The World Health Organization (WHO) has officially commended Niger for successfully meeting the criteria for onchocerciasis eradication, positioning it as the fifth nation globally and the inaugural country in Africa to receive WHO recognition for halting the transmission of the parasite Onchocerca volvulus.
“Achieving the elimination of any disease represents a monumental accomplishment, demanding unwavering dedication,” stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “I applaud Niger for its steadfast commitment to liberating its populace from this stigmatizing, sight-robbing illness, which inflicts immense human suffering upon the most vulnerable. This triumph stands as further proof of the remarkable strides we are making in combating neglected tropical diseases. By showcasing that elimination is indeed feasible, it ignites hope for other nations still grappling with onchocerciasis today.”
Onchocerciasis, commonly known as river blindness, is a parasitic ailment and globally, the second leading infectious cause of irreversible blindness, surpassed only by trachoma. It spreads through the bite of an infected blackfly, typically found thriving near fast-flowing rivers and streams. The disease disproportionately impacts rural communities across sub-Saharan Africa and Yemen, though smaller endemic pockets also persist in Latin America.
Niger’s strategic initiatives and impactful partnerships
Between 1976 and 1989, under the guidance of the WHO Onchocerciasis Control Programme in West Africa (OCP), Niger implemented robust vector control measures, including insecticide spraying, which significantly curtailed onchocerciasis transmission levels. Subsequently, following generous donations of ivermectin from Merck, Sharpe & Dohme (MSD), a comprehensive mass drug administration (MDA) campaign utilizing ivermectin and albendazole was conducted from 2008 to 2019 in areas still affected by lymphatic filariasis, which were then closely monitored. Given ivermectin’s efficacy against both diseases, and as the targeted MDA zones for lymphatic filariasis also overlapped with onchocerciasis endemic regions, this intervention critically contributed to disrupting the transmission cycle of the Onchocerca volvulus parasite.
Niger initiated preliminary assessments to verify the interruption of onchocerciasis transmission in 2014, shortly after discontinuing MDA for lymphatic filariasis in most areas. Subsequent entomological and epidemiological surveys conclusively demonstrated that the integrated approach of medication and vector control had successfully eliminated onchocerciasis transmission, evidenced by a dramatic reduction in prevalence from approximately 60% to a mere 0.02%.
Beyond the crucial vector control interventions and pharmaceutical contributions from MSD, the collaborative partnership between the Government of Niger, the WHO, and various non-governmental organizations proved instrumental to Niger’s success. This alliance facilitated the mobilization of essential resources and technical expertise. Continuous surveillance of disease prevalence and its ramifications enabled swift adjustments to strategies, ensuring the sustained effectiveness of all interventions.
“Onchocerciasis has for too long inflicted immense human suffering. It has also impeded the economic advancement of affected communities by forcing populations away from rivers, which are often vital for their livelihoods,” explained Dr. Matshidiso Moeti, WHO Regional Director for Africa. “Niger’s achievement brings an end to this burden for its people. It also establishes Niger as a beacon for neglected tropical disease elimination across Africa. The country had already demonstrated its public health leadership in 2013 by eliminating Guinea worm disease. Today marks yet another historic leap forward.”
Global strides in disease elimination
On a global scale, 54 countries have successfully eliminated at least one neglected tropical disease.
Niger now joins four other nations whose onchocerciasis elimination has been certified by the WHO, all of which are located in the Region of the Americas: Colombia (2013), Ecuador (2014), Guatemala (2016), and Mexico (2015).
Within the WHO African Region, 21 countries have eliminated at least one neglected tropical disease. Onchocerciasis is the second neglected tropical disease eradicated in Niger, building upon the country’s certification as free from dracunculiasis (Guinea worm disease) transmission in 2013.
