THE CARTER CENTER
Waging Peace.
Fighting Disease.
Building Hope.

Onchocerciasis Elimination Program for the Americas

The Carter Center's Onchocerciasis Elimination Program for the Americas (OEPA) works to end illness and transmission of onchocerciasis in Brazil, Ecuador, Guatemala, Mexico, Venezuela, and Colombia. 

Headquartered in Guatemala, OEPA partners with the ministries of health of the affected countries in Latin America as well as with the Pan American Health Organization (PAHO), the U.S. Centers for Disease Control and Prevention, academic institutions, and independent organizations.

Since 2003, the endemic countries have maintained at least 85 percent treatment coverage, which must be sustained to halt transmission. In 2008, the Pan American Health Organization (PAHO) issued an urgent call to interrupt the disease's transmission by 2012. (Read the resolution, "Toward the Elimination of Onchocerciasis in the Americas (PDF).")

As of June 2013, a total of 11 foci of the 13 endemic areas have interrupted transmission as a result of health education and Mectizan® distribution. Colombia (2007) and Ecuador (2009) became the first countries in the world to halt river blindness transmission through health education and semiannual distribution of Mectizan. In July 2013, Colombia publicly announced it became the first country in the Americas for World Health Organization verification of eliminating river blindness.

Mexico and Guatemala, formerly the region's two most endemic countries, have interrupted transmission of river blindness, halted Mectizan treatment, and begun their post-treatment surveillance.Ecuador, having completed its three years of post-treatment surveillance, has filed a request to WHO for a verification team visit.

Transmission of the disease remains only in the hard-to-reach border area between Venezuela and Brazil in Amazon rainforest.

Today, as the result of highly successful national programs, this once 'neglected' tropical disease has been wiped from 96 percent of the region and no one need fear becoming blind from river blindness in the Americas.

Thanks to these achievements, the Americas will soon free itself from the threat of this debilitating disease.

 

At-Risk Populations

Diverse populations and ecosystems are affected by river blindness. In Guatemala and Mexico, the mestizo and indigenous populations who live on coffee plantations were the most at risk. The nomadic Yanomami of Brazil and Venezuela are some of the most severely affected groups as their travel throughout the Amazon rainforest — some of the only areas left in the Americas with active river blindness transmission — places them at continuous risk for exposure.

Local volunteers who work to eradicate onchocerciasis.
Carter Center Photos
Local health workers, including these men, have dedicated countless hours to eradicating onchocerciasis in their communities.

Achieving Regional Elimination

River blindness is less widespread in the Americas than in Africa. Semiannual treatments — in some cases up to four times annually — with Mectizan®(ivermectin, donated by Merck) over many years can halt disease transmission and improve health by reducing the presence of the parasite's larvae in the human body.

Before OEPA started operations in 1993, only 41,911 treatments of Mectizan were administered throughout Latin America, vastly underserving the populations at risk. However, program efforts have increased distribution considerably.

After several years of monitoring and evaluation of the program, in 2001, the Carter Center's International Task Force for Disease Eradication, in partnership with the World Health Organization, confirmed that river blindness could be eliminated from the Americas by treating 85 percent or more of infected people with semiannual doses of Mectizan. (Read the Final Report of the Conference on the Eradicability of Onchocerciasis.)

A woman takes a dose of Mectizan.  A woman in an onchocerciasis-endemic area takes a dose of Mectizan®. Like the rest of her community, she will be spared a future of blindness from this debilitating disease.

River blindness has cost Pitasia Gonzales of Mexico her sight, but she is hopeful for her family's future. Read More >>