The World Health Organization (WHO) has officially commended Niger for successfully meeting the criteria for onchocerciasis elimination. This monumental achievement positions Niger as the fifth nation globally and the inaugural country in the African Region to be acknowledged by the WHO for halting the transmission of the Onchocerca volvulus parasite.

“Achieving disease elimination represents a profound milestone, demanding unwavering dedication,” stated Dr. Tedros Adhanom Ghebreyesus, the Director-General of the WHO. “I extend my heartfelt congratulations to Niger for its steadfast commitment to liberating its populace from this stigmatizing, blinding illness, which inflicts immense human suffering upon the most vulnerable. This triumph serves as yet another testament to the remarkable strides we are making in combating neglected tropical diseases. By demonstrating that elimination is indeed attainable, it instills hope in other nations still grappling with onchocerciasis today.”

Onchocerciasis, commonly known as river blindness, is a parasitic ailment and stands as the second leading infectious cause of blindness worldwide, trailing only trachoma. It is transmitted through the bite of an infected black fly, typically found in close proximity to rivers and streams. The disease predominantly affects rural communities across sub-Saharan Africa and Yemen, although smaller endemic pockets are also present in Latin America.

Country-led initiatives drive effective partnerships and progress

Between 1976 and 1989, under the guidance of the WHO Onchocerciasis Control Programme (OCP) in West Africa, Niger implemented vector control measures, including insecticide spraying, which significantly curtailed onchocerciasis transmission levels. Following generous donations of ivermectin from Merck, Sharpe & Dohme (MSD), a mass drug administration (MDA) campaign utilizing ivermectin and albendazole was executed from 2008 to 2019 in areas still impacted by lymphatic filariasis, which were subsequently monitored. Given ivermectin’s efficacy against both diseases, and as the areas targeted for lymphatic filariasis MDA were also onchocerciasis-endemic zones, this intervention played a crucial role in interrupting the transmission of the Onchocerca volvulus parasite.

Niger initiated preliminary assessments for onchocerciasis transmission interruption in 2014, after discontinuing MDA for lymphatic filariasis in most regions. Subsequent entomological and epidemiological surveys confirmed that the combined approach of medication and vector control had successfully eliminated onchocerciasis transmission, evidenced by a dramatic reduction in prevalence from approximately 60% to a mere 0.02%.

Beyond vector control interventions and MSD’s drug donations, the robust partnership among the Nigerien government, the WHO, and non-governmental organizations was instrumental to Niger’s success. This collaboration facilitated the mobilization of essential resources and technical support. Continuous surveillance of disease prevalence and its impact allowed for agile adjustments to strategies, ensuring the effectiveness of all interventions.       

“Onchocerciasis has long inflicted immense human suffering. It has also impeded the economic development of affected communities by forcing populations away from rivers, which are often vital for their livelihoods,” explained Dr. Matshidiso Moeti, WHO Regional Director for Africa. “Niger’s success lifts this burden from its people. It also establishes Niger as a beacon for neglected tropical disease elimination in Africa. The nation had already demonstrated its public health leadership in 2013 by eliminating Guinea worm disease. Today marks another historic leap forward.”

Global strides in disease elimination

Globally, 54 countries have successfully eliminated at least one neglected tropical disease.

Niger now joins four other nations whose onchocerciasis elimination has been certified by the WHO, all located within the Region of the Americas: Colombia (2013), Ecuador (2014), Guatemala (2016), and Mexico (2015).

Within the WHO African Region, 21 countries have eliminated at least one neglected tropical disease. Onchocerciasis represents the second neglected tropical disease eliminated in Niger; the country was certified free of dracunculiasis (Guinea worm disease) transmission in 2013.