The World Health Organization (WHO) has commended Niger for successfully meeting the criteria to eliminate onchocerciasis. This landmark achievement makes it the first country in Africa and the fifth worldwide to receive WHO validation for halting the transmission of the Onchocerca volvulus parasite.
“Eliminating a disease is a major accomplishment that requires tireless dedication,” stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “I congratulate Niger for its commitment to freeing its people from this blinding and stigmatizing disease, which causes immense human suffering among the poorest populations. This success is another testament to the remarkable progress we have made in combating neglected tropical diseases. By demonstrating that elimination is possible, it offers hope to other countries still battling onchocerciasis.”
Onchocerciasis, commonly known as river blindness, is a parasitic disease and the world’s second-leading infectious cause of blindness after trachoma. It is spread through the bite of an infected blackfly, typically found near rivers and streams. The disease predominantly affects rural communities in sub-Saharan Africa and Yemen, with smaller endemic areas also present in Latin America.
Effective Country-Led Initiatives and Partnerships
Between 1976 and 1989, Niger implemented vector control measures under the WHO Onchocerciasis Control Programme in West Africa (OCP). These efforts, involving insecticide spraying, significantly reduced the transmission levels of the disease. Following drug donations of ivermectin from Merck, Sharpe & Dohme (MSD), a mass drug administration (MDA) campaign using ivermectin and albendazole was conducted from 2008 to 2019 in areas still affected by lymphatic filariasis, which were subsequently monitored. Since ivermectin is effective against both diseases, and the MDA target areas for lymphatic filariasis were also endemic for onchocerciasis, this intervention also helped to stop the transmission of the Onchocerca volvulus parasite.
Niger initiated preliminary assessments for the interruption of onchocerciasis transmission in 2014, after halting MDA for lymphatic filariasis in most regions. Subsequent entomological and epidemiological surveys confirmed that the combination of medication and vector control had successfully eliminated transmission. This was evidenced by a dramatic reduction in prevalence from approximately 60% to just 0.02%.
In addition to vector control and drug donations from MSD, the partnership between the government of Niger, the WHO, and non-governmental organizations was instrumental to this success. This collaboration helped mobilize essential resources and technical support. Continuous monitoring of the disease’s prevalence and impact allowed for rapid strategy adjustments, ensuring the effectiveness of the interventions.
“Onchocerciasis has long caused immense human suffering and hindered the economic development of affected communities by driving people away from rivers, which are often vital to their livelihoods,” explained Dr. Matshidiso Moeti, WHO Regional Director for Africa. “Niger’s success lifts this burden from its people. It also establishes Niger as a model for eliminating neglected tropical diseases in Africa. The country already demonstrated its public health leadership in 2013 by eliminating Guinea worm disease. This is another historic step forward.”
Global Progress
Globally, 54 countries have successfully eliminated at least one neglected tropical disease.
Niger now joins four other nations verified by the WHO for eliminating onchocerciasis, all located in the Region of the Americas: Colombia (2013), Ecuador (2014), Mexico (2015), and Guatemala (2016).
Within the WHO African Region, 21 countries have eliminated at least one neglected tropical disease. Onchocerciasis marks the second such disease eliminated in Niger, as the country was certified free of dracunculiasis (Guinea worm disease) transmission in 2013.