The Programme was set up in 1995 to expand and build on the successes of the Onchocerciasis Control Programme in West Africa (OCP). The goal of the African Programme for Onchocerciasis Control (APOC) is to eliminate onchocerciasis as a disease of public health importance in Africa.
At the heart of APOC’s strategy to eliminate onchocerciasis is community-directed treatment with ivermectin (CDTI). This approach relies on active community participation to distribute ivermectin treatment. Communities plan their own distribution systems and make decisions about how and when the ivermectin is distributed. They decide which members of the community will be trained to deliver the treatment, and they also monitor the CDTI process.
At the end of 2014, more than 112.4 million (65.3%) people living in 22 African APOC country members received ivermectin treatment, of the 172 291 582 at-risk population to onchocerciasis in poor rural communities.
APOC’s achievements - (at December 2014)
- 112.4 million people receiving regular treatment in APOC countries
- >186 000 endemic communities had implemented treatment activities in 22 countries
- The partnership included 186 000 endemic communities (including those from the former OCP countries that reported treatment data), 31 endemic African countries, 20 donor countries and institutions, 14 international NGDOs and several local NGOs
- Health interventions co-implemented with CDTI: 34.9 million people were reached with additional health interventions using the APOC network of with partnerships of trained health workers and CDDs in 2014
- Training of community-directed distributors: 22 countries reported that a total of 640,737 community-directed distributors (CDDs) were trained and/or retrained
- Training of health workers : 107,275 health workers at regional, district and health facility levels were trained or retrained in 2014 in 24 countries in Africa
- 22 countries reported that distribution of ivermectin was carried out by 699 656 community-directed distributors (CDDs)
- In 2014, 571,409,500 ivermectin tablets were shipped by MDP to 24 countries. 51% of the medicines supplied were for Lymphatic filariasis, 27% for Onchocerciasis and LF, and the remaining 22% was for Onchocerciasis alone.
- More than 1 036 million treatments provided by communities: 1997-2014 (cumulative)
- 108 projects running in 16 countries; Intervention in 11 former OCP countries.
- Treatment cost of annual ComDT with ivermectin: US$0.57 per person
- Agreement reached to pre test CDI strategy in curricula of 52 faculties of medicine and nursing schools in Africa
- Results of the updated health impact assessment carried out in 2012 (DGF progress report):
- a reduction of the prevalence of Onchocerciasis infection by 61% (the number of persons infected of 39.9 million drop to 15.7 million
- a reducción of the prevalece of severe itching by 66%
- a reduction of the prevalence of oncho blindness by 50% (Note blindness is not cured, but treatment prevent/reduce ocular lesions leading to blindness, so no new cases are recorded)
- Number of disease cases prevented related to APOC operations as at 2011:
- Infection: 24.2 million; severe itching: 9.8 million; low vision: 500,000; blindness: 300,000.
- Number of DALYs saved : 1,300,000 in 2011
- Cumulative total of DALYs saved up to 2011: 9.8 million
- 27 out of 35 endemic countries for LF in the African region (including Sudan) are also endemic for Onchocerciasis.
- 18 out of 35 LF endemic countries reported MDA treatment.
- In the African region 127,603,682 persons were treated of which 120,004,235 (94%) were treated in APOC countries by LF programmes. (Source: WER No. 38, 2014, 89, 409-420)