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The Carter Center has joined forces with The World Bank and other international partners in a 12-year, $120 million project to fight river blindness (onchocersiasis) in sub-Saharan Africa.

Launched at a World Bank conference in December 1995, the African Programme for Onchocerciasis Control (APOC) aims to eliminate river blindness as a public health threat. The disease causes itching, blindness, and disfigurement among an estimated 15 million people in 16 African nations. Another 100 million people in those countries are at risk of the disease.

APOC is based on a partnership involving The World Bank, other nongovernmental organizations (NGOs) like The Carter Center, bilateral donors, international agencies, and governments in countries affected by river blindness. The program is modeled on the Onchocerciasis Control Program (OCP), formed by The World Bank in 1974 and administered by the World Health Organization. OCP largely has eliminated river blindness in an 11-country region of West Africa.

Under APOC, community-based treatment programs will be established to distribute Mectizanr, the drug that prevents river blindness. Merck & Co. Inc., a U.S. pharmaceutical company, will donate the tablets.

River blindness is a debilitating illness spread by tiny black flies that breed in fast-flowing rivers. When the flies bite people, they deposit microscopic larvae that mature and produce thousands of microworms called microfilariae. The immature worms migrate throughout the body, resulting in rashes and constant itching. They also can get into the eyes, where they cause inflammation and scarring, which can lead to permanent blindness. When taken once a year, Mectizan controls the disease and prevents blindness.

Carter Center-Based Committee Facilitates Drug Distribution
Merck and The Carter Center have worked together since 1988 to facilitate drug distribution through the Mectizan Donation Program. The program is administered by The Task Force for Child Survival and Development, an independent partner of the Center. A committee of experts, chaired by Task Force Executive Director and Carter Center Health Policy Fellow William Foege, M.D., reviews and approves applications from governments and NGOs that want to distribute the drug.

"Our experience in facilitating the distribution of Mectizan shows that communities can learn to take responsibility for treating river blindness and other diseases," Dr. Foege said. "This is an important step that leads to im-proved primary health care and quality of life for people living in remote areas of Africa."

To date, Merck has donated more than 29 million tablets, worth more than $80 million, in 32 African and Latin American nations. More than 15 million people were treated in these countries in 1995.

"The international community realized that the availability of free Mectizan presented a unique opportunity to control river blindness as a public health problem in Africa," said James Wolfensohn, World Bank president. "President Carter has lent his support in promoting the APOC. In particular, he and The Carter Center support the model of global partnership for disease control throughout Africa represented by this new program." Thus far, several countries and organizations have pledged $30 million of the $120 million needed for APOC.