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Copyright 1999 InterPress Service, all rights reserved.
Worldwide distribution via the APC networks.
*** 15-Oct-99 ***
Title: HEALTH-AFRICA: Efforts to end River Blindness At Risk
By Abid Aslam
WASHINGTON, Oct 15 (IPS) - The World Bank's efforts to eradicate
river blindness in some 30 African countries faltered this week
when donors failed to come up with new funding.
At stake were the the future of the African Programme for
Onchocerciasis Control (APOC), with projects in 19 countries, and
the Onchocerciasis Control Programme (OCP), an older effort
covering another 11 countries.
Before this week's donor meeting in Paris, the twin programmes
had been touted as models of the type of public-private
cooperation needed to overcome the Third World's development
challenges.
The efforts had brought together governments, international
institutions and pharmaceutical companies - which donated drugs
for the fight against river blindness, a tropical skin disease
caused by a parasitic worm, the larvae of which can migrate into
the eye and cause blindness.
More than a million people had the disease in the 11 countries
covered by the OCP and some 100,000 had gone blind, according to
the Bank. The agency said the programme had succeeded in
protecting some 30 million people against infection.
The two-year-old APOC programme faced a funding gap of eight
million dollars through the year 2001 and if new money was not
found by the end of this year, ''we will begin to cut into
programmes,'' said Bruce Benton, manager of the World Bank's
regional river blindness unit.
The OCP, set up 25 years ago, was in peril of going unfunded
for what were to be its final three years, Benton told a news
conference in the French capital.
Funders reduced the OCP's shortfall from 7.5 million dollars to
just under six million dollars but put off any further
commitments.
The APOC programme was a victim of its own success, Benton
said, because it had opened 57 projects in its first two years -
far in excess of what had been expected.
Donors, however, balked at approving 500,000 dollars needed to
fund a study to evaluate the exact needs of a programme to combat
elephantiasis, also caused by tiny worms and marked by a
debilitating swelling of the body, usually in the limbs.
The funding setback to the river blindness project came as
international agencies and drug manufacturers launched a new anti-
malaria effort in Africa.
The World Health Organisation (WHO) this week announced a new
drive to provide nearly 60 million African families with
insecticide-treated bed nets over the next five years.
The agency's 'Roll Back Malaria' campaign was being co-sponsored
by the United Nations Children's Fund (UNICEF), the UN
Development Programme (UNDP), the World Bank and the United
States Agency for International Development (USAID).
Public and private-sector institutions in countries where
malaria was endemic also had signed on to the campaign, aimed at
halving worldwide cases of the disease by 2010.
An estimated 700,000 African children died last year from
malaria, the victims of bouts of raging fever brought on by bites
from anopheline mosquitoes.
Fewer than two million African households had specially-treated
bed nets, according to health experts. Recent studies, however,
showed that children's chances of getting malaria were halved by
sleeping under the simple devices.
Bed nets by themselves were not sufficient protection because
they tore easily and mosquitoes could find their way through even
the smallest holes. Under the new effort, however, nets would be
treated with a WHO-approved, non-toxic insecticide made from the
chrysanthemum plant.
The insecticide had been shown to create a chemical barrier
that covered up small holes and tears, according to the health
agency. Maintaining that protection would involve periodically re-
treating the bed nets.
A study in The Gambia, in West Africa, found that this helped
to reduce by about one-fourth the number of child deaths from all
causes - including not only malaria but also other diseases that
took root in children weakened by earlier bouts of malarial fever.
However, the nets were beyond the means of most families
because they cost four dollars each. The British government
pledged 70 million dollars to the new campaign in a bid to reduce
the price to two dollars.
The US contribution to the effort was a 15-million-dollar
contract awarded by USAID to the Washington-based Academy for
Educational Development to educate the public about bed nets and
to develop a commercial market for them.
Such efforts have been criticised by African health and
community development experts as pushing market-driven solutions
at the expense of alternative approaches - and as providing
financing to Western development organisations without sufficient
consideration for local groups already doing similar work.
Officials here said, however, that the market approach was the
only one that would permit governments to back out after making
initial investments in a scheme that eventually would finance
itself through sales.
The campaign's backers also drew parallels between 'Roll Back
Malaria' and the Universal Childhood Immunisation campaign
launched by UNICEF in the 1980s. That campaign's goal had been to
immunise 80 percent of the world's children, up from 20 percent
when it was launched.
Officially, the agency boasted that it had met that goal,
making the effort one of this century's great public health
victories and the crowning achievement of its late executive
director, James Grant.
Internal correspondence, however, showed that some UNICEF
health experts and their counterparts in a number of Third World
governments remained sceptical.
They expressed doubts about the efficacy of drugs and delivery
systems and in some cases questioned the accuracy of progress
reports. Because vaccines sometimes were not at full potency at
the time of use, in many areas the drive had succeeded in
vaccinating children - but not immunising them. (END/IPS/aa/mk/99)
Origin: ROMAWAS/HEALTH-AFRICA/
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[c] 1999, InterPress Third World News Agency (IPS)
All rights reserved
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