Former U.S. President Jimmy Carter and Mexican businessman Carlos Slim announced Thursday a partnership to assist the regional initiative working with six countries in the Americas to eliminate river blindness (onchocerciasis): Brazil, Colombia, Ecuador, Guatemala, Mexico, and Venezuela.
The announcement comes as the Mexican government celebrates eliminating transmission of river blindness nationwide, joining Colombia, Ecuador, and Guatemala.
“This unique contribution from Carlos Slim further demonstrates Mexico’s global health leadership and the overall spirit of international commitment to ensure that all people in Latin America can enjoy the river blindness success we celebrate today in Mexico,” said former U.S. President Jimmy Carter, founder of The Carter Center, which works with the countries and partners throughout Latin America to eliminate the disease through its regional initiative, the Onchocerciasis Elimination Program for the Americas (OEPA).
Mexico’s success is the culmination of a more than 80-year national effort to first control, and then eliminate, the debilitating disease. Mr. Slim announced this integral alliance between the Carlos Slim Foundation and The Carter Center to bolster OEPA’s efforts to assist the remaining countries, Brazil and Venezuela, to target the Americas’ final cases of river blindness which are located in Yanomami communities deep in the Amazon rain forest.
“We are proud to join The Carter Center in its partnership with affected countries to stop the scourge of this dreaded disease once and for all. Eliminating a disease like river blindness is the right thing to do, we are committed to support the health, education and well-being of Mexican and Latin American populations,” said Carlos Slim, founder of the Carlos Slim Foundation.
Mexico’s first case of river blindness was diagnosed by Dr. Friedrich Fülleborn in 1923. In 1930, the national program to combat the disease was launched, based on a strategy of surgical removal of the subcutaneous nodules formed by the adult worms. Mass distribution of the safe and effective oral medication Mectizan®, donated by Merck, began to be used by the program in 1988. When the OEPA joined the fight against river blindness in 1993, cases were located in three transmission zones (foci) in two southern states, Oaxaca and Chiapas.
Onchocerciasis was wiped out from the Northern Chiapas focus and Oaxaca focus by the late 2000s using a strategy of semiannual distribution of Mectizan and health education. Southern Chiapas used both semiannual and quarterly treatments to eliminate onchocerciasis, completing its post-treatment surveillance phase in 2014. The country soon will apply to the WHO for formal verification as river blindness-free. Today, as a result of country leadership and strong partnerships, there are approximately 170,000 people in Mexico’s three formerly-endemic areas who are now no longer at risk of contracting river blindness.
In the late 1980s an estimated 500,000 people in the Americas were at risk of river blindness in six countries: Brazil, Colombia, Ecuador, Guatemala, Mexico, and Venezuela. The donation of Mectizan by Merck stimulated new partnerships and opportunities to fight river blindness.
Today, the population requiring Mectizan treatment in the Americas has been reduced by more than 95 percent.
In 2013, Colombia became the first country officially verified by the WHO as free of onchocerciasis, and on Sept. 22, 2014, Ecuador was the second to country receive WHO verification. The governments of Guatemala and Mexico have both eliminated disease transmission, completed their post-treatment surveillance period, and are getting ready to start the official process to request verification from the WHO.
Transmission only continues in the cross-border region between Venezuela and Brazil, commonly referred to as the Yanomami area. Interrupting onchocerciasis transmission from this final area in the Americas is the biggest challenge to the regional initiative, particularly due to the scattered migratory Yanomami population, who live in the dense, nearly inaccessible terrain of the deep Amazon rainforest. The Ministries of Health in Brazil and Venezuela are working with The Carter Center/OEPA, PAHO and other partners to meet the goal of verifying the elimination of onchocerciasis from the Americas by 2019.
River Blindness (onchocerciasis) is classified as one of the 17 Neglected Tropical Diseases (NTDs) by the World Health Organization (WHO). It is caused by a worm parasite (Onchocerca volvulus) that is transmitted through the bites of flies that breed in rapidly flowing waters along fertile river banks. The infection can cause intense itching, skin discoloration and disfigurement, eyesight damage, and blindness. In addition to the suffering it causes, the disease has an economic impact, reducing an individual’s ability to work and learn.