nce again I call you to take a break from the incessant worries and the pilling agonies. Let us look at something bright.

At a time when the devastation of AIDS continues to scare the world, a successful public health campaign against River Blindness rounded off in Africa offering hope of how HIV/AIDS may perhaps one day be brought under control. That is some good news if you review exactly how this happened: how Africans and several concerned interests- including a pharmaceutical company- in the international community pulled this up.

River blindness or oncoceriasis brought to many West African villages a damning scourge. Although less than 10% of the world's blind population have suffered it, it is most prevalent in sub-Saharan Africa where some 28 countries are affected. An overwhelming number of the infectious cases of the diseases are found in the region.

In one West African village populated by 61 people, 10 of them were blind because of this disease. The World Health Organisation estimates indicated that oncoceriasis afflicts 18 million people worldwide and a further 120 million, about the population of Nigeria, risk contracting it.

Much of the economic life of the victims were dislocated and their ability to work greatly reduced. The disease could take as much as thirty years to set in. In that period people couldn't farm the land effectively, and are often forced to relocate from fertile banks to where there is less fertile land. That had consequences for agricultural and economic productivity in a region where poverty, famine and want present serious living challenges.

At the peak of the disease in the 70s, about 250,000 square kilometers of productive river valley were abandoned, and that was translated to an economic loss of some $30 million per year. One of the most affected countries in West Africa, Burkina Faso had 400,000 people infected by the parasite in 1974 about the time the Oncoceriasis Control Programme started. In Senegal about 600 villages were affected

At the onset of the disease, victims feel a very devastating itching especially once the black fly, which spreads the worm that causes the disease, bites. The black fly is normally found near streams and rivers. (From where the disease got the name river blindness) And these are rivers along some of the most fertile banks especially in West Africa.

After the bite, a parasitic worm is transmitted into the body, which spreads all over causing terrible itching, muscle pains and weakness. When the worms at its adult stage eventually attacks the eyes, it leads to permanent blindness.

However recent claims by some German scientists say bacteria living inside the worms may be the cause of river blindness. In an edition of the journal Science last year, the researchers said their discovery also meant the disease could be treated with a common antibiotic. If forthcoming studies confirm this, that would itself be another fatal blow against the disease by preventing future infections.

Meanwhile, it was about 30 years ago that the United Nations first heard the horror stories of the victims, men, women and children going blind in western Africa. With scarce resources to do the battle, the Oncoceriasis Control Programme, OCP was born. And before long, success stories followed suit and that drew the attention of donor countries, governments and the World Bank.

Achieving the level of success now identified with the campaign against river blindness did not come by isolated dints of hard work: it took a coalition of efforts and groups. The coalition that worked on river blindness drew from private companies like the Merck, a pharmaceutical firm: which provided the drugs free of charge, several UN agencies, about 26 donors, 30 African governments, rural communities and about 40 non-governmental organisations, NGOs.

One of the NGOs is Sight Savers International that monitored the drug distribution programmes and provided training in West Africa for the programme. SSI is a part of the 26-member organisation including the WHO that formed vision 2020. Besides, SSI had been on the task for some 50 years although the drugs that treated river blindness came less than 30 years ago. So far, SSI's programme manager Catherine Cross says the agency alone delivered protection from river blindness to more than 5.5 million people worldwide.

One crucial element used by SSI and other agencies in the battle against this disease was the active involvement of the local people. And this may be instructive in waging the war against HIV/AIDS. For instance SSI trained local people and passed on the skills to teach and rehabilitate the blind. They trained primary eye health care workers, ophthalmic paramedics and ophthalmologists in the use of new technology and techniques. In the event, local people and governments ran a major part of the distribution programmes.

Perhaps this model may illuminate a thing or two in the current battle against HIV/AIDS. Franks Richards, a public health physician with the Carter Center surely hopes so. "The lesson for the international community is that you have to involve the national authorities and local communities." I cannot agree more with Richards.

But he has more to say: "there is a lesson for the donors too," crediting Merck which provided free drugs for the campaign. He then linked it up with the HIV/AIDS battle stressing that "You look at HIV/AIDS-people can't buy drugs." Currently UN officials say although about 70 international businesses are part of the global fight against HIV/AIDS, their contributions still account for much less what is needed in Africa alone

The campaign ended officially last December and at the last count 600,000 cases of blindness had been prevented, according to the World Health Organisation. Besides 18 million villagers were freed of the threat of river blindness and thousands of farmers are now moving to reclaim 25 million hectares of fertile river land, which is sufficient arable land to feed 17 million people, according to WHO. In Burkina Faso, about 50 kilometers of rivers and streams were eventually treated with insecticides that eliminated the flies.

WHO Director-General Gro Harlem Brundtland, noted that the "accomplishments of this programme inspire all of us in public health to dream big dreams because we can reach 'impossible' goals and lighten the burden of millions of the world's poorest people." Richards also concurred saying the OCP is a model for community empowerment, and is the needed model "for any kind of health delivery system in developing countries."

From Africa, Ghana's deputy Health Minister Moses Danyaba also commended the OCP as the "example for other disease elimination programmes around the world." He added that the OCP is one of WHO's great success stories in the history of the elimination of disease.

It was in 1988 that Merck, an international pharmaceutical firm, provided what is the major weapon in the fight against river blindness. In that year Merck offered the Mectizan to fight the disease for free. More than 60,000 rural communities and over 100,000 distributors in sub-Saharan Africa were involved in managing and distributing the drug. Hundreds of volunteers were involved and later the communities themselves took over the distribution of the drug.

By 2001 Merck said it had donated 100-200 million tablets of Mectizan at a cost of $1.50 each. And last year September when Merck distributed its 250 millionth free dose of the drug, it went to Celestina Hiza, a 60-year-old Tanzanian grandmother in the village of Bombani where there was a huge event to mark the occasion. The Tanzanian Vice President and 2,000 villagers attended the event.

Hiza had suffered the uncontrollable itching and developed the skin lesions that are signs of the midway growth of the parasite in the body. The drug came in time for her, as the disease was yet to reach its mature stage where irreversible blindness could occur. She told the British Broadcasting Corporation that since she had been taking the drug the itching stopped. "This has been a relief to me. I am now able to go back to farming my land and looking after my family."

Merck's Chief Executive Raymond Gilmartin was also at the Bombani village event, where he said the company is "committed to continuing the supply of Mectizan free of charge to whoever needs it wherever they are in the world." Doctors say if taken over 15 years, the life of the adult parasite, Mectizan is as good as 100% effective. There had also been some hope that perhaps antibiotics might be the cheapest and safest way of wiping out the disease. Some group of scientists from United Kingdom, Cameroon and Germany under the auspices of the School of Tropical Medicine, University of Liverpool said in 2000 that their experiments show that by using antibiotics to kill the bacteria living on the parasite that can also kill the parasite itself.

Paula Seager of Sight Savers International then noted that such an antibiotics "is going to be a great news if we can speed up the treatment." It was hoped then that by now trials based on that experiment would be holding in Ghana

At least now we know one thing: we can fight some of these diseases in our continent to a standstill. Our people don't have to become sitting ducks, and if all concerned tried hard enough, may be we can at the very least arrest AIDS and stop the impending doomsday threat.

• Another version of this article is also running in the current edition of AFRICAN RECOVERY, a UN publication.