The remarkable story of how a large public-private partnership
worked to control and defeat riverblindness-a scourge which had
devastated rural communities and impeded socioeconomic development
throughout much of Sub-Saharan Africa for generations.
Riverblindness (onchocerciasis)-a pervasive neglected disease,
transmitted by the blackfly, that causes horrific itching,
disfigurement, and loss of vision-is also known as "lion's stare"
in reference to the fixed, lifeless glare of the eyes blinded by
the disease. The disease has destroyed countless lives for
generations, particularly in Africa. Its effects are so devastating
that the areas where it is most common (large expanses of land
around rivers where the fly breeds) end up abandoned as villages
move farther and farther away to more arid environments in order to
escape the fly-biting, and hence the disease. The disease
devastates communities from multiple angles: a large portion of
each stricken community's population is disabled, often permanently
blind in the prime of life, placing a burden on the rest, and
communities' efforts to escape infection force them to move to
areas where farming is less productive. To defeat riverblindness
would not only release these communities from the heavy toll of the
disease, but would also open more fertile areas in Africa to be
inhabited, thus alleviating extreme poverty. These were the goals
of the World Bank, led by then-president Robert McNamara, when
launching a partnership to combat riverblindness more than
forty-five years ago. In this book, Bruce Benton tells the
remarkable story of that partnership's success. An authoritative
account of the launch and scale-up of the effort, the book covers
the transformation of the fight from a top-down high-tech operation
to a grassroots drug treatment program covering all of endemic
Africa. How, Benton asks, did the effort become such a unique
partnership of UN agencies, donors, NGOs, a major pharmaceutical
company, universities, African governments, and the stricken
communities themselves? Highlighting the importance of disease
control in alleviating absolute poverty and promoting development,
Benton examines the key developments, individuals, and notable
qualities of the partnership in realizing success. He also extracts
lessons from this particular story for addressing future challenges
through partnership. Drawing on Benton's twenty years of experience
managing the riverblindness program for the World Bank, along with
extensive research and interviews with 100+ players in the program,
Riverblindness in Africa is the first and only book of its kind.
The story of the battle has an epic scale, both in terms of
geography and the vast number of people and organizations involved.
It provides a template for a broad range of global health efforts
and is an excellent example of evolving, increasingly effective
approaches to disease control and elimination.
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