Reducing the Burden of Preventable Diseases Among the Poor: Onchocerciasis and Filariasis

The Organization participates actively in the regional initiative to eliminate onchocerciasis, or river blindness, from the Americas, where the six remaining endemic countries-Brazil, Colombia, Ecuador, Guatemala, Mexico, and Venezuela-have dramatically reduced the at-risk population. PAHO has cosponsored regional conferences on elimination of the disease, provided technical support to national programs, and developed standardized epidemiological evaluations. Those evaluations indicate that the at-risk population shrank from 4,700,000 in 1995 to 660,000 in 1999.

Although the World Health Organization has called for the global elimination of lymphatic filariasis by 2020, the Region of the Americas expects to reach that goal much sooner. In the seven endemic countries-Brazil, Costa Rica, Dominican Republic, Guyana, Haiti, Suriname, and Trinidad and Tobago-the infection is focalized and the number of cases small. Elimination will entail mass multi-drug therapy of the at-risk population, and GlaxoSmithKline is donating one of the drugs, albendazole, for as long as the disease persists. To ensure success of the regional program, the Organization is orchestrating partnerships with the endemic countries' ministries of health, the private sector, including the Bill and Melinda Gates Foundation, cdc, other international and bilateral agencies, and nongovernmental organizations. PAHO has advocated the designation of national program managers in all seven countries, four of which have also set up national task forces. With PAHO's support, the countries are using new diagnostic tools-antigen detection cards-to map and measure the magnitude of the problem. Those tools are enabling Guyana, Haiti, and the Dominican Republic to identify target populations and, perhaps, to show that Brazil, Costa Rica, Suriname, and Trinidad and Tobago may not require an elimination program and may only have to deal with residual morbidity.

This article originally appeared in the
Preventing and Controlling Diseases chapter of
"Charting a Future for Health in the Americas:
Quadrennial Report of the Director—Centennial Edition"