The Mectizan Donation Program - highlights from 2005

Abstract

Through the Mectizan Donation Program, Merck & Co., Inc. has donated Mectizan (ivermectin, MSD) for the treatment of onchocerciasis worldwide since 1987. Mectizan has also been donated for the elimination of lymphatic filariasis (LF) since 1998 in African countries and in Yemen where onchocerciasis and LF are co-endemic; for LF elimination programs, Mectizan is co-administered with albendazole, which is donated by GlaxoSmithKline. The Mectizan Donation Program works in collaboration with the Mectizan Expert Committee/Albendazole Coordination, its scientific advisory committee. In 2005, a total of 62,201,310 treatments of Mectizan for onchocerciasis were approved for delivery via mass treatment programs in Africa, Latin America, and Yemen. Seventy-seven percent and 20% of these treatments for onchocerciasis were for countries included in the African Programme for Onchocerciasis Control (APOC) and the former-Onchocerciasis Control Programme in West Africa (OCP), respectively. The remaining 3% of treatments approved were for the six onchocerciasis endemic countries in Latin America, where mass treatment is carried out twice-yearly with the goal of completely eliminating morbidity and eventually transmission of infection, and for Yemen. All 33 onchocerciasis endemic countries where mass treatment with Mectizan is indicated have ongoing mass treatment programs. In 2005, 42,052,583 treatments of co-administered albendazole and Mectizan were approved for national Programs to Eliminate LF (PELFs) in Africa and Yemen. There are ongoing PELFs using albendazole and Mectizan in nine African countries and Yemen; these represent 35% of the total number of countries expected to require the co-administration of these two chemotherapeutic agents for LF elimination. In Africa, the expansion of existing PELFs and the initiation of new ones have been hampered by lack of resources, technical difficulties with the mapping of LF endemicity, and the co-endemicity of LF and loiasis. Included in this review are recommendations recently put forward for the co-administration of albendazole and Mectizan in areas endemic for LF, loiasis, and onchocerciasis.

Figure 1

Treatments with Mectizan Approved for Onchocerciasis, 1988–2005 (Humanitarian Donation and Mass Treatment Programs Combined). The figure in the 2005 column refers to the total number of treatments with Mectizan approved (rounded to the nearest 10,000) during the 2005 calendar year for onchocerciasis for mass treatment programs and humanitarian donations combined. For any given year indicated in this figure, the year of treatment approval may be different from the year during which treatments actually occurred.

Figure 2

The 26 Countries in Africa where Mass Treatment with Mectizan is Indicated and Ongoing for Onchocerciasis, as of the end of 2005. Countries are colored coded according to their inclusion in the former-OCP () or APOC () regions. As of the end of 2005, there were mass treatment programs with Mectizan for onchocerciasis in all 26 African countries where such intervention is epidemiologically justified. These 26 countries, plus Niger and Mozambique, are eligible for Mectizan combined with albendazole for national PELFs. This map is reproduced with permission of the Annals of Tropical Medicine and Parasitology, 2006, Volume 100, pages 733–46.

Figure 3

Foci in Latin America (OEPA region) where Onchocerciasis is Endemic and where Mass Treatment with Mectizan is Indicated and Ongoing, as of the end of 2005. In Latin America (OEPA region), as of the end of 2005, all onchocerciasis endemic foci were indicated for twice-yearly mass treatment with Mectizan, regardless of endemicity, as a strategy for the elimination of onchocercal morbidity and transmission of infection. This map is reproduced with permission of the Annals of Tropical Medicine and Parasitology, 2006, Volume 100, pages 733–46.

Figure 4

Treatments with Mectizan Approved for Onchocerciasis (Mass Treatment Programs Only) by Region, 2005. The figure on top of each bar refers to the number of treatments (in millions) with Mectizan approved for delivery via mass treatment programs for onchocerciasis for the particular region or country indicated. All treatment approval figures have been rounded to the nearest 100,000, with the exception of that for Yemen (rounded to the nearest 10,000). The year of treatment approval may be different from the year during which treatments actually occurred.

Figure 5

Treatments with Albendazole and Mectizan Approved for Programs to Eliminate Lymphatic Filariasis (PELFs), 2000–2005. The figure on the top of each bar refers to the number of treatments (in millions) with albendazole and Mectizan approved for national PELFs in Africa and Yemen in the calendar year indicated. All annual treatment approval figures have been rounded to the nearest 100,000. For any given year indicated in this figure, the year of treatment approval may be different from the year during which treatments actually occurred.