Niger becomes first African country to eliminate onchocerciasis as a public health problem
Brazzaville, January 2025 – Niger has achieved a historic milestone as the first African country to eliminate onchocerciasis, also known as river blindness, as a public health problem. This achievement makes Niger the fifth country globally to interrupt transmission of the parasitic disease, setting an example for the rest of the African continent.
Onchocerciasis, which is transmitted by the bites of infected blackflies and primarily affects rural populations near river systems, is the second leading infectious cause of blindness worldwide. This disease has long caused immense suffering, especially in sub-Saharan Africa, where it has left millions struggling with blindness and disability. The World Health Organization (WHO) verified Niger’s success, praising the country for its dedication and commitment to eliminating neglected tropical diseases (NTDs).
“Eliminating a disease is a significant achievement that requires tireless dedication,” stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “I congratulate Niger for its commitment to liberating its population from this blinding and stigmatizing illness that cause so much human suffering among the poorest. This success is yet another testament to the remarkable strides we have made against neglected tropical diseases and offers hope to other nations still battling onchocerciasis, showing them that elimination is possible.”
“Niger’s achievement marks a significant public health progress in protecting vulnerable communities and families from the debilitating impacts of this neglected disease,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “This success highlights the strong commitment by Niger’s leaders and the relentless work by health workers, communities and partners. It also demonstrates that with sustained efforts we can eliminate neglected tropical diseases that afflict many communities in our region.”
Country leadership and effective partnerships
The journey to onchocerciasis elimination in Niger began in 1976, when the country under the umbrella of WHO Onchocerciasis Control Programme in West Africa (OCP 1976-2002), focused on large-scale vector control through aerial spraying of insecticides and the distribution of Ivermectin, a medicine donated by Merck & Co. under the Mectizan Donation Program. With the transition to the African Programme for Onchocerciasis Control (APOC 1995-2015), the strategy shifted toward community-directed treatment with Ivermectin (CDTI), empowering local communities to take ownership of their health. In 2008, Niger introduced mass treatment with both ivermectin and albendazole in communities where onchocerciasis and lymphatic filariasis were endemic which undoubtedly had an impact on any remaining onchocerciasis infections. The combination of mass treatment and vector control successfully reduced the prevalence from about approximately 60% down to 0.02%, eliminating the transmission of the disease. Since then, surveillance has been implemented to preserve and sustain the progress achieved with technical support from WHO, ESPEN and partners. Data from both epidemiological and entomological surveillance continued to show diminishing disease prevalence allowing the country to achieve verification of elimination.
Regional progress
In the WHO African region, 21 countries have eliminated at least one neglected tropical disease. Onchocerciasis is the second neglected tropical disease eliminated in Niger: the country was certified free of dracunculiasis (Guinea worm disease) in 2013. This accomplishment is a testament to Niger’s visionary leadership and commitment to public health, as well as the unwavering support of the country’s health workers and volunteers. It underscores the importance of sustained investment in NTD programs and highlights the potential for other African nations to follow suit.
Onchocerciasis elimination cannot be achieved in isolation, and cross-border initiatives remain critical. To maximize impact, it is essential that countries collaborate on regional efforts to eliminate the disease.
“I commend the government’s efforts and those of all stakeholders who have made this achievement possible. We reaffirm our commitment to eliminating onchocerciasis and other NTDs across Africa to ensure a brighter, healthier future for all,” Dr Moeti said.
Some challenges affecting onchocerciasis elimination persist. The co-endemicity with loiasis in in some countries in Central Africa complicates treatment protocols due to severe reactions in co-infected individuals. We look forward to innovative approaches to diagnosis and treatment, and other innovative solutions to overcome these challenges and ensure that all countries in the African Region achieve onchocerciasis elimination.
This milestone is especially timely as the WHO’s Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) ensures that countries like Niger receive tailored technical assistance, data-driven strategies, and cross-sectoral collaboration to achieve disease elimination. By fostering partnerships, and promoting sustainability, ESPEN has enabled Niger to meet the rigorous verification standards set by the World Health Organization.