There is no vaccine or medication to prevent infection with O. volvulus.
Between 1974 and 2002, disease caused by onchocerciasis was brought under control in West Africa through the work of the Onchocerciasis Control Programme (OCP), using mainly the spraying of insecticides against blackfly larvae (vector control) by helicopters and airplanes. This has been supplemented by large-scale distribution of ivermectin since 1989.
The OCP relieved 40 million people from infection, prevented blindness in 600 000 people, and ensured that 18 million children were born free from the threat of the disease and blindness. In addition, 25 million hectares of abandoned arable land were reclaimed for settlement and agricultural production, capable of feeding 17 million people annually.
The African Programme for Onchocerciasis Control (APOC) was launched in 1995 with the objective of controlling onchocerciasis in the remaining endemic countries in Africa and closed at the end of 2015 after beginning the transition to onchocerciasis elimination. Its main strategy has been the establishment of sustainable community-directed treatment with ivermectin (CDTI) and vector control with environmentally-safe methods where appropriate.
In 2015, more than 114 million people were treated in in Africa where the strategy of CDTI was being implemented, representing approximately 60% coverage of the number of people who require treatment globally.
After the closure of APOC, a new programme was launched in the African Region. The Expanded Special Project for the Elimination of Neglected Tropical Diseases in Africa (ESPEN) was officially launched at the World Health Assembly in May 2016. Among its many roles, it will initially focus on several priority countries to support their neglected tropical diseases (NTDs) programmes, including their onchocerciasis programmes, and will create a pool of experts that can provide technical assistance to all member countries. ESPEN, like OCP and APOC, is housed in the WHO Regional Office for Africa.
The Onchocerciasis Elimination Program of the Americas (OEPA) began in 1992 with the objective of eliminating ocular morbidity and interruption of transmission throughout the Americas by 2015 through biannual large-scale treatment with ivermectin. All 13 foci in this region achieved coverage of more than 85% in 2006, and transmission was interrupted in 10 of the 13 foci by the end of 2011. At the end of 2016, 1 of the 3 remaining foci was undergoing post-treatment surveillance after having stopped ivermectin treatment and 2 foci remained under treatment. Elimination efforts are now focused on the Yanomami people living in Brazil and Venezuela (Bolivarian Republic of).
Following successful large-scale treatment of populations in affected areas with the support of international partners, Colombia and Ecuador were able to stop transmission of the disease in 2007 and 2009 respectively. Mexico and Guatemala were also able to stop transmission in 2011. Elimination efforts are now focused on the Yanomami people living in Brazil and Venezuela (Bolivarian Republic of).
On 5 April 2013, the Director-General of WHO issued an official letter confirming that Colombia has achieved elimination of onchocerciasis. Colombia was the first country in the world to be verified and declared free of onchocerciasis by WHO. This has been followed by Ecuador in September 2014, Mexico in July 2015, and Guatemala in July 2016.
