River Blindness

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River Blindness Elimination Program

The Carter Center works with national ministries of health in Latin America and Africa to eliminate river blindness, one of the leading causes of preventable blindness worldwide.

What is River Blindness?

River blindness, also known as onchocerciasis, is a parasitic infection that can cause intense itching, skin discoloration, rashes, and eye disease that often leads to permanent blindness. The parasite is spread by the bites of infected black flies that breed in rapidly flowing rivers.

  • a woman measure a young man's height to determine his dose of medication.

    Meleshew Sisay, a community drug distributor in Gondar District’s Mender 3 community, Ethiopia, measures the height of a child to determine proper dosage of medication to prevent and treat river blindness. (Photo: The Carter Center/ R. Youngblood)

How Widespread is the Disease?

Approximately 20.9 million people are infected with the parasite that causes onchocerciasis, with more than 240 million at risk of the disease in sub-Saharan Africa, Latin America, and Yemen.

The Carter Center currently works to eliminate river blindness in the following countries: Brazil, Ethiopia, Nigeria, Sudan, Uganda, and Venezuela. Together with the respective ministries of health and partners, the Carter Center's Onchocerciasis Elimination Program for the Americas has successfully eliminated river blindness transmission from Colombia (2013), Ecuador (2014), Mexico (2015), and Guatemala (2016).

Our Strategy

The Carter Center assists ministries of health in six nations to eliminate river blindness through health education and mass drug administration (MDA) of the medicine Mectizan®, donated by Merck & Co., Inc. When necessary and feasible, the programs add black fly vector control as a complementary approach.

Mectizan kills the parasite larvae in the human body, preventing blindness and skin disease in infected persons, and stopping the transmission of the parasite to others. The Carter Center works through national ministries of health to provide health education and mobilize affected communities to distribute Mectizan.

  •  Yanomami people living along the Brazil-Venezuela border.

    The last cases of river blindness in the Americas are limited to the region where the migratory Yanomami live along the Brazil-Venezuela border. (Photo: The Carter Center)

In Latin America, The Carter Center works through its Onchocerciasis Elimination Program for the Americas (OEPA) to eliminate the disease from the region by helping to provide multiple Mectizan treatments per year in endemic areas. Today, efforts focus on Brazil and Venezuela, where transmission still occurs in an isolated area on the border of the two countries.

In Africa, where more than 99 percent of the global cases exist and most Mectizan treatments are annual, the Center and its partners have successfully interrupted or eliminated river blindness transmission in parts of Ethiopia, Nigeria, Sudan and Uganda with repeated Mectizan MDA.

Results and Impact

  • The Carter Center has assisted in the distribution of more than 500 million treatments of Mectizan® in Africa and Latin America.
  • In December 2022, Nigeria’s National Onchocerciasis Elimination Committee recommended that four Carter Center-assisted states (Abia, Anambra, Enugu, and Imo) halt Mectizan® treatment for onchocerciasis, having interrupted onchocerciasis transmission and thus met WHO criteria to do so. The decision covers a record 18.9 million people, the largest stop-treatment decision for river blindness in history. In 2021, Plateau and Nasarawa states became the first in Nigeria to meet the national criteria for elimination of onchocerciasis transmission, protecting about 2 million residents. Delta state also interrupted transmission in 2021, allowing it to stop MDA for another 2.8 million residents.
  • Uganda has eliminated river blindness transmission in 14 of the 17 original transmission foci, with transmission interrupted in one additional focus that is under post-treatment surveillance. Interruption of transmission is suspected in the two remaining foci, meaning there are no longer any areas with ongoing transmission. Currently, 2.5 million people are no longer at risk since the launch of the national elimination policy in 2007.
  • The Ethiopian Onchocerciasis Elimination Expert Advisory Committee determined in October 2022 that transmission had been interrupted in 17 districts of the South West and Oromia regions and that treatments could be stopped for more than 1.3 million residents. Transmission was interrupted in Metema Subfocus (Amhara Region) in 2017.
  • In the Americas, only two countries, Brazil and Venezuela, have ongoing river blindness transmission. In 2013, Colombia became the first country in the world to be granted verification of elimination of river blindness by the World Health Organization. Ecuador, Mexico, and Guatemala followed in Colombia's steps, receiving official verification of elimination in 2014, 2015, and 2016, respectively.
  • In Sudan, transmission was eliminated in the Abu Hamad focus (River Nile state) in 2015 and interrupted in the Galabat subfocus (Gedarif state) in 2017.
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The Carter Center works to eliminate river blindness, not just control it, in all the areas where we are fighting this neglected disease in Africa and Latin America.

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