Mectizan Donation Program

Partnership objectives

  1. Elimination of lymphatic filariasis in African countries co-endemic for onchocerciasis and LF by 2020.
  2. Elimination of onchocerciasis globally by 2025.

In Latin America, MECTIZAN, provided on a twice-yearly basis to all eligible individuals in endemic communities. In Latin America, MECTIZAN, provided on a twice-yearly basis to all eligible individuals in endemic communities. Copyright Carter Center, MSD

What are the health needs and challenges?

Onchocerciasis, or river blindness, is a debilitating disease that threatens the health and livelihood of more than 130 million people in parts of Africa, Latin America and the Middle East. Onchocerciasis is transmitted through the bite of black flies and can cause intense itching, disfiguring dermatitis, eye lesions and, eventually, blindness. While the original goal of the program was to control the disease, recent evidence from WHO indicates that elimination is now feasible in Africa. As a result, the program’s strategy shifted from disease control to disease elimination.

Lymphatic filariasis (LF) is a devastating parasitic infection spread by mosquitoes. It is caused by thread-like parasitic worms that damage the human lymphatic system. The disease is estimated to infect over 120 million people, with more than 40 million incapacitated or disfigured with swelling of the limbs and breasts (lymphoedema) and genitals (hydrocele), or swollen limbs with dramatically thickened, hard, rough and fissured skin (elephantiasis). Around 856 million people are at risk, and 30 percent of those infected live in Africa. 

Description of partnership activities and how they address needs and challenges

In 1987, MSD* announced that it would donate MECTIZAN® (Ivermectin), our breakthrough medicine for the treatment of onchocerciasis, to all who needed it for as long as needed. 

To facilitate the donation and delivery of MECTIZAN, MSD established a multi-sectoral partnership, involving the World Health Organization (WHO), the World Bank and UNICEF, as well as ministries of health, nongovernmental development organizations and local communities. In 1988, MSD established the MECTIZAN Donation Program (MDP), housed at the Task Force for Global Health, to provide medical, technical and administrative oversight of the donation of MECTIZAN. In 1991, MSD, MDP and the WHO established the Non-Governmental Development Organization (NGDO) Coordination Group for Onchocerciasis Control.

In 1998, MSD expanded the donation to include mass treatment for the elimination of lymphatic filariasis (LF), commonly referred to as elephantiasis, in African countries where the disease co-exists with river blindness. Over 400 million people are estimated to be at risk of infection in Africa.

For LF, the program collaborates with the Global Alliance to Eliminate Lymphatic Filariasis, a group of partners committed to developing political, financial and technical support for LF programs globally.

The program reaches more than 250 million people in 32 countries annually, with more than 2.8 billion treatments donated since 1987. 

The Mectizan Donation Program is the longest-running, disease-specific drug donation program and public/private partnership of its kind, and is widely regarded as one of the most successful public/private health collaborations in the world.

Lessons learned                         

While much has been achieved in the treatment and progress toward elimination of onchocerciasis, a number of additional challenges remain that MSD and partners are actively addressing.

Many of the community-directed programs have implemented at least one other health intervention in addition to MECTIZAN delivery, thereby helping countries and their partners to improve health care by expanding health services in these hard to reach communities. However, further integration with the LF program is needed.

Summary of impact and forward looking information

Thanks to the program, over 2 billion treatments have been donated for river blindness and lymphatic filariasis, respectively reaching more than 146,000 communities in 29 countries in Africa, six countries in Latin America and in Yemen. The program reaches more than 250 million people annually. 

As a result of the investments and work of many partners, the efforts toward control and elimination of both Onchocerciasis and LF are advancing. In Latin America, Colombia, Ecuador, Guatemala and Mexico have received verification from WHO that river blindness has been eliminated. In addition, the distribution of MECTIZAN has stopped in several sub-national areas in Africa where it is believed that onchocerciasis transmission has been interrupted. For lymphatic filariasis in African countries co-endemic with onchocerciasis, treatment has stopped in several sub-national areas and post treatment surveillance is ongoing in Zanzibar, Togo and Yemen.

The WHO established goals to eliminate lymphatic filariasis and river blindness by 2020 and 2025, respectively. In 2017, MSD announced an expansion of the MDP to an additional 100 million people per year through 2025, following the publication of new WHO guidelines showing that adding ivermectin to the treatment regimen used in LF endemic countries where there is no river blindness can accelerate the time needed to achieve elimination of LF. 

 

*MSD is known as Merck & Co., Inc., in the U.S. and Canada.

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River Blindness

Partnership information

Company(ies) MSD

Partner(s) Carter Center, CBMI, Helen Keller International, Interchurch Medical Assistance (IMA), Light for the World, Lions Club International, Mectizan Donation Program, Mission to Save the Helpless, Nigeria, Organisation pour la Prevention de la Cecite (OPC), Pan American Health and Education Foundation, Pan American Health Organization (PAHO), Task Force for Global Health, United Front Against River Blindness, Vision 2020, World Bank, World Health Organization (WHO)

Type of Partner(s) IGOs, NGOs, PDPs

Therapeutic Focus Neglected Tropical Diseases

Disease(s) Lymphatic Filariasis, Onchocerciasis (River Blindness)

Program Type(s) Availability of Treatment - Product Donations, Health System Infrastructure - Development of Physical Infrastructure, Prevention Programs - Mass Drug Administrations (MDA)

Targeted Population(s) Children, Elderly, Marginalised / Indigenous People, Men, Mothers, Women

Region(s) Latin America & Caribbean, Middle East & North Africa, Sub-Saharan Africa

Number of Countries 34

Country(ies) Angola, Benin, Brazil, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, Ghana, Guatemala, Guinea, Guinea-Bissau, Liberia, Malawi, Mali, Mexico, Mozambique, Niger, Nigeria, Senegal, Sierra Leone, South Sudan, Sudan, Tanzania, Togo, Uganda, Venezuela, Yemen

Start Date 1987

More information MSD Responsibility

Anticipated completion date Ongoing

« Merck has been a valued partner in the effort to eliminate river blindness and lymphatic filariasis. We look forward to building on our achievements to date and to expand as needed, the delivery of the donated medicine to achieve the elimination targets. »

Dr. Ariel Pablo Mendez, Assistant Administrator for Global Health, USAID