Niger’s landmark achievement: first african nation to eliminate onchocerciasis

The World Health Organization (WHO) has officially commended Niger for successfully meeting the criteria for onchocerciasis elimination, positioning it as the fifth nation worldwide and the pioneering country in Africa to receive WHO recognition for halting the transmission of the Onchocerca volvulus parasite.

“The eradication of any disease represents a monumental achievement, demanding unwavering dedication,” stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “I applaud Niger’s steadfast commitment to liberating its people from this stigmatizing, sight-robbing ailment that inflicts immense human suffering upon the most vulnerable. This triumph stands as further testament to the remarkable strides we are making in the battle against neglected tropical diseases. By demonstrating that elimination is indeed feasible, it instills hope in other nations currently grappling with onchocerciasis.”

Onchocerciasis, more commonly known as river blindness, is a parasitic disease and ranks as the second leading infectious cause of blindness globally, trailing only trachoma. Its transmission occurs through the bite of an infected blackfly, typically found thriving near flowing water bodies. The disease predominantly impacts rural communities across sub-Saharan Africa and Yemen, although smaller endemic pockets are also present in Latin America.

Country-led initiatives and impactful partnerships drive success

Between 1976 and 1989, under the guidance of the WHO Onchocerciasis Control Programme in West Africa (OCP), Niger implemented crucial vector control measures, including insecticide spraying, which significantly curtailed onchocerciasis transmission levels. Subsequently, thanks to generous donations of ivermectin from Merck, Sharpe & Dohme (MSD), a comprehensive mass drug administration (MDA) campaign utilizing ivermectin and albendazole was executed from 2008 to 2019 in regions still affected by lymphatic filariasis, followed by vigilant surveillance. Given that ivermectin is effective against both diseases, and as the areas targeted by the lymphatic filariasis MDA were also onchocerciasis-endemic zones, this intervention played a critical role in interrupting the transmission of the Onchocerca volvulus parasite.

Niger initiated preliminary assessments for the interruption of onchocerciasis transmission in 2014, following the cessation of MDA for lymphatic filariasis in most areas. Subsequent entomological and epidemiological surveys conclusively demonstrated that the combined approach of medication and vector control had successfully eliminated onchocerciasis transmission, evidenced by a dramatic reduction in prevalence from approximately 60% to a mere 0.02%.

Beyond the vital vector control interventions and MSD’s drug donations, the collaborative partnership between the Nigerien government, the WHO, and non-governmental organizations proved instrumental in Niger’s success. This collaboration facilitated the mobilization of essential resources and technical support. Ongoing monitoring of disease prevalence and its ramifications allowed for prompt strategic adjustments, ensuring the efficacy of all interventions.

“Onchocerciasis has for too long inflicted immense human suffering. It has also stifled the economic development of affected communities by forcing populations away from rivers, which are often vital for their livelihoods,” explained Dr. Matshidiso Moeti, WHO Regional Director for Africa. “Niger’s triumph brings an end to this burden for its people. It also establishes Niger as a beacon for neglected tropical disease elimination across Africa. The nation had already showcased its public health leadership in 2013 by eliminating Guinea worm disease. Today marks another historic advancement.”

Global progress in disease elimination

On a global scale, 54 countries have successfully eliminated at least one neglected tropical disease.

Niger now joins four other nations whose onchocerciasis elimination has been officially verified by the WHO, all located within the Region of the Americas: Colombia (2013), Ecuador (2014), Guatemala (2016), and Mexico (2015).

Within the WHO African Region, 21 countries have eliminated at least one neglected tropical disease. Onchocerciasis is the second neglected tropical disease successfully eliminated in Niger; the country received certification for being free of dracunculiasis (Guinea worm disease) transmission in 2013.