Public–private partnerships in blindness prevention: reaching beyond the eye

Abstract

The control of river blindness (onchocerciasis) has been one of the major public health achievements of recent decades. Initially, vector control was used to stop transmission of the parasite Onchocerca volvulus by blackflies (Simulium) but the introduction of ivermectin (Mectizan) as a means of morbidity control enabled new strategies of distribution to be developed based on community directed treatment. The donation of Mectizan by Merck & Co. Inc. for onchocerciasis control in 1987 'as long as needed' was a public health landmark to be followed by a donation from GlaxoSmithKline of albendazole in 1997 for lymphatic filariasis to which Merck also responded by agreeing to extend their donation to include the coadministration of Mectizan and albendazole. Both the drugs, however, have wider impacts than those specific to filarial parasites and are effective against a range of intestinal parasites, whilst ivermectin has an important effect on ectoparasites. The wider benefits of the annual public health intervention-collateral benefitsFtherefore include deworming, improved nutritional status, increased growth, improved school performance and attendance, and improved haemoglobin status as a result of the impact of albendazole on hookworm, a major cause of anaemia. More recently, studies suggest that worm-free children have a significantly reduced frequency of malaria specific episodes of fever and Ascaris-infected children have a two-fold higher frequency of cerebral or severe malaria than those without Ascaris. These findings suggest that programmes based on annual interventions to control river blindness and lymphatic filariasis can contribute disproportionately more to a range of public health problems than has been hitherto recognized, thereby assisting in attaining the millennium development goal targets.

Incorporating a Rapid-Impact Package for Neglected Tropical Diseases with Programs for HIV/AIDS, Tuberculosis, and Malaria

“…Therefore, the combination of ivermectin and albendazole for the elimination of LF in Africa and ivermectin for onchocerciasis control—the cornerstones of the Global Programme to Eliminate Lymphatic Filariasis ( http://www.filariasis.org) and the African Programme for Onchocerciasis Control ( http://www.apoc.bf/en), respectively—add considerable benefits to the treatment of ascariasis and trichuriasis [ 45]. At the same time, combinations of ivermectin and azithromycin prevent blindness by reducing the incidence of onchocerciasis and trachoma, respectively [ 46]. Through its impact on ectoparasite infections, ivermectin also indirectly helps to reduce the frequency and severity of skin infections [ 45, 47].…”

Expanding malaria diagnosis and treatment in Lao PDR: lessons learned from a public–private mix initiative

“…Public–private mix strategies have been used previously in public health interventions for tuberculosis [ 1 , 2 ], neglected tropical diseases [ 3 ], as well as prevention of blindness [ 4 ], with some degree of success. There are limited instances demonstrating strong collaboration with the private sector for malaria diagnosis and treatment in published literature other than collaboration with the pharmaceutical industry for the provision of anti-malarial drugs [ 5 ].…”

Neglected Tropical Diseases and the Millennium Development Goals-why the "other diseases" matter: reality versus rhetoric

“…Indeed NTD control provides the very platform on which they can be built [69]. This paper rejects and refutes the sentiments expressed by Allen and Parker and Cavalli et al [11] and provides detailed responses to their assertions and claims by referencing peer reviewed publications on NTDs not referenced by them and providing references to data from many countries where NTD control is a part of country health programmes.…”