Concordia International School Shanghai Model United Nations ◆ Seventh Annual Session
Forum:
General Assembly 3rd Committee
Issue:
Taking
steps
to
lessen
the
incidence
of
River
Blindness
(Onchocerciasis) in sub-Saharan Africa and other afflicted areas
Student Officer: Ha Eun (Monica) Park
Position:
Deputy Chair
Introduction
Onchocerciasis, which is also known as River Blindness or Robles Disease, is defined as a
disease caused by infection with Onchocerciasis volvulus. It is transmitted to humans through the
repeated exposure to bites of infected blackflies. Onchocerciasis often results in itching, bumps under
skin and severely, blindness. Although there have been considerable amount of efforts to prevent the
disease, there is no vaccine introduced against Onchocerciasis. There are many countries in both Africa
and Latin America, including Angola, Burkina Faso, Gabon, Togo, Uganda, Venezuela and Mexico that
are currently suffering heavily and severely from the River Blindness. Nonetheless of its severity, many
countries are tolerant of and indifferent to the issue. Therefore, new resolutions and policies should be
primarily focused on prevention, treatment and epidemiology.
Definition of Key Terms
Onchocerciasis
Onchocerciasis is defined as a parasitic disease caused by the filarial worm Onchocerca volvulus
according to the WHO (World Health Organization). When transmitted through human body, it causes a
various symptoms such as blindness, skin rashes, lesions, itching and depigmentation.
Epidemiology
According to WHO, Epidemiology is defined by the study of the distribution an determinants of
health-related states or events, and the application of this study to the control of disease and other
health problems. Epidemiology focuses not only on the analysis of health issues but also on the practical
solutions to prevent and control endemic diseases.
Neglected Tropical Disease (NTD)
Neglected Tropical Disease includes variety of disease that is mainly prevalent in tropical
conditions or in developing regions of Africa, Asia, and the Americas, where adequate sanitation and
hygiene are lacking.
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Concordia International School Shanghai Model United Nations ◆ Seventh Annual Session
History
Discovery and Spread of River Blindness
Onchocerciasis was originated in Africa and was exported to America during the slave
trade era. In 1874, the micro filarial, which causes River Blindness, was discovered by an Irish naval
surgeon, who was eagerly seeking to identify skin disease in the west coast of Africa.
In 1915, ocular disease was first identified by physicians and philanthropists in Guatemala.
Ocular disease was first found in the eyes of Americans, especially among the coffee workers. They
concluded that ocular disease, which is caused by infectious worms that can cause inflammation of the
skin, eyes and face, is most prevalent in tropical area. In 1930, a Belgian ophthalmologist conducted
further research and found certain types of organisms that caused the “River Blindness” in Belgian
Congo. Infected patients described seeing threads or worms in their vision, which were the movement of
inflammatory organisms in their eyes. Although such reports and researches were controversial among
the international scientific community at the beginning, it was proven to be true in 1934 by the Harvard
African Expedition.
Since 1988, parasiticide has been provided for free by Merck (pharmaceutical firm) through the
donation program (also known as MDP). The donation program (MDP) worked with Ministries of Health
and various NGOs, such as the World Health Organization, to lessen the spread of River Blindness in
endemic areas.
The Onchocerciasis Control Program (OCP) that was launced in 1974 by the World Health
Organization with joint efforts of the World Bank, the United Nations Development Program and The
Food and Agriculture Organization, have worked to reduce the number of people suffering from
Onchocerciasis in 20 donor countries. Today, the number of infected people in areas where OCP had
been operated have almost got eliminated. In fact, in 2007, Colombia became the first country in the
world to halt the River Blindness.
Key Issues
Widespread of Disease
More than 99 percent of River Blindness cases were found in African region. In areas
where the African Program for Onchocerciasis Control has been launched since 1995, WHO
reported that 26 million people were infected by Onchocerciasis in 2008. Including American
region, there are approximately 123 million people in 38 countries at risk of infection of River
Blindness and about 25.7 million people were reported to be infected.
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Concordia International School Shanghai Model United Nations ◆ Seventh Annual Session
Lack of treatment options
Unfortunately, the only treatment that exists is extremely toxic to human. Ivermectin, which is a
treatment introduced by Mectizan, aims to reduce the number microorganisms in the skin, face and eyes
to stop disease from spreading. Infected people are recommended to receive treatment of three times in
one year over 10 to 15 years at maximum. However, ivermectin is likely to cause severe and adverse
reactions or side effects. In addition, many control programs are either not feasible or cost effective,
making it very difficult for developing countries or neglected countries to adopt the programs by
themselves.
