Question

Create a Case Study "Controlling onchocerciasis in sub-Saharan Africa" with the information below

Health Condition: Onchocerciasis, or riverblindness, afflicts approximately 42 million people worldwide, with well over 99 percent of its victims in sub-Saharan Africa. An estimated 600,000 people are blind and an additional 1.5 million Africans are visually impaired due to onchocerciasis. In 11 West African countries in 1974, nearly 2 million of the area’s 20 million inhabitants were infected with onchocerciasis, and approximately 200,000 were blind.

Intervention or Program: The Onchocerciasis Control Program (OCP) was launched in 1974 in 11 West African countries. Weekly aerial spraying, with environmentally safe insecticides helped control the disease-vector, – blackflies that bred in fast-moving waterways, thereby halting transmission of the disease. In 1995, a second program, the African Programme for Onchocerciasis Control (APOC), was established to control the disease in 19 Central, East and Southern African countries. Through a broad international partnership and the participation of 115,000 remote, rural local communities, APOC and OCP distributed a drug donated by Merck & Co., Inc., Mectizan, to more than 45 million people in Sub-Saharan Africa in 2005. The drug prevents and alleviates the symptoms of the disease with one annual dose.

Impact: OCP produced an impressive change in health between 1974 and 2002:

Transmission of the disease-causing parasite was halted in 11 West African countries;

600,000 cases of blindness were prevented;

22 million children born in the OCP area are now free from the risk of contracting riverblindness;

About 25 million hectares of arable land—enough to feed an additional 17 million people per annum—is now safe for resettlement;

APOC is expanding this success to Central, East, and Southern Africa, where 54,000 cases of blindness are expected to be prevented each year.

Cost and Cost-Effectiveness: OCP operated with an annual cost of less than $1 per protected person. Commitments from 27 donors during the 28-year project totaled $600 million. The annual return on investment was calculated to be about 20 percent, primarily attributable to increased agricultural output; about $3.7 billion will be generated from improved labor and agricultural productivity. The annual cost of APOC operations, taking into account the donation of all needed drugs, is approximately $0.58 per person treated.

Answer 1

Introduction:
    Onchocerciasis is also known as river blindness,it is a parasitic disease caused by the filarial worm onchocerca volvulus..Transmitted by repeated bites of infected blackflies..The infection lives and breeds near fast-flowing streams and livers and can results in blindness,visual impairment,skin disease,nodules under the skin and itching..
Sub-saharan Africa with onchocerciasis:
    Total 26 million people living near the rivers and fast moving streams of sub-saharan africa..more than 500,000 documented cases of severe visual impairment and 2,70,000 reported cases of permanent blindness.
Intervention or programs:
    The socio economic factors impact this disease to become more severe..onchocerciasis control Programme(OCP) in 1975 helps to control this disease to making them economically stable to African river communities..In 1995,the African Programme for Onchocerciasis Control(APOC) was created to eliminating the disease completely as a major public health concern..in 2016 The expanded special project for Elimination of neglected Tropical disease(ESPEN) was launched..
Efforts of control:
    Treated with ivermectin spray to black fly breading sites..The APOC created in 1995,it reduced the incidence river blindness by 73%..it provided community-directed treatment with Ivermectin(CDTI).. around 1,27,000 communities participated in the CDTI program 500,000 community drug distributors have been trained,46.8 miilion people receiving the treatment..In 1991 non -governemntal development organizations(NGDOs) with state,national,direct governments to organize mass and community-based distribution of ivermectin in endemic areas..WHO,UNICEF,UNCP worked wth African scientist to develop the concept of cmmunity directed treatment with ivermectin..APOC managed CDD network now helping expand coverage with ivermectin,vitamin A and mebendazole throughout the country..
Cost-effectiveness:
    OCP programe by annual cost of less than 1dollar per person..27 donars during the 28 year project total 600 million dollar,they soend 20% to increasing agricultural output,3.7 billion dollar for improved labor and agricultural productivity..APOC to operate this project per year it cost 0.58 dollar per person treated and APOC providing total price tag of 180milloin dollar..
Outcome:
    OCP produced changes in disease control among 11 west african countries,600,000 cases of blindness prevented,22 million chlidren born in the OCP now without riverblindness..25 miiion hectares and arable land enough to feed extra 17million people per year with safe and resettlement..APOC expanding this programe to prevent the disease each year..