Thirty-three years ago, our company established the MECTIZAN® (ivermectin) Donation Program (MDP)—the longest-running disease-specific drug donation program and public-private partnership of its kind.
- In 2019 alone, 403 million treatments were approved and 344 million treatments were shipped to endemic countries for the elimination of river blindness and lymphatic filariasis (LF)
- In 2019, Yemen received validation from the World Health Organization (WHO) for eliminating LF as a public health problem
Supporting the global elimination of river blindness and the global elimination of lymphatic filariasis (LF) as public health problems
The MDP operationalizes the commitment our company made in 1987 to donate MECTIZAN for the treatment of onchocerciasis (also known as river blindness) to all who needed it, for as long as needed. Since then, the program has expanded to include additional commitments to donate MECTIZAN for the treatment of LF.
LF and river blindness are two debilitating parasitic diseases that primarily impact communities in developing countries. LF causes painful and disfiguring chronic enlargement of the arms and legs, and, in men, severe swelling in the genitals. River blindness causes severe rashes, intense itching, lesions, skin depigmentation, vision impairment and, over time, blindness. At the time of MDP’s inception, river blindness was one of the leading causes of preventable blindness worldwide.
Both LF and river blindness can be treated through mass drug administration by trained community health workers. River blindness is treated through MECTIZAN alone. In countries where river blindness coexists with LF, an annual single dose of MECTIZAN, administered together with a second drug, albendazole (donated by GlaxoSmithKline), is the recommended treatment for the diseases. Following the revised guidelines of the World Health Organization (WHO) for the elimination of LF, MECTIZAN also is recommended as an annual treatment in combination with diethylcarbamazine citrate (DEC) and albendazole, known as “IDA” triple therapy, for certain at-risk populations.
Following our 1987 commitment, we continue to donate as much MECTIZAN as is necessary to eliminate river blindness globally. In 1998, we made a new commitment to expand MDP to include mass treatment for the elimination of LF in African countries where onchocerciasis and LF are co-endemic.
In 2017, the donation of MECTIZAN was once again expanded to provide up to an additional 100 million treatments per year through 2025 to support the elimination of LF globally, in countries where onchocerciasis is not endemic. The most recent expansion supports WHO’s guidelines for the elimination of LF with annual treatments of a combination of the “IDA” triple therapy to at-risk populations.
In 2019 alone, 403 million treatments were approved and 344 million treatments were shipped to endemic countries for the elimination of river blindness and LF.
Within our company, the Office of Corporate Responsibility oversees the donation of MECTIZAN and manages coordination across the company and with our external partners.
To facilitate the donation and delivery of MECTIZAN, we established a multisectoral partnership involving WHO, the World Bank, ministries of health, nongovernmental organizations (NGOs) and local communities. In 1988, we established the at the Task Force for Global Health, as well as the MECTIZAN Expert Committee to provide technical and scientific advice on the implementation of the program.
- The Bill & Melinda Gates Foundation
- The Carter Center
- Christian Blind Mission International (CBMI)
- Eisia Inc.
- Global Alliance to End LF
- Helen Keller International
- Interchurch Medical Assistance (IMA)
- Light for the World
- Lions Club International
- Task Force for Global Health
- Pan American Health Organization (PAHO)
- Sightsavers International
- United Front Against River Blindness
- UK Department for International Development (DFID)
- World Health Organization (WHO)
- World Bank
Programs and initiatives
The London Declaration
We are an original signatory to the London Declaration, a collaborative effort launched in 2012 to accelerate progress toward eliminating or controlling ten neglected tropical diseases (NTDs) by the end of the decade. Our company joined 12 other global pharmaceutical companies and many other stakeholders, including endemic country governments, WHO, the Bill & Melinda Gates Foundation, the U.S. Agency for International Development (USAID), the UK Department for International Development (DFID), nongovernmental organizations (NGOs) and other organizations in this effort.
