The African Program for Onchocerciasis Control

The proven success of OCP at many levels and the advent of Mectizan® led a number of Non Governmental Development Organizations (NGDO's or NGOs) to develop Mectizan® distribution programs in a number of onchocerciasis endemic countries outside of the OCP. In 1992 six NGDO's (including HKI) esthablished the NGDO Coordination Group for Ivermectin Distribution (renamed in 2002 as the NGDO Group for Onchocerciasis Control). As of 1994, 95% of the Mectizan® distribution outside the OCP area was through NGO supported programs. The success of these activities led the NGDO Coordination Group to advocate strongly for the development of a continent-wide program to eliminate onchocerciasis as a public health problem - The African Onchocerciasis Control Program (APOC). APOC is a unique partnership of NGOs, participating governments, the private sector, bilateral agencies and multi lateral agencies. WHO is the executing agency and the fiscal agency is the World Bank, which has set-up a separate trust fund to finance activities. All parties are represented in the governing body of APOC, the Joint Action Forum (JAF). The objective of APOC's is to establish, within a period of 15 years, effective and self-sustainable, community directed Mectizan® treatment programs throughout the endemic areas in the geographic scope of the program and, if possible to eliminate the disease by using environmentally safe methods of vector control in selected foci.

Because Mectizan® needs to be distributed over a long period of time, only a community directed approach can be sustained for long enough to have an impact on the disease. APOC covers 19 countries . It is estimated that 17.5 million people are infected in Africa, of whom 85% are in the APOC countries and 15% are in the OCP countries (the current low percentage in the OCP countries is due to the successful control in these countries). Given the shared borders between many of the APOC and OCP countries, another important aspect of APOC's mandate is to preserve the success of OCP.