Possibly the most successful international cooperation initiative ever mounted was the Onchocerciasis Control Programme (OCP) in West Africa. Lasting 28 years, it involved 11 countries directly and many others indirectly, raised US$ 570 million and has left an indelible mark on the history of development assistance in sub-Saharan Africa.
Before the start of OCP in 1974, some 30 million people lived in the tropical forests and savannahs of West Africa that are home to the black fly that carries onchocersiasis. Nearly 2.25 million people were infected with the parasite and 100,000 were blind. The black fly limited access to an estimated quarter million square kilometres of fertile land, losing the region US$ 30 million income a year (Akande, 2003). To counter the threat effectively meant dealing with the whole river system in one sweep: a country-by-country approach could allow the black fly to recolonize a cleared section. This in turn stopped people from using some of the best land that was available for farming—contributing to serious food shortages.
OCP had the good fortune to have a few highly committed champions such as the late Robert McNamara, then President of the World Bank; Dr. Roy Vagalos of the pharmaceutical company Merck & Co.; Dr. Rene le Berre, a French entomologist and pioneer in the diagnosis and treatment of river blindness; and Dr. Vincent Resh, a stream ecologist and expert on aquatic biomonitoring. McNamara used the power of the media and his position to persuade and convince three other UN agencies, namely, the United Nations Development Programme (UNDP), the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO), to join in the effort to control and eradicate river blindness (Akande, 2003).
Together the four organizations attracted financial support for the programme from donors and partners. Its success was hugely influenced by the actions and impact of the print and electronic media. Heavyweight dailies such the New York Times, the Financial Times (United Kingdom), the Guardian (United Kingdom) and the Los Angeles Times assigned reporters to cover the story – a rare instance of good news from the developing world – and they filed encouraging reports on OCP activities and on a new drug to treat river blindness. These newspapers helped to change public opinion and gain support for the programme.
The mass media played an important role in raising funds directly or indirectly for OCP. Press releases, aides memoires, features and stories were shared with the media by the four partner agencies and non-governmental organizations, foundations and charity organizations used print, television and the Internet to obtain money from the public and private sectors. In 1987, when Merck & Co. wanted to use the new drug, Ivermectin, to treat onchocerciasis, the Houston Chronicle carried a story on the drug that caught the eye of multi-millionaire John Moores. That article resulted in his not only contributing US$ 25 million for the distribution of the new drug but also establishing the River Blindness Foundation to continue the assistance effort (Taylor, 2002).
OCP raised US$ 570 million in 28 years through good governance and intensive public and media awareness campaigns, especially thanks to its transparency in all its financial affairs and the progress that it was making in conquering the disease. As the former WHO Director-General, Gro Harlem Brundtland, noted at the OCP headquarters in Ouagadougou (Burkina Faso) in a statement provided to the Inter Press Service in 2002 upon the conclusion of the programme, “the accomplishments of this programme (OCP) inspire all of us in public health to dream big dreams because we can reach ‘impossible’ goals and lighten the burden of millions of the world’s poorest people”. Dr. Brundtland was confident, furthermore, that despite various criticisms, the follow-up phase to OCP, known as the African Programme for Onchocerciasis Control (APOC), would continue the programme’s success. The good news, according to Paul Ejime, a media consultant to WHO/APOC, writing in 2010 in Nigeria’s Vanguard News, was the first-ever African individual donation of US$ 1 million to APOC, granted by General T. Y. Danjuma, a philanthropist and survivor of river blindness. General Danjuma urged the Government of Nigeria to contribute more towards the elimination of the disease.
The visual media supported the print media in publicizing OCP. Films such as “Source of Hope”, a documentary by Jay Sullivan (2003) about the fight against river blindness in West Africa, won the Cine Golden Eagle award and the New York Film Festival's Silver World Medal in 2003. Other notable films were co-sponsored by the Government of France and WHO, including one in 1985 and another in 1997. The 1985 film, entitled “Mara, the Look of the Lion”, won ten awards and focused primarily on OCP actions and achievements at that time. The 1997 production carried a strong message urging participating countries to consolidate the achievements of OCP within their national health services before the programme ended (Government of France, 2002).Further, numerous documentaries, pictures and photos showed the devastation caused by river blindness, especially the perpetual itching and disfiguring lesions of the disease. In some families, the only people who were not affected by river blindness were the children. The films and photographs were a revelation to the outside world, touching the hearts of many people and some private companies and foundations. There is no doubt that the visual media dramatically raised the level of awareness and galvanized support to control and eradicate river blindness in West Africa.
