Niger makes history as the first african nation to eradicate river blindness

The World Health Organization (WHO) has officially recognized Niger for meeting the stringent requirements to eliminate onchocerciasis. This achievement makes Niger the first country in Africa and the fifth globally to successfully stop the transmission of the Onchocerca volvulus parasite.

“Eradicating a disease is a monumental feat that demands unwavering perseverance,” stated Dr Tedros Adhanom Ghebreyesus, the Director-General of the WHO. “I applaud Niger for its dedication to protecting its citizens from this debilitating condition, which often leads to blindness and social exclusion among the most vulnerable. This victory is a testament to the incredible strides being made against neglected tropical diseases. By proving that elimination is attainable, Niger offers a beacon of hope for other nations still battling onchocerciasis.”

Commonly referred to as river blindness, onchocerciasis is a parasitic infection and stands as the world’s second leading infectious cause of blindness, following trachoma. It is spread through the bites of infected black flies, which typically breed near fast-flowing rivers. While small endemic pockets exist in Latin America and Yemen, the disease primarily impacts rural populations across sub-Saharan Africa.

Strategic initiatives and powerful country-led partnerships

Niger’s journey toward this milestone began decades ago. Between 1976 and 1989, under the WHO Onchocerciasis Control Programme (OCP) in West Africa, the nation implemented vector control measures, using insecticides to significantly lower transmission rates. Following donations of ivermectin from Merck, Sharpe & Dohme (MSD), mass drug administration (MDA) campaigns using ivermectin and albendazole were conducted from 2008 to 2019 in regions affected by lymphatic filariasis. Because ivermectin treats both conditions, these efforts simultaneously interrupted the transmission of the Onchocerca volvulus parasite.

Preliminary assessments regarding the cessation of transmission started in 2014. Comprehensive epidemiological and entomological surveys later confirmed that the combination of vector control and medicinal interventions had successfully wiped out transmission. This was reflected in a dramatic drop in disease prevalence, which plummeted from roughly 60% to just 0.02%.

The collaboration between the government of Niger, the WHO, and various non-governmental organizations was vital to this success. This partnership facilitated the mobilization of technical expertise and essential resources. Furthermore, consistent monitoring of the disease’s prevalence allowed for agile strategy adjustments, ensuring that all interventions remained highly effective.

“For too long, river blindness has caused profound human suffering and hindered economic growth by forcing people away from fertile riverbanks essential for their livelihoods,” noted Dr Matshidiso Moeti, the WHO Regional Director for Africa. “Niger’s triumph removes this burden and establishes the country as a pioneer for the elimination of neglected tropical diseases in Africa. Having already eliminated Guinea worm disease in 2013, Niger continues to demonstrate exceptional leadership in public health.”

Advancements on the global stage

Currently, 54 nations worldwide have successfully eliminated at least one neglected tropical disease. Niger now joins a select group of four other countries previously certified by the WHO for eliminating onchocerciasis, all of which are in the Americas: Colombia (2013), Ecuador (2014), Guatemala (2016), and Mexico (2015).

Within the WHO African Region, 21 countries have now eradicated at least one neglected tropical disease. For Niger, onchocerciasis represents the second such victory, following its 2013 certification as being free from dracunculiasis (Guinea worm disease).