Together with the other pharmaceutical companies, we committed to continuing or increasing donations of medicines to treat or prevent these diseases. Donors committed financial resources, and NGOs agreed to support implementation needs. The partners came together under the banner of “Uniting to Combat NTDs” to track progress and identify gaps that need to be addressed in order to reach the goals of the London Declaration by 2020. Many important milestones have been reached since 2012, including 31 countries eliminating at least one NTD.
In April 2020, in response to the COVID-19 pandemic and the implementation of public health measures on physical distancing, the WHO issued interim guidance to countries on the implementation of their NTD programs. This guidance recommends that mass drug administration, including the distribution of MECTIZAN, and other community-based activities for NTDs be postponed until further notice. Through the MDP, we are working with countries as they implement WHO guidance while also being ready to help them resume the planned distribution of MECTIZAN when the guidance is lifted.
During this period of suspended NTD activities, WHO guidance encourages health authorities to use existing NTD platforms to support implementation of COVID-19-related measures as appropriate, highlighting the importance of the health intervention platforms that have been developed and supported in countries by MDP and other NTD programs.
|MECTIZAN Donation Program||2015||2016||2017||2018||2019|
|Direct financial investment in the program (in millions)1, 2||$5.80||$3.74||$3.10||$2.20||$3.10|
|Total treatments approved (in millions)||176||283||300||346||403|
|Treatments approved for river blindness (in millions)||55||64||97||111||131|
|Treatments approved for lymphatic filariasis (LF) (in millions)||94||141||89||152||201|
|Treatments approved for joint river blindness and LF programs (in millions)||27||78||114||83||70.7|
|Countries where elimination of LF has been validated by the World Health Organization (target: 30)||0||0||1||1||2|
|Latin American countries where the elimination of river blindness has been verified by the World Health Organization (target: 6)||3||3||4||4||4|
|1Direct investment includes operational support and grants.|
2Total investment decreased due to successful completion of eight-year grant in support of the African Program for Onchocerciasis Control.
Milestones and impact
An estimated 40,000 cases of river blindness are prevented by the MECTIZAN Donation Program annually. In addition, the donation of MECTIZAN led to the development of CDTI (community-directed treatment with ivermectin) programs, through which trained community volunteers distribute medicines, a critical element in effective mass-treatment programs in remote areas that often lack trained health care workers. The system is also used to distribute other health interventions including the treatment for other neglected tropical diseases, provision of vitamin A, cataract identification, bed nets distribution and immunizations.
To date, WHO has verified that in Latin America, river blindness has been eliminated in Colombia, Ecuador, Guatemala and Mexico. The remaining two affected countries in Latin America, Brazil and Venezuela, are continuing treatment in an area in the Amazon jungle shared by the two countries where transmission continues.
In Africa, national onchocerciasis elimination committees (NOECs) have been established in 22 of the 30 endemic countries. Under the guidance of the NOECs, MECTIZAN treatment has stopped in 15 of the 17 focus areas in Uganda, five states in Nigeria, two of the four focus areas in Sudan and 16 districts in Ethiopia. In total, nearly 14 million people no longer need treatment for onchocerciasis in these areas, which are currently completing three years of post-treatment surveillance, as recommended by WHO.
For LF, Togo and Yemen have received validation from WHO that the disease had been eliminated as a public health problem. Four other countries, Cameroon, Malawi, Mali, and Uganda, have stopped treatment with MECTIZAN in all endemic communities and are currently conducting the post-treatment surveillance necessary for validation. In addition, more than 89.2 million people in sub-national regions of ten other countries no longer need MECTIZAN treatment for LF, as the transmission of the disease has been interrupted.
At the same time, as part of the commitment our company made to donate MECTIZAN for IDA, we have expanded the program into 13 new countries and territories: American Samoa, Egypt, Fiji, Guyana, India, Kenya, Madagascar, Malaysia, Papua New Guinea, Samoa, Sao Tome & Prinicipe, Timor Leste and Tuvalu.
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For more information on our neglected tropical disease (NTD) research, visit the Infectious Diseases page.