In the battle to fight a major cause of preventable blindness, the Carter Center’s River Blindness Program and Lions Clubs International Foundation are celebrating the delivery of more than 50 million Mectizan treatments in 11 countries in Africa and the Americas since 1996.

Around the world, river blindness has an enormous economic impact, preventing people from working, harvesting crops, receiving an education or caring for children. Fertile banks of swiftly flowing rivers teem with black flies whose multiple bites insert a microscopic parasitic worm into victims. The worm’s offspring swarm through the body, especially the skin and eyes, eventually causing river blindness, also known as onchocerciasis.

River blindness has infected 18 million people. Half a million are visually impaired and another 270,000 are irreversibly blind because of the disease, according to the World Health Organization. The estimated economic burden of global blindness is more than $25 billion annually.

"Fighting blinding diseases has profound significance, not just for me as an interested observer, but for the child who will never go blind and for his parents and grandparents, who now have hope their lives can improve," said former President Jimmy Carter, an active Lions Clubs member. "When people receive Mectizan, it is often the only time they experience such hope. The distribution of more than 50 million treatments is an incredible achievement."

Health education and the distribution of Mectizan treatments not only have prevented millions from contracting river blindness but also have saved multitudes of communities from near extinction. Villagers who once abandoned fertile land near rivers to avoid being bitten have returned to their land and revived their local economy.

In coffee-producing countries like Guatemala, for example, onchocerciasis may be considered an occupational hazard; the fast-flowing streams where black flies breed often are located near where workers harvest coffee. In parts of Ethiopia, almost everyone in an endemic village will harbor the disease, and it is estimated that a typical child is bitten more than 20,000 times each year.

But health education and treatment have transformed individual lives. Semanza Erisa, 54, lived in the bush, an outcast from his Ugandan village after being infected. His skin, he said, was like that of a hippopotamus; the severe itching he experienced forced him to rub against trees in search of relief. But six years of treatment defeated the disease and saved him from losing his sight. Today, Erisa works as a handyman and supports a wife and child in his home in the village.

"Lions have been ‘Knights of the Blind’ for nearly 80 years," said Kay Fukushima, chairperson of Lions Clubs International Foundation. "We are overjoyed that, in cooperation with the Carter Center, we’ve been able to save the sight of millions of people."

The foundation has provided the Carter Center with $24.1 million in grants since 1996 to prevent blindness in Africa and the Americas.

Taking Mectizan is simple enough, but the key challenges are reinforcing distribution networks, educating villagers about the efficacy and safety of the medication, and enlisting the support of community leaders.

"Local Lions, in conjunction with the Carter Center and ministries of health, hold river blindness educational workshops for villagers, community leaders and policy makers," said Moses Katabarwa, Carter Center epidemiologist for the River Blind-ness Program and a Lion. "Lions on the ground are extremely active and passionate. They see the difference they are making in the fight against blindness."

A Carter Center conference on the eradicability of onchocerciasis in January 2002 concluded that river blindness cannot be eradicated globally using current tools and technology because of conditions specific to Africa. However, regional eradication of the disease in the Americas is possible if drug treatment can be given two times a year to at least 85 percent of those who need it.

In Africa, where 99 percent of cases occur, annual administration of Mectizan indefinitely will keep onchocerciasis controlled so that it no longer poses a public health problem. In 1987, Merck & Co. announced its decision to donate Mectizan in whatever amounts are needed to prevent onchocerciasis for as long as necessary.