Many Africans were helped to preserve their sight and this is why that mattered

If you ever visit the beautiful building of the World Health Organisation in Geneva, you will notice an unusual sculpture in front of it. A boy and an adult man are walking together, the boy in front of the adult. Both are holding on to a wooden stick — the boy at the front, the adult man at the back. Okay, you’ll think — that is quite cute, but what does it symbolize?

Perhaps, the need for people to invest in their children and their education? Or, how at some point the adults need to step aside and let the younger ones go forward? Or, is the message of the sculpture that the world would be a much better place if, instead of adults, it was led by children, with their energy, their enthusiasm, and their kindness?

All of these seem like satisfactory possible explanations of the symbolism of this interesting sculpture. Then, you will quickly forget about the sculpture and enter the building, where old friends would be waiting for you with new hilarious stories from rarely visited, distant countries. You will meet them at the restaurant of the World Health Organisation, where a delicious and very affordable multicultural food is being served.

However, if you then visit the World Bank, and then a whole host of other international organizations, from the United Nations to the ministries of various countries, you will begin to come across this very same sculpture, always prominent and placed in the most obvious place. At that point you will inevitably start to wonder if there is, perhaps, something more to that sculpture? Why is it so ubiquitous?

If you then take a closer look at it, you will realize that, unlike the child, the adult man looks far in front instead of watching where he is going. Is he meant to represent a clairvoyant, a visionary? Then, you look at his eyes a little better. Suddenly, everything becomes clear. The boy is his son. The boy is also his guide. And the boy’s father is blind.

Near the great rivers of West and Central Africa, great black flies multiply, in which the parasitic worm of the Latin name Onchocerca volvulus has taken root. Through a significant number of bites from this fly, the parasite is introduced into the human body. It causes terrible itching, the appearance of lumps under the skin and on the body, and eventually blindness.

For hundreds, and perhaps thousands of years, tens of millions of West and Central Africans were infected by the time they reached adulthood, causing many to go blind over time. Because of this, they would live short lives in extreme misery. Their children would take care of them and lead them around by holding a stick — just as is depicted by the sculpture. As the disease is concentrated in areas where large black flies of the Simulium type live, i.e. around large rivers, the term “river blindness” has become common when referencing this particular parasitosis.

This disease is endemic in thirty African countries, where the worm has infected about 37 million people and permanently blinded about 300,000 of them. However, anyone familiar with international health issues will immediately conclude that — compared to a large number of other, much larger, and even more terrible and deadly problems — river blindness cannot be considered as that important globally. Why, then, is this sculpture so prominently displayed in so many places?

In the early 1970s, Western laboratories managed to develop a number of drugs, mostly antibiotics, vaccines, and treatments against parasites, that could wipe out many of the horrendous diseases from the face of the Earth, especially those which occur among the poorest people. But in order to achieve any real success, these innovations of Western biomedicine needed to penetrate extremely underprivileged areas, with hardly any educated or literate people living there.

The countless sorcerers, druids, and shamans who did live there wouldn’t permit access to any westerners and their chemicals. Extremely dangerous, and often deadly infectious diseases, were instead treated with their various spells and herbs. The biggest challenge, therefore, was to gain the trust of the uneducated population and convince them of the power of medicine based on scientific research.

Then, in the World Bank’s development program, a decision was made that the trust of so many neglected people would be easiest to gain if blindness was eradicated. Of all the possible diseases — many of which are much worse, more frequent, and more dangerous — river blindness was chosen because its prevention by drugs from Western countries would be considered a miracle among the local population. Scientists William C. Campbell and Satoshi Ōmura developed the so-called avermectins, a family of chemical compounds that were a precursor to ivermectin, a drug for onchocerciasis, i.e. river blindness.

The massive “Onchocerciasis Control Programme” (OCP) was launched back in 1974 in collaboration with the World Bank, several international and United Nations organizations, and eleven African governments. At its peak, it covered 30 million people. By combining insecticides and larvicides, which killed the flies, and treatment with ivermectin, by the year 2002, the disease was eliminated as a health problem in these eleven countries. But more importantly, its elimination has built confidence in Western medicine in neglected areas of Africa and has become a precursor to a number of other programs that have simultaneously eliminated much more prevalent infectious diseases and saved hundreds of millions of lives. In 2015, William C. Campbell and Satoshi Ōmura received the Nobel Prize in Physiology or Medicine for their work on avermectins.

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