Eradicating river blindness in Guatemala scratches the surface of a global problem

A young girl takes a Mectizan pill as her family members look on outside of their home in the Chicacao District, July 16th, 2009. Along with heath education, mass distribution of Mectizan (donated by Merck) is a key facet of The Carter Center’s strategy to eliminate river blindness in the Americas. (Credit: The Carter Center/P. Dicampo)

The eradication of onchocerciasis – otherwise known as river blindness – in Guatemala is a tremendous achievement, but only scratches the surface of the effort to eradicate the neglected tropical disease worldwide.

Guatemala is one of six countries in the Americas that have been affected by the disease. Once the most endemic country in the Americas, Guatemala recently joined Colombia, Ecuador and Mexico – which were granted verification of elimination between 2013 and 2015 – in successfully eradicating the disease.

“Elimination has been made possible by our country’s strong commitment, the efforts of our health workers and volunteers, and the high level of participation and empowerment of affected communities,” Lucrecia Hernández Mack, the Guatemalan minister of health, said in a press release. “Health is a priority for all. So we will continue to work to eliminate other neglected infectious diseases affecting our most vulnerable population.”

River blindness is a parasitic infection transmitted by the bites of infected flies that breed in rapidly flowing rivers, and can cause intense itching, skin discoloration, rashes and eye disease. If left untreated, parts of the eye, including the optic nerve, are damaged, causing permanent blindness.

In the Americas, the disease is now only transmitted among indigenous people living along the border of Brazil and Venezuela. Both countries have committed to eradicating river blindness. If they are successful, that would be the end of the disease in the Americas, which as a region has reduced its onchocerciasis-affected population by 95 percent.

Still, the World Health Organization (WHO) estimates that at least 25 million people are infected worldwide, and some 123 million people are at risk of infection. After trachoma, river blindness is the second-leading cause of infectious blindness, and the fourth-leading cause of preventable blindness worldwide. Sub-Saharan Africa alone accounts for 99 percent of existing cases, along with isolated areas in Yemen and in several Latin American countries.

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In the Americas, the current progress is largely due to elimination efforts by the Carter Center’s Onchocerciasis Elimination Program for the Americas, the Mectizan Donation Program from the pharmaceutical company Merck, and ongoing efforts by the World Health Organization and Pan American Health Organization. At the front lines of the fight, community health workers have been educating their communities about the disease, and distributing the drug Ivermectin, which effectively kills off the parasite in those infected and prevents the disease from spreading.

“Guatemala deserves enormous credit for its 100-year struggle against river blindness.  It was the great Guatemalan researcher Dr. Rodolfo Robles, who discovered onchocerciasis in the Americas in 1915,” said former President Jimmy Carter, founder of The Carter Center, in a statement. “Health workers, community educators and program leaders in Guatemala deserve the credit for their unrelenting work and determination to improve the health of future generations.”

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The Carter Center and Merck are working with other organizations and governments to end river blindness in Uganda and other affected regions of Africa. More than 240 million treatments have been distributed as a result of the partnership with the Carter Center, Humanosphere reported last month, in addition to the work done through the WHO. Work is continuing in Brazil, Ethiopia, Guatemala, Nigeria, Sudan, Uganda and Venezuela to bring the number of global cases down to zero.

(Video footage owned by The Carter Center.)

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Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com