ONCHOCERCIASIS CONTROL IN UGANDA - HOW CAN SELF-SUSTAINING, COMMUNITY-BASED TREATMENT WITH IVERMECTIN BE ACHIEVED

In Uganda, the control of onchocerciasis by mass treatment with iverme ctin (Mectizano(R)) began in 1990 and has expanded greatly since 1992. The parties involved in the programme are the Uganda Ministry of Heal th and its National Onchocerciasis Task Force, the Mectizan Donation P rogramme, the African Programme for Onchocerciasis Control, a number o f non-governmental development organizations and the communities where the disease is endemic. Their aim is to make the programme self-susta ining, without further outside aid, within a period of 12 years. The m ethodology of the ivermectin-distribution programme, based on communit y-directed treatment, is outlined; the constraints under which the fou r co-operating parties have to work are described and the effects of t he social changes produced by community-directed distribution are disc ussed, all in terms of influence on the achievement of a programme tha t will be able to sustain itself without the need for outside aid.