EDITORIAL WHITHER ONCHOCERCIASIS CONTROL IN AFRICA

infection are African. The discovery by Merck & Company (Rahway, NJ) of ivermectin as an effective oral treatment of the disease, and their unprecedented donation of hundreds of millions of doses of Mectizan since 1987 have revolutionized the assault on this scourge. This article discusses options for securing what has been gained so far. In west Africa, the highly successful 30 year-old Onchocerciasis Control Program (OCP), which was first based on aerial spraying in savannah areas of 11 disease-endemic countries and later added mass drug administration (MDA) in savannah and forest areas, ended in December 2002. Launched in 1974, the OCP has broken transmission in most of its target area and prevented more than 200,000 cases of blindness at a cost of approximately U.S. $556 million. 3 The African Program for Onchocerciasis Control (APOC) was launched in 1995 to help develop sustainable annual MDA with Mectizan, and health education in the remaining 19 affected countries in Africa and Yemen, using a “community-directed treatment with ivermectin” (CDTI) approach. 4 The APOC