The
Onchocerciasis Control Program (OCP), one of the most successful vertical disease control programs in the history of public health, came to an end in 2003 with devolvement of responsibilities for control program activities passed to the countries affected. Fortunately, 15 years ago the
Mectizan Distribution Program (MDP) was founded to provide a complementary approach to controlling the disabling consequences of this
parasitic infection. With over 250 million doses of
ivermectin distributed over the past 15 years, the MDP is well on its way to both solidifying the progress made by the OCP and extending program reach well beyond the boundaries of the OCP. Through the extensive clinical testing protocols implemented in a variety of countries in Aftica,
ivermectin has been proven to be a safe and highly effective treatment for
onchocerciasis. Regular distribution to populations living in endemic areas has demonstrated significant reductions in blinding ocular complications, transmission, and disability caused by onchocercal
skin disease. As yet undocumented, are the likely significant impact regular population dosing with
ivermectin has on intestinal helminth
infections,
lymphatic filariasis, and human
scabies infection. While there are significant barriers to continued program success, focussed attention on expanding and improving community-directed
ivermectin distribution is likely to lead to further progress against this resilient
infection.