Success in River Blindness battle

Press, 24 November 1982, Page 40

Success in River Blindness battle

NZPA , Ouagadougou A costly international programme to fight River Blindness, which has infected more than one million victims in the Volta river basin of West Africa, is marking up spectacular successes. Some 100,000 people living in the basin have lost their sight, while still larger numbers suffer from poor eyesight, intense itching and skin diseases including depigmentation and elephantiasis. The cause is a parasite, Onchocerca Volvulus, which transmits its tiny larvae into humans via the Simulum Damnosum, commonly known as the sandfly. Onchocercosis, or River Blindness, has been fought with encouraging success, but a costly budget since 1974 by a World Health Organisation special programme based in the capital of Upper Volta. The programme spreads through other countries of West Africa—Benin, Ivory Coast, Ghana, Upper Volta, Mali, Niger and Togo. Chemotherapy has proved a difficult treatment for the disease, and drugs available until now have had to be used under close medical supervision. Since it was impossible directly to attack the parasite which can develop over a 15-year period in the bodies of its victims, the programme undertook a large-scale fight against the fly, or more specifically against its eggs, to check its reproduction. The sandfly reproduced in running river water. Its eggs are destroyed by distributing insecticide into the water from boats or by spraying from small planes and helicopters. The programme ran into difficulties coping with the

scale of the disease and enlarged its control area from 654,0005 q km in 1974 to 750,000 sq km, as some “liberated” zones had become reinfested by sandfly from untreated neighbouring regions.

The programme’s joint committee, which in addition to the W.H.O. includes the Food and Agriculture Organisation, the United Nations Development Programme, the World Bank, financing bodies, and the countries affected by Onchocercosis, will decide in December in Bamako, the Mali capital, whether to extend the control area still further. Under consideration will be new regions in Ghana, Togo and Benin in the south, and westwards into Mali, Senegambia, Guinea and Guinea-Bissau, Sierra Leone and Liberia.

An extension of the programme would require even greater resources. But the plan, which in its first fiveyear phase .up to 1979 cost SUSS4 million, could, be threatened by more reinfestations of controlled areas if it is not extended. But so far, Di Ebrahim Samba, director of the pro-, gramme against Onchocercosis, can affirm that about 85 per cent of the formerly infected zone is under control.

Another encouraging sign is that after six years of fighting the fly, lesions on the eyes of victims noted at the beginning of the programmes have stabilised, and some patients who were less seriously infected have been cured.

But the battle is not yet won. The disease has only been contained, and is receding because of unremitting efforts. Thousands of kilometres of rivers are treated with larvi-

cide each week. Three hundred observation points have been set up along water courses giving researchers a permanent picture of sandfly population and particularly to analyse the degree of contamination, when they have been captured. The programme’s final objective is to stamp out the scourge and free the people from its catastrophic consequences. But it also aims to repopulate dozens of villages and fertile valleys from where the people had fled, seeking refuge in more healthy regions.