Elimination of human onchocerciasis: History of progress and current feasibility using ivermectin (Mectizan®) monotherapy

► Vector control was used successfully in Kenya to eliminate Onchocerca volvulus from discrete foci. ► Vector control in the savanna region of West Africa substantially decreased O. volvulus in the region, eliminated severe ocular disease in some formerly hyperendemic areas, significantly reduced skin disease, and prevented more than 200,000 cases of blindness. ► Ivermectin (registered for human use as Mectizan®) was shown to be powerfully microfilaricidal without generating clinically-significant side effects, resulting in a paradigm shift in onchocerciasis control away from reliance solely on vector control. ► On October 21, 1987, Merck and Company agreed to donate Mectizan® “for as long as it might be needed” for control programs. ► Recurrent treatment with Mectizan® has interrupted transmission in seven of the thirteen foci in the Americas when given semiannually and three hyperendemic onchocerciasis foci in Mali and Senegal when used at semi-annual or annual intervals.