Colombia

Colombia eradicates “river blindness,” paving way for hemisphere and Africa

 
 
President Jimmy Carter and his wife Rosalynn help measure people's heights to determine how many Mectizan treatments should be received to prevent river blindness in Afeta, Ethiopia.
President Jimmy Carter and his wife Rosalynn help measure people's heights to determine how many Mectizan treatments should be received to prevent river blindness in Afeta, Ethiopia.
Louise Gubb / The Carter Center

jwyss@MiamiHerald.com

This sometimes troubled Andean nation became a global role model this week when the World Health Organization certified it as the first country to eliminate onchocerciasis — the second-leading infectious cause of blindness.

It took Colombia and international health organizations more than a decade to drive the insect-borne illness, also known as river blindness, out of its stronghold. But the effort is a beacon to five other Latin American nations that are also battling the malady and Africa — where river blindness runs rampant.

“Colombia’s achievement demonstrates that a future free from river blindness is possible for everyone in the Americas,” said former U.S. President Jimmy Carter, founder of The Carter Center, who traveled to Bogotá for the event. The Carter Center runs the Onchocerciasis Elimination Program of the Americas, or OEPA, which has been coordinating and financing the eradication efforts in Colombia and throughout the hemisphere.

Purging Colombia of onchocerciasis was more of a siege than a battle. The hotspot for the disease was in the isolated riverside community of Naicioná, in the department of Cauca, in western Colombia.

There, health workers administered the anti-parasitic drug Mectizan — donated by pharmaceutical giant Merck — every six months for 12 consecutive years. In 2007, it was determined that onchocerciasis had quit spreading through the community of 1,366. The drug regime was stopped and the community was closely monitored for an additional three years. Last year, an international mission visited the site to verify that river blindness was no longer present, and on Monday the World Health Organization made the official announcement along with Colombian President Juan Manuel Santos.

Sol Beatriz Sanchez worked in Naicioná on the eradication program for almost nine years. Now with Colombia’s Ministry of Health, Sanchez said she was relieved her work was paying off.

“It’s thrilling to be a part of that process,” she said. “It was years of work and with lots of risks. [Naicioná] is very isolated and, like other parts of Colombia, it’s affected by the armed conflict and insecurity.”

Colombia’s achievement could be the beginning of the end for onchocerciasis in the Americas. Mexico and Guatemala — once the region’s most infected areas — have interrupted the disease and suspended the Mectizan treatment. Ecuador has also ended the drug regime and has completed the three-year monitoring process. It has asked for a visit from the WHO verification team.

But the disease remains active in isolated spots along the Venezuelan-Brazilian border, particularly among the Yanomami indigenous group.

More than 99 percent of those suffering from the disease are in 31 nations in Africa.

While the scale of the problem is much greater in Africa, Colombia is still a model for how to confront the disease, said Donald Hopkins, vice president of health programs at The Carter Center.

“This is a success that will reverberate in several directions,” he said. Not only will it encourage other Latin American nations that are already following the treatment protocol, but give African efforts the “momentum” to keep pursuing solutions. “This has to be encouraging for other nations -- to see that the process works,” he said.

Onchocerciasis is transmitted through the bites of infected black flies, which carry larval forms of the parasite. As the parasites grow beneath the skin they can cause rashes, lesions, intense itching and, in some cases, blindness. the illness is considered one of 17 “neglected” tropical diseases.

This week, Sanchez began meeting with colleagues to design a strategy to fight another disease on that list: trachoma, a micro-organism responsible for three percent of all cases of blindness.

“That,” she said, “is our next challenge.”

Read more Colombia stories from the Miami Herald

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