Fighting Disease:  Uganda

Controlling River Blindness

River blindness is a parasitic disease transmitted by the bite of small black flies that breed in rapidly flowing streams and rivers. The disease, which causes severe itching, eye damage, and often blindness, can be prevented through health education and Mectizan® distribution. Learn more about the Carter Center's campaign to eliminate river blindness from the Americas and to control it in Africa >

For additional information and updates on the River Blindness Program in Uganda, read the latest issue of Eye of the Eagle >

In Uganda, onchocerciasis – also known as river blindness – affects 32 out of 111 districts. Onchocerciasis control in Uganda began in 1991 and was based on annual, mass treatment with Mectizan. The original Ministry of Health program enjoyed financial support from the River Blindness Foundation and SightSavers International. In 1996, The Carter Center assumed the activities of the River Blindness Foundation. In 1997, the African Program for Onchocerciasis Control (APOC) began supporting some Ugandan efforts and introduced the community-directed approach to distribution of Mectizan® (ivermectin, donated by Merck).

The community-directed kinship intervention approach, pioneered by Carter Center epidemiologist Dr. Moses Katabarwa, has been adopted as national health policy in Uganda. It already has been introduced with positive results for malaria control, with significant reduction in infant mortality, and other programs.

In addition, Uganda governmental support for these efforts is strong politically and, to some extent, financially. Involvement and active participation of members of the affected communities have increased over the years as well. Some districts also are providing support for the program.

In early 2007, high-ranking Ugandan government officials announced the country's strategy for eliminating river blindness nationwide. Uganda, one of 18 endemic countries in Africa, is the first to announce a nationwide plan to eliminate river blindness.

Ugandan officials believe that eliminating the disease will be more cost-effective than continuing control efforts indefinitely for its estimated 2 million people at risk. In previous decades, the country has successfully eliminated the disease from three isolated areas.

One factor that makes Uganda a good place to try elimination is the nature of river blindness vectors there. The black fly responsible for about 70 percent of river blindness transmission in the country (called Simulium neavei) has a very short flight range, which means that these flies are unlikely to spread the disease to neighboring areas because they cannot travel far. In other parts of Africa, the fly that transmits the disease (Simulium damnosumspp) has a flight range of more than 100 kilometers, making a vector control program more difficult to execute.

In 2008, the first meeting of the Uganda Onchocerciasis Elimination Committee (UOEC) was held, with support from The Carter Center. Established by the Uganda Ministry of Health, the UOEC is charged with ensuring that onchocerciasis elimination efforts are vigorously carried out and supported with scientific data.

In 2010, the Carter Center River Blindness Program assisted community-directed treatment with Mectizan and health education to 24 (or 75 percent) of endemic districts. In 2010, The Carter Center assisted in providing 2.5 million treatments (or 78 percent) of the national output in program areas.

Also in 2010, with Carter Center support, Uganda trained or retrained more than 95,000 community-directed distributors (CDDs). Uganda has a better ratio of community-directed distributors to population served than any other Carter Center-assisted program at one CDD to 28 people served.

Watch the video: River Blindness in Uganda >

Read the Real Lives, Real Change feature: Welcomed Home, an Outcast Begins To Heal >

Read the news feature: Uganda Attempts Nationwide Elimination of River Blindness >

Read the news feature: Uganda's Success Against River Blindness: An Inspiration for Africa and an International Challenge >

Learn more about the Carter Center's River Blindness Program in Uganda (in search result format) >