18 Million More Nigerians Free of River Blindness

By 
Emmanuel Miri

After decades of community health education (shown here) and treatment with antibiotics, Nigerians in four states are no longer at risk of the parasitic disease river blindness.

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Dr. Emmanuel Miri is the Carter Center’s country representative in Nigeria.

In a historic decision last December, Nigeria’s Onchocerciasis Elimination Committee determined that mass drug administration for river blindness was no longer necessary in four states. Covering 18 million people, it is the largest stop-treatment decision in the program’s history. This was a great accomplishment for the committee and for us at The Carter Center, who have been assisting with river blindness elimination in Nigeria for almost 30 years.

As public health practitioners, we feel a great sense of satisfaction and fulfillment in this achievement. Elimination of disease is a contribution to humanity. Just as we eliminated Guinea worm disease in our country, we are working toward eliminating river blindness, lymphatic filariasis, and trachoma as well.

The path to success with river blindness has been challenging. There were times when logistical issues caused medication shortages, so we had to redistribute supplies from less endemic to more endemic areas. We also had to contend with migration prompted by flooding and erosion; insecurity that made it dangerous to work in certain places; the COVID-19 pandemic and monkeypox outbreaks; and turnover among community-based drug distributors, the heart of our program.

Together with our partners, we found ways to overcome or work around all of these challenges. We follow all protocols to avoid COVID-19 and monkeypox. As for insecurity, the program works closely with security agents and traditional institutions for advice on where to go and where not to go. The solution to attrition was to employ more married women, who are less prone to economic migration than men and therefore more reliable. We make sure to reward our community-based personnel, supervisors, and community leaders who perform well. This could be a model for other countries to follow.

I invite you to join us in celebrating this moment, and I look forward to even greater things to come.