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In: Mectizan (Ivermectin) and the Control of Onchocerciasis: Strengthening the Global Impact. A symposium sponsored by Merck and Co., Inc. marking the fifth anniversary of the donation of Mectizan for the treatment of onchocerciasis and held with the technical cooperation of the World Health Organization at the Hudson Theater in New York on September 23, 1992. Summary proceedings of the symposium. Rahway, New Jersey, Merck and Company, 1992. 57.Christoffel-Blindenmission (CBM) is an interdenominational Christian service organization for blind and disabled persons in many of the world's poorest developing countries. It supports more than 300 eye care programs in approximately 70 countries at an annual cost of US $15-16 million. Funded by many individual donors, fund raising activities are conducted in Europe, North America, and Australia. CBM operates through 8 regional offices: 3 in Asia, 3 in Africa, and 2 in Latin America. Program development and evaluation are the responsibility of regional representatives, each of whom uses the services of a medical consultant. CBM's program support is usually long term, based on a recipient's annual budget application and evaluation. Since 1988, CBM has been distributing 200,000 tablets of Mectizan each year to voluntary hospitals in 14 African countries to treat patients with onchocerciasis. CBM also supports community-based treatment programs in Ecuador and Zaire, and, in collaboration with OCP, in Sierra Leone. Plans for 1993 include establishing a program for 600,000 people in the Central African Republic (CAR) in collaboration with the CAR Ministry of Health and the River Blindness Foundation. As an organization, CBM identifies 5 specific barriers to be overcome in developing and sustaining programs of treatment with Mectizan: 1) Poor communication systems in the endemic areas, which require development of an appropriate infrastructure. 2) Lack of health knowledge, which requires a community awareness action. 3) Limited availability of financial resources in the worst-affected countries, requiring a mobilization of funds for long-term commitment. 4) Inadequately-trained personnel, requiring staff training as an integral part of all programs. 5) Affected communities have so many health problems that integration of distribution of Mectizan with already existing or developing primary health care activities is becoming increasingly important.
In: Mectizan (Ivermectin) and the Control of Onchocerciasis: Strengthening the Global Impact. A symposium sponsored by Merck and Co., Inc. marking the fifth anniversary of the donation of Mectizan for the treatment of onchocerciasis and held with the technical cooperation of the World Health Organization at the Hudson Theater in New York on September 23, 1992. Summary proceedings of the symposium. Rahway, New Jersey, Merck and Company, 1992. 61.Helen Keller International (HKI), founded in 1915, is the oldest US organization dedicated to blindness prevention in the developing nations. HKI's early work in xerophthalmia was followed by extensive programs in the provision of primary eye care and cataract services. More recently, the organization has become involved in onchocerciasis control programs. Their philosophy is to provide the kind of technical assistance that builds sustainable infrastructure within a national health program. They prefer to work in countries that have priorities in blindness prevention programs; and where those do not exist, they strive to develop them in cooperation with local authorities. In Burkina Faso and Niger, HKI is working with the local governments to implement surveillance systems that can detect reappearance of onchocerciasis in previously infected areas. In Mexico, HKI will be working with the existing onchocerciasis control program to develop an information system that can improve the efficiency of distributing Mectizan. In Cameroon, HKI is coordinating a program for distributing Mectizan in the Sanaga River Valley; and in Brazil, they are discussing a collaborative program of onchocerciasis control among Indians living on the Venezuela-Brazil border. In each country, they are trying to develop a cadre of persons at the national and local levels who can assume responsibility for programs of treatment with Mectizan as soon as possible. Previous experience with the distribution of vitamin A to control xerophthalmia taught that successful programs exist at the community level only when they involve the people themselves, as well as the health professionals. HKI believes that private, volunteer organizations are uniquely qualified to develop community-based interventions in cooperation with governments and multinational organizations. Such programs in the onchocerciasis-endemic areas will result in economic improvement, self-sufficiency, and improved health.