Niger poised to be first country in Africa to eliminate river blindness

Niger poised to be first country in Africa to eliminate river blindness

DUBAI, 9th December, 2021 (WAM) -- Niger has completed the necessary evaluations in line with guidelines from the World Health Organisation (WHO) to certify the elimination of onchocerciasis (commonly known as river blindness), unlocking billions for the country’s economy over the last several decades.

It was announced yesterday at Expo 2020 Dubai that Niger is preparing the requisite paperwork for WHO verification and pending certification, and the country is now poised to be the first in Africa to declare it has eliminated the NTD - a feat once considered impossible. After over 40 years of work to control or eliminate river blindness in West Africa, the achievement in Niger provides a proof of concept that elimination is possible, not just in West Africa but across the entire continent.

An event was held today in the Niger Pavilion at Expo 2020 Dubai to celebrate this progress and honour Niger. The event was hosted by Reaching the Last Mile, a portfolio of global health programmes driven by a commitment of His Highness Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the UAE Armed Forces, the Bill & Melinda Gates Foundation, and The END Fund.

The hosts share a history of working together to combat NTDs through the Reaching the Last Mile Fund (RLMF). Administered by the END Fund, RLMF is a 10-year, global partnership launched by His Highness Sheikh Mohamed bin Zayed Al Nahyan together with support from philanthropists, governments and organisations such as the Bill & Melinda Gates Foundation.

Attendees included Reem bint Ibrahim Al Hashemy, Minister of State for International Cooperation, and Director General, Expo 2020 Dubai Bureau; Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation; and Ambassador Agada Garba, Ambassador of the Republic of Niger to the United Arab Emirates.

On this occasion, Bill Gates said, "Niger’s leadership in the fight against a disease that once seemed impossible to defeat has been exemplary. I have deep gratitude to all who contributed to this achievement, including the Nigeriens whose efforts made it an attainable dream. In particular, I want to thank His Highness for his vision in initiating the Reaching the Last Mile Fund, which has brought new technologies and approaches to the NTD sector and supported Niger in reaching the finish line."

For the elimination of river blindness in Niger to be officially certified by WHO, the next step will be for Niger to submit an elimination dossier. If accepted a formal declaration of the elimination of transmission will be made by WHO. The END Fund is currently supporting the Niger national programme in its efforts to compile a comprehensive dossier.

Ellen Agler, CEO of the END Fund, commented, "Niger’s achievement is truly inspirational. The country has shown incredible leadership and perseverance through a long and uncharted journey towards river blindness elimination. It has been the END Fund’s privilege to support Niger in arriving at a destination many thought couldn’t be reached.

"The significance of this moment cannot be underestimated. These efforts have created billions in economic gains for Niger, and the energy and momentum this will generate across the global NTD sector is immeasurable. On behalf of the entire ecosystem of partners the END Fund represents, we honour Niger’s leadership, and we are excited to support the next wave of countries across Africa following in Niger’s footsteps," she added.

The urgent need to end NTDs NTDs affect more than 1.7 billion people - often those living in under-resourced areas, in remote communities, and without basic services like access to clean water and sanitation.

Significant progress has been made since the landmark 2012 London Declaration on NTDs, which unified partners across sectors, countries and disease communities to push for greater investment and action on NTDs. Today, hundreds of millions of people no longer require treatment for NTDs and with the elimination of river blindness in Niger, 35 countries will have eliminated at least one NTD since 2012.

Niger’s achievement with river blindness demonstrates what is possible with long-term, sustained investments, country ownership of the goal, and effective public-private partnerships. Innovation and new technologies also play a critical part - from applying real-time and highly granular satellite and other geospatial data to better identify vector breeding locations at the village-level, to the pending introduction of new drugs like moxidectin, which in combination with existing drugs could accelerate the elimination of both river blindness and lymphatic filariasis in Africa.

History of river blindness in Niger More than half a century ago, vast areas of fertile land were abandoned in West Africa because of a tiny black fly carrying a parasite that causes severe discomfort and eventually leads to onchocerciasis. The disease is the world’s second leading infectious cause of blindness.

In 1974, the West African Onchocerciasis Control Programme (OCP) was launched to stamp out the disease in the region. Early efforts were focused on controlling the black fly spreading the disease-causing parasite and began with ground and helicopter spraying.

The progress made through vector control was complemented with mass drug administration campaigns which began in 1987 following donations of ‘Ivermectin’ from Merck, which offered countries a pathway to scale up treatment for river blindness like never before. The Mectizan Donation Programme (MDP) public private partnership between Merck & Co., WHO, and endemic countries is the longest-running drug donation programme.

NTD campaigns in Niger depend on the critical support of frontline health workers and drug distributors, who serve local communities throughout the country - including hard-to-reach villages in the north and nomadic groups in the central zone who regularly change location.

Through these sustained efforts, this past August, the Onchocerciasis Expert Advisory Committee advised the Niger Ministry of Health that the national elimination programme had successfully achieved their target of eliminating the transmission of onchocerciasis.

The link between NTDs and economic prosperity Niger’s new economic trajectory is profiled in a new report from Dalberg entitled, "Eliminating onchocerciasis and lymphatic filariasis (LF): Reaching the last mile."

According to the report, countries that eliminate onchocerciasis and LF create significant economic benefits that catalyse economic growth. For example, by eliminating onchocerciasis and controlling LF, Niger added an estimated US$2.8 billion to its economy over the last 45 years.

Once the burden of disease was lifted, individuals were able to lead productive lives and save on health expenditures; families were released from caretaking and enabled to pursue education and work; and rural communities resettled in productive lands around rivers, improving agricultural outputs and boosting local incomes.

Health workforces are also revitalised as caretakers are freed to pursue work outside the home. This is particularly impactful regarding women caretakers who are freed to reinvest in their communities, as women-led investments are proven to have a multiplier effect on local economies.

The report also found that failing to eliminate disease transmission creates risks that can hamper economic development, and limit the potential of affected populations.

RLMF: partnering for a healthy future RLMF focuses on ways to accelerate progress - from investing in mapping exercises, to supporting advanced lab facilities and cross-border collaborations. Mapping exercises enable countries to make informed decisions about whether they can safely stop treatment or need to start treatment for previously unreached populations. Prior to these surveys, many countries had a limited understanding of their transmission status.

And while eliminating a disease is the bulk of the fight, RLMF goes even further to prove elimination is possible and thus end needless expenditure of resources on a public threat that no longer exists. Verifying the elimination of river blindness is an incredible challenge in and of itself and RLMF catalysed several technological advancements to support Niger in arriving at this stage of elimination.