Her Royal Highness Princess Alexandra,
• Excellencies,
• Distinguished Ladies and Gentlemen
I would like to begin by thanking the President of the World Bank Dr Jim Yong Kim for the invitation to speak at this historic gathering that celebrates our joint achievement in eliminating Onchocerciasis, as a major public health problem.
From the very beginning Onchocerciasis was identified as a socio-economic problem. Fertile lands for agricultural production along rivers were being abandoned while people in affected countries were living in poverty in the arid lands.
Onchocerciasis was a significant public health problem, which caused blindness, severe itching, wrinkling and depigmentation of the skin.
In the words of one of the traditional leaders in Chad, Chief Ekollosu and I quote “In Africa when you are infected with Onchocerciasis you are dead, when you are blind it is like a second death”, unquote.
Ladies and Gentlemen
This disease particularly affected the communities of the savanna region of West Africa and Governments of these countries requested as early as 1960 that concerted action be put in place to fight onchocerciasis.
As you all know UNDP, FAO, the World Bank and WHO co-sponsored the preparatory mission to seven countries in West Africa (Benin, Burkina Faso, Côte de lvoire, Ghana, Mali, Niger and Togo) and the report of the mission provided the platform for the creation of the Onchocerciasis Control Programme in the Volta River Basin (OCP) in 1973. The OCP was later expanded to include four additional countries, Guinea (Conakry), Sierra Leone, Guinea Bissau and Senegal with a name change to The Onchocerciasis Control Programme in West Africa.
Ladies and Gentlemen :
At the beginning, in the absence of an effective medicine to treat onchocerciasis, the solution was the aerial spray of insecticides along the fast flowing rivers to reduce the population of the black flies, responsible for the transmission of the disease.
The discovery of ivermectin and its donation in 1987 by Merck & Co. Inc., for as long as needed, introduced a powerful tool in the management of the Onchocerciasis control programme. It brought about the community-directed treatment strategy, which rapidly scaled up treatment in the affected countries.
The scourge of Onchocerciasis and the success of the OCP led to the launching of the African Programme for Onchocerciasis Control (APOC) in 1995 initially to control the disease, but currently overseeing the elimination of the disease in the whole of Africa.
This Private Public Partnership played a crucial role in the success that we today are celebrating. This lasting partnership motivated other pharmaceutical companies to join other pro-poor health initiatives.
We must emphasize that the long-term and sustained support of donors and partners to OCP and APOC resulted in millions of children and rural populations being freed from blindness, skin disease and unrelenting itching due to Onchocerciasis. An additional 250 000 km2 has been made available for cultivation and habitation in West Africa, contributing on this way, to poverty alleviation.
At the closure of OCP in 2002, Onchocerciasis had been eliminated as a public health problem in the 10 out of the 11 countries covered by the Programme. 600 000 cases of blindness had been prevented. 18 million children born in the controlled areas had been spared from the risk of river blindness. In short, normal life and socio-economic development had restarted in these areas.
Ladies and Gentlemen:
Recognizing the need to scale up interventions to reduce the global burden of Neglected Tropical Diseases, the Ministers of Health of the African Region in 2013, adopted the Regional Strategy on NTDs for the period 2014 – 2020.
The strategy drew most of its approaches from the experience and achievements of the OCP and APOC programs. For instance, the role of private public partnerships, country leadership and community directed interventions.
Furthermore, the African health Ministers agreed to expand the mandate of APOC to cover Lymphatic filariasis and contribute to control other NTDs during the period 2016-2020. Towards the same aim, in December 2013, the APOC governing body approved the creation of a new programmatic entity: “The Programme for the Elimination of Neglected Diseases in Africa – PENDA” that is expected to have a broader mandate.
The success of PENDA programme will depend on renewed long-term commitment and concrete support of the international community to national and global NTD efforts.
In my opinion, the new vision is relevant, but a complex undertaking, which calls for an “investment case” and a “pledging conference” to build a solid support mechanism. Governments of recipient countries and a broader partnership should commit to bridge the gap between promises and effective delivery. Together with the private sector, and representatives of the civil society and communities, we should be able to move from Declarations to concrete actions.
The London Declaration, The World Health Organization’s global roadmap on NTDs, and the Regional African strategic plan for NTDs provide enough ground to facilitate the development and implementation of multi-year national NTD plans.
The world has the means to alleviate poverty through the reduction of NTDs burden that affects mostly the poor people living in the tropics and subtropical areas. For the African region case, we need 2.5 billion USD to achieve the NTDs targets for 2020; translated into about 300 million USD a year. It is socially fair, technically feasible, financially affordable and politically commendable.
Ladies and Gentlemen
As we celebrate the success of the River Blindness programme, I want to express my appreciation to the main APOC partners such as the WB, USA, ADB, MERK, and other bilateral partners. The efforts and hard work of public health experts, managers, scientists, business community, civil society, health professionals, family and community members including children, for their active participation to the achievement we are today celebrating.
I would be failing in my duties if I don’t mention the names of two outstanding contributors. First, Dr Robert McNamara, the past president of the World Bank who in 1972 was instrumental in bring together UNDP, FAO, the World Bank and WHO to forge the alliance that led to the creation of the Onchocerciasis control Programme.
Secondly, Dr Ebrahim Malick Samba, WHO Regional Director Emeritus, who for more than a decade directed and coordinated the work of the Onchocerciasis in Africa and whose commitment to the cause of public health in Africa remains a shining example.
Happy anniversary!