The drug Ivermectin was originally meant for animals, not humans. However, the results of field trials to determine community acceptance and safety were very promising. Once they were published in The Lancet, they immediately appeared in the New York Times, Le Monde and other international papers (Taylor, 2002), and the drug was accepted for use in the eradication of river blindness. Currently, there are early warning signs of growing resistance to Ivermectin in a few hot spots in West Africa (Lamberton, 2011). Given this ominous development, perhaps the media should continue to play an active role in ensuring that West African governments and international agencies take this warning seriously, if river blindness is to become a thing of the past.
The mass media also helped in conveying essential information to the communities at risk. This was done by training up community health extension workers, who could transmit the information in local languages, and by encouraging school children to pass on information to their parents and neighbours. These approaches helped to overcome problems such as the suspicions harboured by some communities that Ivermectin was a poison sent by some politicians whom they had voted against (USAID, 1999). Modern information and communication technology techniques such as sensors, telephone lines, satellite links and computers were used to observe the deadly black fly and to track its larvae along the Volta River. The data collected were linked and shared with a network of entomologists within the programme area by satellite radios (Singh, 2012).
The records of the success of OCP do not explicitly acknowledge the role of the media, but the programme would have been impossible without their contribution. Few externally funded programmes have continued to enjoy the media cover that OCP receives even today. Coverage was unusually extensive throughout the 28 years of the programme’s first phase, with the 32 partners involved in OCP using all available media outlets to maintain the level of awareness, the sympathy and the understanding of not only the participating countries but also OCP donors, sponsors and supporters. There is little doubt that the mass media exposure largely ensured that the project management and development partners manifested such high levels of trust, accountability and transparency. This, in turn, helped to eliminate confusion at the implementation level, resolve conflicts and unite all partners in the war against river blindness.
According to an African proverb, “only failures make news”. However, in the case of river blindness in West Africa, the opposite was true. It is to be hoped that the media will continue to play an important role in ensuring the success of the second phase of OCP – the APOC programme – against this debilitating disease. As Taylor (2002) noted, "Success has many parents”, this, incontestably, is the case with the implementation of OCP, and the 32 partners involved in that endeavour. In this success story, particular credit must also go to the media at large.
Dr. John.O.Kakonge is a Special Adviser to South-South News, New York, U.S.A.
Akande, L. (2003). “Victory over River Blindness”, Africa Recovery, Vol. 17(1):6.
Government of France (2002). “The closure of the Onchocerciasis Control Programme in West Africa (OCP) 1974–2002”. http://www.diplomatic.gour.fr/en/IMG/pdf? plaquette-gb.pdf
Lamberton, P. (2011). “Have we truly conquered river blindness?” A Global Village, Issue 4, summer 2011. http://aglobalvillage.org/journal/issue4/newfrontiersinhealth/lamberton/
Singh, N.K. (2012). “Telemedicine benefits, 30 May 2012”. http://www.e-pao.net/epsubpageExtractor.asp?src=features.telemedicine benefits
Sullivan, J. (2003). “Source of Hope”, Metizan Donation Programme. http://www.cine.org/archives/winner-archives/pdf/2003-CINE-Winner-Directory.Pdf
Taylor, H. (2002). “River blindness: a good news story”. Ockham’s Razor, ABC Radio National, 21 July 2002. http://www.abc.net.au/radionational/programs/ockhamsrazor/river-blindness---a-good-news-stories/3514288
United States Agency for International Development (1999). Talking Drums: A Communication Handbook for Field Managers of River Blindness Prevention Programme. http://pdf.usaid.gov/pdf-docs/PNADQ939.pdf