Timeline of Onchocerciasis Control Initiatives
N.B. All acronyms are explained at the bottom of this page.

"We [at the World Bank] could hardly pronounce the name of the disease, much less spell onchocerciasis, but we were horrified by what we heard about it. Literally millions of people were at risk of a fate that could be worse than death in that society and time." ~ Robert S. McNamara, President of the World Bank 1968-1981, reminiscing in 1994 about the beginnings of the efforts against onchocerciasis [ab]

A helicopter sprays the lands near rivers as part of a larvicide program funded by WHO. Photo courtesy of WHO/TDR.
  • First attempts to control blackflies were made in the Americas before modern insecticides existed and involved clearing vegetation and applying plant extracts, Paris Green, and creosote to the vector breeding sites. [e]
  • 1944: DDT first used against blackflies. Eventually (year uncertain) succeeded in eradicating S. neavei from the Kodera Valley in Kenya. [e]
  • Establishment of the ***Ecological Group*** to address ecological concerns about pesticide use. [h]
  • Early 1950s: “First comprehensive investigations” of blackfly vector control [f]. Possibly refers to the 1950-65 large-scale trials and pilot campaigns by ORSTOM and OCCGE in West Africa on the larviciding of S. damnosum, which were “quite successful” in reducing blackfly numbers during control efforts but did not solve the problem of regular re-invasions from surrounding areas. [f,r]
  • 1962: A control program, supported by the EDF and the French Aid and Cooperation Fund, covered parts of Côte d’Ivoire, Burkina Faso (then Upper Volta), and Mali. [f]
  • July 1968: At the Tunis Meeting in July 1968, multidisciplinary experts addressed the problem in West Africa and agreed that a large-scale control campaign rather than eradication was the solution. A program was recommended involving 10-15 years of aerial larvicide spraying and simultaneous revamping of the health care systems of the endemic countries, beginning with the Volta river system and extending into Senegal, Mali, and Guinea. [f,h,r]
  • 1969-70: Several African countries applied for aid from EDF, FAO, the World Bank, UNDP, WHO, and USAID in launching control programs. [f]
  • July 1970: A meeting in Geneva set up an international study mission, PAG, to collect and assess epidemiological, entomological, economic and other data in preparation for an multinational control program. [f]
  • 1972: Two French scientists in Africa discovered and convinced Robert McNamara, President of the World Bank, that onchocerciasis can be controlled by preventing blackflies from propagating for a period of 14 years. [h,r]
  • 20 Aug 1973: The final PAG report proposed a 20-year aerial larvicide program, complete with structure and management recommendations to minimize economic and social harms, in the African savanna, where onchocerciasis was more severe. [f]
  • 30 Oct – 1 Nov 1973: Intergovernmental Meeting on Onchocerciasis Control in the Volta River Basin Area, held in Accra, where representatives from seven African countries signed an “Agreement governing the operations of the Onchocerciasis Control Programme in the Volta River Basin Area,” with four UN agencies – the World Bank, UNDP, FAO, and WHO – as the sponsoring agencies and WHO as the executing agency. [f,h]

A researcher catches blackflies using himself as bait. Photo courtesy of WHO/TDR.
  • 1974: The OCP was launched in seven West African countries under the aegis of various agencies of the United Nations, spearheaded by the efforts of World Bank President Robert McNamara. [h, r]
  • 1980s: Clinical trials on ivermectin as an onchocerciasis treatment were underway.
  • 1986-87: The OCP was extended to four more countries to alleviate re-invasion of blackflies into treated areas. [h,r]
  • 1987: Ivermectin (trade name Mectizan®) first developed for human use by Merck Sharp and Dohme Laboratories from a culture obtained from Japanese soil samples. Thanks to unlimited donations from manufacturer Merck & Co., led by chairman Dr. P. Roy Vagelos, it replaced banocide as the treatment of choice for onchocerciasis. [f,h,r]
  • 1989-94: The Ivermectin Distribution Programme was run by the NGDO. [i]

The entrance to a local clinic and distribution center run by the Carter Center. Photo courtesy of WHO/TDR.
  • 1991: The NGDO Coordination Group for Onchocerciasis Control was established at the WHO headquarters. [i]
  • 1992: The OEPA was founded in the Western Hemisphere
  • 1995: The APOC was launched in 19 countries not participating in the OCP by the World Bank and NGDO. [i,r]
  • By 1996: Over 34 million people had been protected from onchocerciasis by the OCP. [r]
  • By 1998: Over 67 million treatments with ivermectin had been taken. [r]
  • December 2002: The OCP officially closed. [i]
  • By 2007: APOC will end. African communities must be fully prepared to continue CDTI without external assistance. [r]