Uganda Sees River Blindness Fading Away
Using community-based health services to relegate a parasitic disease
The rushing tributaries of the White Nile in northwest Uganda’s Moyo District make ideal breeding grounds for the black flies that transmit river blindness, as Fred Matalocu knows only too well.
At 65, Matalocu is old enough to remember how river blindness — a neglected tropical disease also known as onchocerciasis — once devastated his community. Because of the unbearable itching, disfiguring skin damage, and crippling vision loss caused by the infection, people had to stop farming near the rivers and the many other small streams in the area.
“I have suffered from river blindness by scratching my body,” he said. “Some people used rough objects [to scratch themselves] as if their fingernails were insufficient” — objects such as dried maize cobs or sharp stones.
But now, all that is changing. After the Government of Uganda spent years providing treatment with ivermectin (the drug Mectizan, donated by Merck & Co.) paired with community-based health education, Uganda — with support from USAID, RTI International, and The Carter Center — is closer than ever to relegating this parasitic disease to the history books.
To date, USAID has supported Uganda in the delivery of more than 28 million treatments for onchocerciasis. Already, these efforts have brought dramatic relief from the parasitic infection.
Since the 1960s, Uganda’s Ministry of Health has been working to combat river blindness. It first aimed to control it, and then made a bold shift in 2007 to eliminate the disease altogether.
This change in strategy required significant investment for more frequent treatment of communities at risk of contracting the disease, along with strategic methods to control the black flies that transmit the disease.
With the leadership and commitment of local and district health officials, and steadfast support from partners like USAID, the strategy is paying off. Thousands of community volunteers have been trained as drug distributors to reach threatened communities and intensify treatment to eliminate onchocerciasis.
Recently, Uganda’s Ministry of Health announced that active, ongoing transmission of river blindness appears to have ceased nationwide for the first time.
“Uganda was one of the first countries in Africa to formally declare its intention to eliminate transmission of onchocerciasis and will be the first to do so using mass drug administration,” said Senior Scientific Advisor Darin Evans with USAID’s Neglected Tropical Diseases Division.
“Their blueprint for elimination using intensified treatment, advanced monitoring and evaluation, and national ownership has become a model for success in the region and is being replicated in numerous other countries,” he said.
This is a major milestone for Uganda that has required significant effort, but the work is not over. Now efforts will continue to ensure river blindness is really gone for good.
USAID, through the Act to End NTDs | East Program implemented by RTI International and The Carter Center, will continue to provide support for this important work, helping Uganda conduct treatment campaigns and monitor progress in districts along the borders with the Democratic Republic of the Congo and the Republic of South Sudan, including Matalocu’s home district of Moyo.
Moyo District is one of the last endemic districts in the country. Dradere Joyce Alaru, a volunteer community drug distributor, is working to eliminate river blindness there. She visits 27 families in her village twice per year, measuring each person’s height to determine the proper treatment dose.
Alaru’s eyes brighten when she talks about the future of her community.
“The children will be healthy, free from river blindness and disfigurement,” she said.
Fred Matalocu is hopeful that Moyo is forever free of onchocerciasis, and he delights in the economic and social benefits that have come from eliminating this disease that has hindered his community’s progress for so long.
“The decline of the disease has changed everything,” he said. “Crops can be planted near rivers and streams again. People are healthier and more productive. Children can go to school instead of staying home to help family members that have gone blind.”
In short, he said, “Our grandchildren will have a better future.”
About the Authors
Edridah Muheki Tukahebwa is the Country Representative for Uganda at The Carter Center. Sharone Backers is Chief of Party for Uganda on USAID’s Act to End NTDs | East program, led by RTI International.
