The goal of the African Programme for Onchocerciasis Control (APOC) is to eliminate onchocerciasis as a disease of public health importance in Africa. The Programme was set up in 1995 to expand and build on the successes of the Onchocerciasis Control Programme in West Africa (OCP).
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 2011, over 80.2 million people living in 16 African countries were receiving regular ivermectin treatment through this pioneering approach. 17,5 million people received ivermectin treatment in former OCP countries.
APOC’s achievements - (at December 2011)
- 16.2 million persons infected, corresponding to a drop of the number of cases from 41.8 million (1995) to 25.7 million (2008)
- 80.2 million people receiving regular treatment in APOC countries
- 178 821 (97.4%) endemic communities had implemented treatment activities in 24 countries
- 20 countries reported that distribution of ivermectin was carried out by 681 720 community-directed distributors (CDDs) out of which 25% were newly selected and trained during the reporting period.
- 645 696 CDDs and 61 803 health workers at regional, district and front-line health facility levels were trained or retrained in 2011 in 23 countries in Africa.
- 108 projects running in 15 countries
- 1 Million disability adjusted life years (DALYs) per year averted
- Treatment cost of annual ComDT with ivermectin: US$0.58 per person
- 17% economic rate of return
- The average cost of CDTI is S$ 7 per DALY averted
- Health interventions co-implemented with CDTI: In 2011, 62.4 million treatments and commodities were delivered for other health interventions using the network of community volunteers built by APOC within the remote communities
- Protecting 120 million at-risk individuals in poor rural communities
- The itching prevalence was reduced by 68% between 1995 and 2008 with 8.9 million cases prevented since commencement of operations
- By 2011, sight of 800,000 people will have been saved
- Estimated 7.5 million years of labour added (600,000 person-years annually)
- Agreement reached to pre test CDI strategy in curricula of 52 faculties of medicine and nursing schools in Africa
- 1.8 billion ivermectin tablets delivered by communities (cumulative)
- More than 522 million treatments provided by communities: 1997-2010 (cumulative)