| MDG 1: Eradicate extreme poverty and hunger |
Agricultural production losses due to migration from fertile lands [8,18] |
Vector control programs allow 25 million hectares to be reclaimed, enough food to feed over 18 million [8,13] |
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Decreased worker productivity due to severe visual impairment and associated pain and fatigue [13,19] |
Treatment with ivermectin reduces morbidities; [8] continuation of productive work [23]; OCP found to have Economic Rate of Return (ERR) of 20% per year; APOC ERR of 17% a year [8,19] |
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Affected individuals spent more time and money seeking healthcare; medical poverty trap [18,19,24] |
Treatment with ivermectin reduces morbidities; [8] time and money can be redirected |
| MDG 2: Achieve universal primary education |
Children removed from school to care for affected relatives [19] |
Reduced prevalence of onchocerciasis in the community; students stay in school [23] |
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Severe itching and fatigue affect ability to concentrate and learn [18] |
Ivermectin relieves itching from onchocerciasis and reduces ectoparasitic skin infections and certain intestinal parasites; student’s ability to focus and learn improved [5,13,25] |
| MDG 3: Promote gender equality and empower women |
Stigma associated with disease prevents women from being married; impacts mental health [26–28] |
Reduced morbidities allow women to participate freely in community life [29] |
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Girls more likely to be removed from school to care for affected relatives [19] |
Reduced prevalence of onchocerciasis in the community; girls stay in school [19] |
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Recruitment of Community-Directed Distributors (CDDs); women empowered to effect change within the community |
| MDG 4: Reduce child mortality |
(No known impact) |
Reduced morbidities allow women to provide prolonged breastfeeding protection to children [30] |
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Reduced prevalence of onchocerciasis in the community; children under the age of five less likely to become infected, improving development outcomes (helminth infection associated with impaired immune response) [31–33] |
| MDG 5: Reduce maternal mortality |
(No known impact) |
CDDs provide health education, including family planning [34] |
| MDG 6: Combat HIV/AIDS, malaria, and other diseases |
Onchocerciasis as a disease; second leading infectious cause of blindness in the world; morbidities include OSD, hanging groin, weight loss, musculoskeletal pain, insomnia and fatigue [13,18,19] |
Community-Directed Treatment with Ivermectin (CDTI) and vector control strategies; reduced prevalence of onchocerciasis in the community |
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Helminth infections impairs immune response and ability to serocovert after vaccination; co-infection with NTDs and “big three” may worsen outcomes for patients [5,9,13,32,35] |
Ivermectin reduces helminth burden [36,37] |
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CDTI system facilitates integration with other health programs; improved coverage and uptake of services; cost savings [34,35,38–41] |
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Strengthens health systems through operational research, training of CDDs and health workers and expanded distribution lines [5,21,25,34,42,43] |
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Treatment with ivermectin confers secondary benefits; effective against certain intestinal parasites and ectoparasitic skin infections [5,13,25] |
| MDG 7: Ensuring environmental sustainability |
(No known impact) |
Vector control areas make use of environmentally safe larvicides; MDG is not impeded |
| MDG 8: Develop a global partnership for development |
(No known impact) |
Increased access to the drug, ivermectin, through drug donation by Merck [24,43] |
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MDP is one of the largest public-private partnerships ever created; first of its kind and paved the way for similar programs. [25,34] |
