River Blindness is a plague which affects millions of people annually, mostly in Africa but also in Latin America.
River Blindness, or Onchocerciasis, occurs near fast-moving rivers where blackflies live. The flies, which bite, carry the eggs of the worm Onchocerca volvulus which are transmitted when people are bitten.
The eggs then mature into adults, known as. macrofilariae, in humans. They cluster and reproduce prodigiously, creating many larvae or microfilariae. Some of these are then transmitted back into flies and eventually into other people.
Microfilariae cause painful inflammation, severe itching, blindness and even epilepsy or, in the worst cases.
In the 1980s, researchers created at Merck created a drug called Mectizan which has proven very effective. Merck started a program to donate as much Mectizan as was needed for as long as it was needed, with the goal of elimininating River Blindness by 2025.
Despite the success of the medicine however, the problem is still severe and elimination by 2025 is uncertain. This is for several reasons.
First, although insecticides were used in the 1970s, with some real success, those programs are no longer being funded as heavily.
Second, as brilliant as Metcizan has proven to be, currently only one dose a year is provided. Two would be far better; four times a year even better than that.
However, for people who have the disease known as loa loa, Mectizan is potentially dangerous and cannot be used.And
The people who distribute the medicines are typically volunteers and cannot be expected to work for free indefinitely, no matter how motivated they might be.
And politics also is at issue as various civil wars and lesser conflicts make it hard to get the medicine to the people who need it.
Finally, there is the eternal reality with parasites, virii and bacteria: they ultimately adapt to whatever is thrown at them.
Mectizan so far is holding up, but it won’t forever.