The onchocerciasis elimination program for the Americas: a history of partnership

The decision in 1987 by the pharmaceutical firm Merck & Co. to provide Mectizan (ivermectin) free of charge to river blindness control programs has challenged the international public health community to find effective ways to distribute the drug to rural populations most affected by onchocerciasis. In the Americas, PAHO responded to that challenge by calling for the elimination of all morbidity from onchocerciasis from the Region by the year 2007 through mass distribution of ivermectin. Since 1991, a multinational, multiagency partnership (consisting of PAHO, the endemic countries, nongovernmental development organizations, the Centers for Disease Control and Prevention in Atlanta, Georgia, as well as academic institutions and funding agencies) has developed the political, financial, and technical support needed to move toward the realization of that goal. This partnership is embodied in the Onchocerciasis Elimination Program for the Americas (OEPA), which is supported by the River Blindness Foundation (RBF) and now by the Carter Center. OEPA was conceived as a means of maintaining a regional initiative to eliminate what is otherwise a low priority disease. Since its inception in 1993, the OEPA has provided more than US$2 million in financial, managerial, and technical assistance to stimulate and/or support programs in Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela, so as to take full advantage of the Merck donation. Now halfway into a five-year, US$ 4 million grant provided through the Inter-American Development Bank, the OEPA's capacity to support the regional initiative is assured through 1999

Studies on malaria transmission in Orissa State, India 1981 through 1986. II: Observations on the Anopheles fauna.

A general presentation is made of data derived from systematic trend studies on the Anopheles fauna in 12 study villages of Orissa State, India. Adult and larval species prevalences, seasonal densities of prominent anophelines and predilections of various species to feed on human blood are discussed and demonstrated.

Studies on malaria transmission in Orissa state: Part I. Development of a methodology for systematic studies.

Standardized collections of Anopheles were conducted by three Entomology Field Investigation Units (FIU's) working in three distinctively different areas of Orissa State. The FIU's conducted identical routine weekly work schedules in each of 12 mesoendemic or hyperendemic study villages every month. In addition, monthly house-to-house fever case surveys were conducted in each study village and biannual malariometric surveys were carried out with the timing being shifted, so that eventually all seasons were included. Such complete, extensive and meticulous entomological and epidemiological data have not been obtained earlier from this area. In fact, until the present longitudinal data became available, it was necessary to rely upon information which was gathered some 40 years ago, when environmental conditions were substantially different. The ensuing article describes the methodology that was employed to establish these systematic studies.

Gel diffusion determinations on feeding behaviour patterns of anophelines in Orissa State, India.

In 1981 Entomological Field Research Units were established in three districts of Orissa State, India, from which Anopheles bloodmeals were forwarded regularly for analysis to an Entomological Laboratory in Bhubaneswar. At the onset of 1982, the laboratory introduced a modified gel diffusion technique for determining the origin of mosquito bloodmeals and by the end of 1983, 22,300 smears had been processed and analyzed. The technique is relatively very simple, fast and inexpensive. The results are reproducible and the use of double controls (negative and positive) ensure a high degree of reliability.