The filarid parasite Onchocerca volvulus is the causative agent of human on
chocerciasis (river blindness), an infection characterized by chronic skin
and eye lesions. There are three regional programs currently dedicated to c
ontrolling onchocerciasis in the endemic areas of Africa and the Americas:
the Onchocerciasis Control Programme of West Africa, the African Programme
for Onchocerciasis Control and the Onchocerciasis Elimination Program for t
he Americas. All three programs use periodic mass treatment with the microf
ilaricidal drug ivermectin with differing strategic purposes and, as a resu
lt, face different challenges to reach their goals. This paper will review
the strategies, status and challenges of these three programs.