Opening Address by Dr Matshidiso Moeti, WHO Regional Director for Africa, at the Mectizan Donation Program and ESPEN joint side event RC 67

Submitted by teklemariamm@who.int on Wed, 20/09/2017 - 09:39

Honorable ministers;
Distinguished guests ;
Ladies and gentlemen

Welcome to the Mectizan Donation Program and ESPEN joint side event, to celebrate 30 years of Mectizan for river blindness, and the success and future of NTD control and elimination in Africa.

Africa is unfortunately home to an estimated 47% of the global burden of all neglected tropical diseases, also called NTDs. The Region carries the highest global burden of disease for Buruli ulcer, human African trypanosomiasis, and onchocerciasis, known as river blindness. 

NTDs afflict the poorest communities in Africa. They cause disability, disfigurement, stigma, poverty and have detrimental effects on school attendance, child development, agriculture and economic productivity. 

Some NTDs in Africa are controlled or eliminated using either preventive chemotherapy. The availability of quality medicines is the cornerstone of the strategy. 

Thanks to the generosity of the pharmaceutical industry - which donates drugs for NTDs - and the commitment of the African governments and their partners, we have the effective means to fight Lymphatic Filariasis (or LF), onchocerciasis, schistosomiasis, soil transmitted helminthiasis and trachoma. 

We must reinforce our work together to ensure we also have the human and financial resources to distribute the donated medicines to those who desperately need them in our countries.

In 1987, when MSD’s CEO made the unprecedented decision to donate Mectizan “as much as needed, for as long as needed” for the treatment of onchocerciasis, distribution began in OCP countries to treat those already infected, and consolidated the achievements made though the vector control. 

In 1995, the highly successful African Program for Onchocerciasis Control (APOC) was established using ivermectin distribution as the major control strategy. 

Mectizan is a safe and effective treatment, and can be considered as a game changer for the control of onchocerciasis in Africa. The scientists who developed the drug received the Nobel Prize for Medicine in 2015.

When the APOC programme closed according to plan in 2015, the donation of Mectizan together with the innovative CDTI strategy were protecting over 110 million people annually in 19 countries, preventing over 40,000 cases of blindness each year between 1995 -2015. 

Building on these successful achievements, the CDTI strategy was adapted and is broadly used today to distribute other medicines for NTDs and other health interventions. 

The donation of Mectizan opened the door to a massive pharmaco-philanthropy effort, with Africa as the major beneficiary: 

  • 99% of the 7+ billion tablets that have been shipped for the treatment of onchocerciasis and LF go to Africa. 
  • In 1998, MSD expanded the donation of Mectizan to include eliminate LF in African countries where onchocerciasis is co-endemic. 
  • GSK also launched its LF elimination effort in 1998 through its global donation of albendazole - a gesture that further encouraged other companies to contribute. Mectizan is co-administered with albendazole to eliminate LF in African countries endemic for both LF and onchocerciasis.  
  • In 2017, Togo became the first country in Africa to achieve elimination of transmission of LF through sustained distribution of these two medicines.
  • Togo’s success highlights what can be accomplished in the Region if we remain focused, resources are mobilized on time and used efficiently, and, most importantly, if we work together in a coordinated, constructive manner.  
  • GSK later expanded the donation of albendazole for LF to control soil transmitted helminthiasis, working with Johnson & Johnson, which donates mebendazole for STH. 

Additional companies donating valuable medicines for NTDs include Pfizer, which donates Azithromycin for trachoma elimination; EISAI which donates DEC for LF; Merck Serono donates praziquantel for schistosomiasis.

For over 40 years, WHO AFRO has worked to control onchocerciasis, the second major infectious cause of blindness. 

Today - 30 years after the donation of Mectizan by MSD, and after 20 years of the success of the African Program for Onchocerciasis Control (APOC) - the reduction of endemicity has allowed us to shift the goal from control to elimination, a really ambitious achievement. 

The commitment made by Ken Frazier here today turns the idea of control to elimination into reality. I would like to thank Merck for this extremely generous donation and assure them that we are committed to ensuring the fight against river blindness is won.

WHO AFRO is committed, now more than ever, to the elimination of river blindness and other NTD, so in May 2016 we launched the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), to accelerate elimination from Africa of the 5 NTDs targeted by preventive chemotherapy. 

ESPEN is working with Member States to improve access to timely, high quality, short- and long-term achievement the PC-NTD WHO 2020 targets for control and elimination. 

Three main pillars support ESPEN’s work:

  • Country ownership with strong emphasis on long term sustainability and strengthening of health systems;
  • A data driven approach for evidence based action, and a policy of sharing data openly with all our stakeholders to join forces and accelerate progress  towards elimination;
  • An accountable, trustworthy partnership with Health Ministries and their partners where we hold each other accountable for what we agree to do and achieve together.

Today and tomorrow, the remaining challenge for the ESPEN project and Member States is to achieve transmission interruption and complete elimination of NTDs - this has been already demonstrated for river blindness in some areas of Uganda, Senegal and Mali, and is suspected to be eliminated in some areas in Burundi, Malawi, and Nigeria. 

We are grateful to MSD for its renewed commitment to continue the donation of Mectizan until Onchocerciasis and LF are eliminated in every endemic community.

We also thank the Member States for their leadership to ensure effective distribution of the donated tablets from the national down to the community level. NGOs, funding partners and academia are also essential partners in this effort. 

Sustainable development in African nations cannot be achieved unless there is a strong, sustained investment to ensure the distribution of the donated medicines. 

I urge you, honourable ministers, to reinforce the allocation of the human and financial resources necessary to achieve control and elimination of NTDs in Africa.

Finally, please join me in celebrating the 30 years of this remarkable donation of Mectizan that is having an unprecedented impact on disease elimination in Africa.

Let’s continue working together, with a renewed energy, to make these diseases distant memories, to make Africa stronger, healthier and more prosperous. 

Thank you for your attention.