Impact on people in endemic areas
As reported by the World Health Organization, 99% of infected people are currently living in 31
countries in Africa, including Angola, Burkina Faso, Gabon, Togo and Uganda. River Blindness was also
noticed in Yemen and Latin America, including Brazil, Guatemala, Mexico and Venezuela.
Onchocerciasis does not only affect the quality of life, but also shortens it. Although skin infection and
blindness do not seem to have direct impact on mortality rate, the recent research shows that 5% of
deaths in Africa were caused by frequent and continuous exposure to infectious microfilaria.
Major Parties Involved and Their Views
United Nations
United Nations International Children’s Emergency Fund (UNICEF)
UNICEF has put emphasis on protection of children from the River Blindness, since such
tropical ocular disease may steal childhoods as well as their eyesight. UNICEF had agreed on a
partnership with Merck to provide treatment with free-of-charge to anyone who needs it. They
also started a project called WASH to improve quality of water and sanitation of facilities, fulfilling
Millennium Development Goal 7 on environmental sustainability by providing more access to
basic sanitation available. UNICEF supports Rural Water Supply and Sanitation Agencies and
Water and Sanitation Departments in states and local government to promote the importance of
hygiene at household level.
World Health Organization (WHO)
World Health Organization has sent many UN Dispatches to many different endemic
areas, especially to sub-Saharan Africa. As a result, in August 1, 2013, they could successfully
eliminate River Blindness in Colombia, which was the first six endemic countries in America.
Success in Colombia became a milestone in creating and sustaining partnerships to provide
accessible and consistent health education.
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Concordia International School Shanghai Model United Nations ◆ Seventh Annual Session
African Organization
West African Health Organization (WAHO)
WAHO was formed in 1987 by the Head of State and Government from 15 countries in
the Economic Community of West African States (ECOWAS). The WAHO works to provide the
highest possible standard and protection of health of the people in sub-region in Africa by
cooperating with one another to combat the health problems.
Timeline of Relevant Resolutions, Treaties and Events
Various international organizations have dedicated different activities and forums to the issue of
lessening the River Blindness in endemic areas.
Date
Description of event
April 5, 2013
July, 2013
The Director-General of WHO issued an official letter confirming that Colombia
has achieved elimination of onchocerciasis.
Columbia publicly announced that it became the first country in the Americas to
receive World Health Organization verification of eliminating river blindness.
Introduction and distribution of ivermectin, which was commonly used drug that
has contributed to controlling the disease in endemic countries, to eliminate river
July 21, 2009
blindness by the United Nations.
Evaluation of Previous Attempts to Resolve the Issue
Although there have been numerous conferences, control programs and resolutions dedicated to
lessening the River Blindness in endemic areas, River Blindness has not been globally and completely
eradicated.
Onchocerciasis Control Program (OCP) was launched in 1974 in an attempt to stop
Onchocerciasis from being a global health problem. With joint effort of World Health Organization, World
Bank, the United Nations Development Program, and the UN Food and Agriculture Organization, they
could successfully terminate River Blindness in some countries with continuous monitoring on specific
regions. Additionally, a resolution was submitted by Pan American Health Organization and World Health
Organization in 2008 on the issues of eliminating Onchocerciasis in the Americas. The resolution mainly
focused on the collaborative work within in the endemic countries, implementation of the WHO criteria/
policies and periodic provision of report on the progress of the implementation. However, such effort was
not enough to eradicate River Blindness completely since there are more people still suffering from
tropical disease in Sub-Saharan Africa.
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Concordia International School Shanghai Model United Nations ◆ Seventh Annual Session
Possible Solutions
Unfortunately, the issue of River Blindness has not been recognized in many nations, since such
diseases are subjected to specific tropical areas. Therefore, raising public awareness and educating
people with health issues would be the most fundamental solutions to the problem. In addition, more
provision and creation of vaccine would the ultimate way to stop the spread of River Blindness in
endemic areas. Moreover, encouraging member states to create more public-private partnerships would
have a big impact on global. On top of that, member states could work together to improve the supply
route to Africa to make treatments more accessible and available to the people in Africa or any other
endemic areas. Finally, the United Nations could collaborate with other countries and NGOs to lessen
the spread of ocular disease through various law enforcement interventions. For example, Vision 2020,
which is a joint program of the International Agency for the Prevention of Blindness (IAPB) and the World
Health Organization (WHO) with professional associations and eye care institutions, is a global lead for
the elimination of “avoidable blindness”. Vision 2020 provides technical support to countries for
prevention of blindness activities in worldwide.
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Concordia International School Shanghai Model United Nations ◆ Seventh Annual Session
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