Progress in eliminating onchocerciasis in the WHO region of the Americas: disruption of ivermectin mass drug administration in the Yanomami focus area due to the COVID-19 pandemic

ABSTRACT

This article describes how the COVID-19 pandemic significantly reduced provision of treatment in the Yanomami focus area (YFA) in 2020, especially in the Bolivarian Republic of Venezuela. The distribution of ivermectin for mass treatment (MDA) to prevent onchocerciasis was affected worldwide by the COVID-19 pandemic in 2020, as were MDA programs for other neglected tropical diseases (NTDs). On 1 April 2020, WHO recommended that mass treatment campaigns, active case-finding, and population-based surveys for NTDs be postponed until further notice to reduce the risk of COVID-19 transmission associated with large-scale community health interventions. The Carter Center, which provides major funding to MDA in the Bolivarian Republic of Venezuela, temporarily halted its activities in 2020 due to an administrative problem and, once the COVID-19 pandemic had taken hold, in order to adhere to WHO recommendations, its own policies, and the policies of other donor organizations. Ivermectin treatment continued to be offered in Brazil, supported by the government, with essential health services such as vaccination and malaria control. On 27 July 2021, WHO released new interim guidance for NTD programs. This included a risk-benefit analysis to figure out if activities could be resumed safely and detailed standards for reducing risk with all known precautions (such as wearing masks, socialdistance, hand sanitizing and/or handwashing, limiting live meetings and group size). The program in the Bolivarian Republic of Venezuela followed these instructions and made a plan to get back to work safely, which was what WHO wanted.