven, country owned work.

For onchocerciasis, the targets by 2030 are to eliminate the need for mass drug administration (MDA) of ivermectin in at least 1 focus in 34 countries, in more than 50% of the population in at least 16 countries and in the entire endemic population in at least 12 countries. Achievement of these elimination goals will face various challenges but could be obtained by implementation of the actions listed in the NTD road map.

Great progress has been made towards elimination of onchocerciasis as a public health problem in many endemic areas due to the efforts of Member States, implementing partners and major control and elimination programmes, such the Onchocerciasis Elimination Programme for the Americas (OEPA; 1993–present), the Onchocerciasis Control Programme in West Africa (1974–2002), the African Programme for Onchocerciasis Control (1995–2015) and the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN, 2016–present). OEPA plays an important roles, as onchocerciasis has been eliminated in 4 countries in the Region of the Americas. And so it does ESPEN, given that now, 99% of the global burden of the disease is in the African Region, where it is endemic in 26 countries, in 10 of which it is co-endemic with loiasis. Best practices, lessons from the past and partnerships will be crucial in eliminating transmission of onchocerciasis.