Interview avec le Dr. Uche Amazigo, directeur, APOC

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The AfDB President, Donald Kaberuka, on Tuesday, December 8, 2009, in Tunis opened the fifteenth session of the Joint Action Forum (JAF) of the governing board of the World Health Organization’s (WHO) African Programme for Onchocerciasis Control (APOC) which comprises health ministers of several participating countries, representatives of donor countries, development institutions and health development partners.

During the opening ceremony, APOC Director, Dr. Amazigo, delivered a  statement covering, among other areas, the APOC’s historical background, its operational strategy, its performance and perspectives in the years ahead. Please read full interview below.

Question: Most participants in this meeting openly showed their appreciation of your address this morning as it covered every aspect of APOC activities from the creation, purpose, performance, future expectations to its future prospects. Can you give us a brief history of your programme?

Answer: It is with nostalgia that I welcome participants to the 15th session of the Joint Action Forum on behalf of 147,000 Onchocerciasis endemic communities. 41 years ago, the first meeting ever to seek scientific tools to check the untold human suffering and economic devastation caused by river blindness was hosted by WHO here in Tunis in 1961. The Tunis meeting was sponsored by the French government, the World Health Organization (WHO) and the United States Agency for International Development (USAID). The 15th session of the governing body is being hosted by the African Development Bank in the same city where it all began. Forty-one years ago, experts met in Tunis, and six years later the Phase I Onchocerciasis Control Programme (OCP) in West Africa was launched. In 1995, the APOC Phase II programme was launched by the OCP governing body. For 35 years, the APOC governing body in Africa has met annually to review progress and challenges in the fight against the scourge and to speak with one voice regarding the control of river blindness on our continent.

Question: Having come this far, what feelings does APOC brings to mind when mention is made of it?

Answer: APOC is a regional programme with strong ownership by African countries.  The strong support provided by the African Development Bank to APOC symbolizes the great importance the AfDB President, Donald Kaberuka, for example, attaches to the indispensable role of health in economic development in our sub-region. In my village, when wise, old men and women gather at the moonlight ground, they do not gather because of the moon. Everybody can see the moon in his/her own compound. These wise people gather to unite over decisions and issues affecting their community. They believe that “there is strength in number”. Put in another way, “united we stand.” The river blindness control programmes have made significant progress due to united efforts and the support of all stakeholders and the decisions of the governing body. APOC therefore invokes impact. In fact, the impact of the programmes was expressed in the UNESCO report of 2005 and I quote: “ The progress that has been made in combating River Blindness (Onchocerciasis) represents one of the triumphant public health campaigns ever waged in the developing world.” As my ancestors would say, for the support of the Bank, I also want to say: “President Kaberuka, may all you took out to host this august body return to you and the African Development Bank, a million fold.”

Question: What are the challenges facing APOC and what are its operational strategies and achievements?

Answer:  Concerning the challenges before us, I would like to say that a child’s fingers are not scaled by a piece of hot yam (food) which its mother puts into it. As you already know, the control of river blindness is a huge and complex venture which epitomizes the ‘hot yam’ that would scald a child if adequate care is not taken. Fortunately, with the dynamism of our Regional Director, Dr Sambo, the Committee of Sponsoring Agencies, and the governing board’s unparallel support to APOC and to me personally, we can say we are not scalded by the complexity and challenges of controlling this disease.  I cannot forget to mention the twenty incredible donors for their unflinching commitment and support. Remarkably, seven of the nine original donors have been with the campaign continuously over three decades. Such long-term donor commitment has been crucial since it takes years to interrupt the disease transmission.

APOC’s strategy is simply engaging the people in health care delivery. APOC partners have put in place a community-driven strategy and huge grassroots workforce of over half a million trained community selected drug distributors in 15 countries who are addressing the control of Onchocerciasis and other diseases of poverty. This unparalleled commitment is the secret of our success. Thanks to the communities and their drug distributors, the elimination of river blindness is no longer a dream. Recent scientific evidence shows elimination with Ivermectin alone is feasible. The evaluation of more than 65 projects in 12 countries shows the commitment of endemic communities is guaranteed.

Question: What do you expect to achieve at the end of the Tunis meeting?

Answer: The Tunis meeting will examine the results of recent studies to evaluate the potential to shrink the Onchocerciasis map of Africa. In the next two days, we will be making important policy decisions in relation to a paradigm shift from controlling to eliminating of river blindness, co-implementing Onchocerciasis control activities with other interventions and strengthening health systems using the APOC community-directed and people-centred approach. We expect to endorse the JAF approval of the extension of APOC from 2010 to 2015 with new objectives, thereby repositioning APOC from a single to a multi-disease programme. The JAF was convinced that the wider health community could benefit more from Onchocerciasis experiences than it is currently the case.