30 Jan 2025

Niger Leads the Way as the First African Country to Eliminate River Blindness

Niger has officially become the first African country to eliminate onchocerciasis, commonly known as river blindness. Niger now joins four other countries globally (Colombia, Ecuador, Mexico, and Guatemala) that have been verified by WHO as free of onchocerciasis after successfully implementing elimination activities for decades. This historic milestone is not only a triumph for Niger but also provides hope and a clear pathway for other African countries still battling this devastating disease.  

Onchocerciasis, a parasitic disease affecting the eyes and skin, has long been one of the world’s most crippling neglected tropical diseases (NTDs), causing disfiguring skin conditions, visual impairment, and, in severe cases, permanent blindness. For decades, this disease has cast a dark shadow over communities, depriving individuals of health and livelihoods, but over 99% of onchocerciasis cases currently occur in 31 African countries.  

Niger’s battle against onchocerciasis began 50 years ago when an estimated 500,000 people were infected or at risk of infection, presenting a severe public health crisis. The prevalence of blindness due to onchocerciasis was estimated to be close to 5% of the population. In response, Niger joined 10 other West African countries in the Onchocerciasis Control Programme (OCP) in 1975 to curb the disease’s spread. By 2002, the disease burden had dramatically decreased, with the prevalence of onchocerciasis in Niger plunging to just 0.02%, a promising sign the country was on the path to elimination.

Eliminating a disease is never as simple as reducing its prevalence. Niger’s journey required many years of tireless work to ensure onchocerciasis would not return. Achieving elimination was just the first step; the real challenge was maintaining vigilance and ensuring that transmission had been completely interrupted.  

Niger’s success is not a singular effort, rather it is the result of a partnership spanning decades of collaboration among governments, local communities, international organizations, and global health partners. Through this partnership we were able to collectively provide vital financial support, technical expertise, and operational assistance in support of Niger’s elimination efforts.  

These enabled the country to map out high transmission areas, scale delivery, and track progress. The team also trained community health workers, ensuring that communities understood the benefits of participating in mass drug distribution campaigns. The success of Niger’s NTD elimination campaign relied heavily on the vital contributions of frontline health workers, all of whom worked closely with local communities across the country, reaching hard-to-reach villages in the north of the country and nomadic groups in the central region, who frequently relocate. 

This collective effort, combining local knowledge with global expertise, played a transformative role in achieving elimination. 

 “Niger’s success in eliminating onchocerciasis has had profound social and economic impact, from patients saving on out-of-pocket health expenses and being able to lead more productive lives, to families of those affected no longer being responsible for caretaking and able to pursue education and job opportunities,” says Dr Amadou Salissou, National Coordinator of Niger’s Onchocerciasis and Lymphatic Filariasis Programme, who has led the fight against river blindness in Niger for more than 20 years. “Niger’s leadership and journey to eliminating this disease provide a powerful story of resilience, innovation, and collaboration, a successful model for other countries striving for similar victories.” 

Niger’s triumph over onchocerciasis represents not just a public health victory, but a smart economic investment. For nearly half a century, Niger spent millions of dollars controlling the disease, including funding treatments and the surveillance programme. But the long-term benefits have far outweighed these costs. Over the past 45 years through 2021, the country added an estimated USD 2.8 billion to its economy by eliminating onchocerciasis (and also controlling lymphatic filariasis). While the initial costs were significant – millions spent on treatments, surveillance programmes, and healthcare infrastructure – the returns have been extraordinary. Studies show that every dollar invested in preventive chemotherapy for NTDs generates approximately $25 in economic benefits for affected communities. This exceptional return on investment comes through multiple channels: reduced healthcare costs, increased workforce productivity, and freed resources that families can redirect toward education and economic opportunities.   

For Niger’s communities, particularly women, these economic benefits translate into tangible improvements in daily life. 

The elimination of river blindness in Niger shows us that ending neglected tropical diseases is not just a dream – it is an achievable goal with profound rewards. But success demands action from every sector. Governments must demonstrate leadership by increasing domestic funding for NTD programmes, strengthening health systems from the ground up, and elevating NTDs as a national health priority. Technical partners need to share expertise and best practices across borders, while financial partners must step up with sustained, predictable funding. Most critically, we need to empower local communities to lead these efforts, as Niger’s success has shown that lasting change begins at the grassroots level.  

CIFF is proud to join the RLMF partnership, with His Highness Sheikh Mohammed bin Zayed Al Nahyan, the President of the UAE and ruler of Abu Dhabi, the Bill & Melinda Gates Foundation (BMGF) and others, with the aim of accelerating the elimination of onchocerciasis and lymphatic filariasis in 39 countries.  

The path forward is clear: by replicating Niger’s collaborative model, investing in proven interventions, and maintaining unwavering commitment, we can eliminate NTDs within our lifetime. Every dollar invested brings us closer to breaking the cycle of poverty and disease that has held back communities for generations. The time to act is now – millions of lives depend on our collective response.