Statement by the Technical Consultative Committee (TCC) of APOC in response to the article published in the Lancet by Osei-Atweneboana MY, Eng JKL, Boakye D, et al, vol 369 June 16, 2007.Ivermectin (Mectizan) remains effective for onchocerciasis (river blindness) controlThe control of onchocerciasis (River Blindness) through the Onchocerciasis Control Programme (OCP) in West Africa and the African Programme for Onchocerciasis Control (APOC), with unwavering commitment from affected communities, national governments, non-governmental development organizations and an international donor collaboration involving both the private and public sectors, is widely recognized as one of the paramount public health successes in the developing world. For 20 years the scourge of river blindness has been successfully controlled through regular treatments with ivermectin, alleviating poverty and improving the lives of millions of people in Africa. The publication by Osei et al1 in the Lancet suggesting that ‘resistant adult parasite populations which are not responding as expected to ivermectin (Mectizan®) are emerging’, has generated public concern. The Technical Consultative Committee (TCC) of APOC, after careful review, concluded that the study findings are not conclusive and that possibility of other explanations exist that are not related to Ivermectin resistance. TCC, therefore, recommended surveys to clarify the situation in the field within the next 6 months. Furthermore, TCC stressed that the study by Osei et al, as well as other recent studies in Africa, provided compelling evidence that ivermectin is as efficient a microfilaricide today as it was in 1987 when its large scale use in onchocerciasis control was initiated. The TCC therefore strongly recommended the continuation of the current strategy for control of onchocerciasis through annual treatment with ivermectin. The committee recognizes that population-wide treatment with a single anti-parasitic drug brings the risk of emergence of resistance and it will continue to monitor the effectiveness of ivermectin as the operational control tool. TCC supports the continuation of basic and applied research for better monitoring tools for potential appearance of ivermectin resistance as well as research for new methods for control, including a safe field-suitable macrofilaricidal drug.
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