The Global Onchocerciasis Network for Elimination (GONE): working together to see onchocerciasis GONE

More than 150 onchocerciasis partners, including national onchocerciasis coordinators from health ministries in endemic countries, national onchocerciasis elimination committee chairs, experts, researchers, nongovernmental organizations, the donor community and civil society gathered on 1 and 2 November 2023 in Mbour, Senegal, for the first meeting of the new Global Onchocerciasis Elimination Network (GONE) to strengthen collaboration among countries and partners.

Onchocerciasis (also known as river blindness) is the second leading infectious cause of blindness after trachoma. It is classified as a neglected tropical disease (NTD). It can cause intense itching, rashes, skin discoloration, visual impairment and eye disease leading to permanent blindness. The parasite is spread by the bites of infected black flies that breed in rapidly flowing rivers. Globally, at least 244 million people in 31 countries suffer from this debilitating and painful disease. Africa is home to 99% of the people at risk of onchocerciasis; the remaining 1% live on the border between Brazil and Venezuela (Bolivarian Republic of). Four countries have been verified by the World Health Organization (WHO) for eliminating transmission of the disease: Colombia, Ecuador, Guatemala and Mexico.

A global community of partners has been working for decades to address the suffering caused by river blindness. Before control and elimination efforts began, communities deserted fertile farmland near the rivers where the black flies breed, which had devastating socioeconomic impacts. The control efforts led to remarkable progress towards the elimination of onchocerciasis as a public health problem. Manifestations of the disease are increasingly rare, and transmission is being eliminated nationally and subnationally. This success led to a shift in approach by WHO from control of the disease to elimination of transmission. In 2023, Niger became the first country in Africa to submit a dossier to WHO to verify elimination of transmission.

Senegal, the host country of the inaugural GONE meeting, is also leading the onchocerciasis elimination effort in Africa by achieving remarkable milestones. Following the required evaluations, treatment stopped in 2022 and the 3-year post-treatment surveillance phase was initiated. Senegal is now the second country in Africa to submit a verification dossier to WHO. “This achievement is a result of the hard work and dedication of our government, the health workers and network of community volunteers, and the commitment of our local and international partners,” stated Hon. Dr Marie Khemesse NGOM NDIAYE, Minister of Health and Social Action of Senegal.

Progress toward control and elimination was facilitated by strong partnerships maintained through regional initiatives such as the Onchocerciasis Elimination Program for the Americas (OEPA), the Onchocerciasis Control Programme (OCP) in West Africa, the African Programme for Onchocerciasis Control (APOC) and, more recently, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN). These initiatives all aim to sustain distribution of ivermectin with high coverage, leaving no one behind. This progress would not have been possible without the donation of Mectizan® (ivermectin) by MSD; the company committed to provide the medicine as much as needed, for as long as needed until elimination of onchocerciasis is achieved. “The Mectizan Donation Program was established in 1987 by the pharmaceutical company MSD to facilitate access to its drug Mectizan® (ivermectin) for the elimination of river blindness. The Program reaches more than 400 million people annually and over 12 billion Mectizan® 3 mg tablets have been shipped to endemic countries by MSD since the inception of the program,” said Dr Yao Sodahlon, Director, Mectizan Donation Program.

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