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Annex 2.1 Page 2 of 5

4.    The Program has now virtually eliminated riverblindness in the original seven-country area' where operations were launched in 1974 and it has ceased operations in 80% of this area. This is an impressive achievement considering that the area was once the most heavily infected area in the world, with a disease prevalence ratę of 15%. This original area now contains morę than 20 million people.

5.    Considerable progress has also been madę in securing controi over the disease in neighboring areas-known as the extension areas. It was determined necessary to extend operations into these areas in the mid-1980s to controi up to the limits of the breeding sites of the blackfly if the Program was ultimately to be brought to a successful conclusion. The extensk>n areas include fbur additional countries^{1 2} and 10 million morę people. Program operations now cover the entire extension areas and have succeeded in halting reinvasion of infected blackflies back into Ae original area. As a result, the original area is fully protected from any renewed transmission of Ae disease.

6.    The Program is employing a relatively new drug, ivermectin (Mectizan), to

complement vector contro!. Uniike vector controi, Mectizan will not halt transmission and it has no proven impact on Ae adult worms in humans. However, it kills Ae infant worms in Ae body preventing Aem from causing debilitation and blindness. Last year, Ae Program planned and oversaw Ae treatment of nearly one million people wiA Mectizan. The Program's current strategy is to combine Mectizan treatment, to prevent impending blindness, wiA vector controi to stop transmission and eliminate Ae adult worm reservoir throughout Ae human population over Ae long term. There is now some evidence to suggest Aat Ae combination of vector controi and Mectizan treatment may be accelerating Ae pace wiA which Ae Program is achieving elimination of Ae disease. Considerable progress has been madę recently in research supported by Ae Program to find a safe and effective drug which would kill Ae adult worm. Such a discovery, while not essential to Ae Program's ultimate success, would shorten its duration and virtually guarantee its sustainability.

7.    The Program‘s impact to datę can be summarized by Ae following data: Thirty

million people are currently protected from riverblindness transmission. Ninę million children, bom sińce Ae Program began, face no risk of contracting Ae disease. One and a half million people who were once seriously infected have completely recovered and carry no tracę of Ae parasite. The Program has prevented 150,000 cases of blindness. And successful controi is freeing up approximately 25 million hectares of arabie land which could not previously be inhabhed or cultivated due to Ae severity of Ae disease.

1

Including major portions of Benin, Buriana Paso, Cfitc d'Ivoire, Ghana, Mali, Niger and Togo.

2

Guinea, Ouinea-Bissau, Senegal, and Sierra Leone