15 years of APOC - World Health Organization

15 years of APOC
Research
APOC... in brief How APOC works
APOC’s operations and activities have always been guided
and based on research and evidence. Research results are used
to determine all policies for control activities. APOC’s main
research partner is UNDP/World Bank, WHO Special
Programme for Research & Training (TDR). APOC also
works with universities and other research institutions.
One of the challenges facing APOC at the beginning was to
determine the delivery method most capable of eliminating
oncho as a public health problem? A multi-country study
carried out by TDR concluded that distributors selected by
the communities with support from their communities are
able to carry out the distribution of Mectizan® tablets
efficiently, give the correct dosage, exclude those who should
not be treated and report on the distribution.
Policy
From Research to Policy to Implementation
All research results are discussed at the Committee of
Sponsoring Agencies (CSA) which makes recommendations
to the Joint Action Forum (JAF) for approval before
implementation. In 1997 The JAF approved and adopted the
Community-Directed Treatment with Ivermectin (CDTI) as
the programme’s main drug delivery strategy.
Implementation
The APOC Strategy - CDTI
The Community-Directed Treatment with Ivermectin (CDTI)
adopted by APOC in 1997 relies on active participation and
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promotes community ownership and empowerment of
communities. Communities take responsibility for ivermectin
distribution and decide how, when and by whom the
ivermectin treatment should be administered. CDTI has
proved very successful and in the rural areas where health
services are weak or sometimes even non-existent, it is
contributing significantly to reducing the onchocerciasis
burden in Africa. Increasingly this strategy is now being used
by communities to bring other health interventions to the
people who need them most.
The Mectizan Donation Programme set up by Merck
administers the procurement and delivery of the drugs to
countries that need and request it. The MDP works closely
with ministers of health and other partners
Where APOC works
Out of the 19 countries REMO results showed that four had
mainly hypo-endemic areas with small pockets of mesoendemic
communities and so would not require mass drug
administration. Clinic-based treatment was therefore
recommended.
APOC therefore works in the remaining 15 countries:
Angola, Burundi, Cameroon, Central African Republic, Chad,
Congo, Democratic Republic of Congo, Ethiopia, Equatorial
Guinea, Liberia, Malawi, Nigeria, Sudan, Tanzania, and
Uganda and four ex-OCP countries: Cote d’Ivoire, Ghana,
Guinea Bissau and Sierra Leone.
African Programme for Onchocerciasis Control