I ver mectin!
If you are, like I am, blessed/lucky enough to live in a place where the thought of contracting river blindness, malaria, and even head lice, are things that you think about…. ummmmm…like pretty much never…take a moment and be thankful about that.
With the eradication of disease comes prosperity. Did you know we had malaria (a mosquito borne illness) here in the United States in the South until it was eliminated in 1947? A million people around the world die from malaria each year.
Did you know that we had major outbreaks of Yellow Fever (also a mosquito borne illness) here in the States until 1905? Due to the highly infectious nature of this illness (despite attempts at reaching 90% vaccination rates in endemic regions around the world) there are still 30,000 deaths (and 500,000 cases of it) a year.
Did you know that the last major outbreak of cholera (spread through contaminated food and water) to hit the United States occurred in 1911? Since cholera was introduced to Haiti by an aid worker after the massive earthquake of 2010, there have been about 350,000 cases of cholera and over 14,000 deaths.
How about diphtheria? Diphtheria is a respiratory illness that has been largely eradicated in the United States (only a rare few cases in the past decade). Did you know that the tetanus shot you get for skin injuries is usually a Td? You probably know the “T” stands for tetanus, but did you know that the “d” stands for diphtheria? Since the diphtheria vaccine was introduced in 1920 and high levels of vaccination rates were obtained, diphtheria for U.S. citizens became a thing of the past. Not so for the people of Russia in the 1990′s and more recently the people of Haiti and the Dominican Republic where large epidemics have occured. And speaking of tetanus, there are hundreds of thousands of deaths annually worldwide from tetanus. Only 50-100 of those many deaths occur in the United States. Those cases are nearly always in unvaccinated/undervaccinated individuals.
These diseases are shackles to poor and developing nations and is one of the causes of keeping them impoverished, uneducated, and with seriously limited opportunities .
Because our medical system and our society in general is not constantly plagued by these expensive (both from the medical standpoint as well as the economic standpoint) diseases, we are free to grow and expand our economy and to put finances towards treating things that in developing nations are often not addressed at ALL! Like cancer, depression, osteoporosis, heart disease, kidney disease, diabetes, etc (etcetcetcetcetc.) There are diseases of aging in our country that are not even SEEN in other countries due to short life expectancy. For 2011 the life expectancy for a Swazi is projected to be 31.88 years. No, that is not a typo. This is in large part due to a completely preventable and most often untreated, disease, HIV.
People in the United States actually have access to a drug called Latisse…this drug treats the condition of “inadequate, or not enough lashes”. That’s eyelashes, people. We have a drug for growing EYELASHES. Now, part of me is absolutely appalled by such an apparent lack of perspective by the American public. Another part of me is thrilled that we have the time, resources, and overall health to be able to treat such a thing as a problem! I don’t think I’ll ever meet someone from Swaziland, or Zambia, or Ethiopia (etc.) who ever THINKS about having inadequate lashes. But I digress. Back to real diseases…
There’s all manner of diarrheal illness, and pneumonias, and African Sleeping Sickness, and polio, and meningococcal meningitis, and bubonic plague, and tuberculosis, and hepatitis, and typhoid, and ebola, and tetanus, and lymphatic filariasis andandandandandand. I could go on! Many of these diseases fully, or almost fully, preventable through education, simple medications, and vaccinations.
On a personal level, I have friends who suffer from chronic malaria. People with chronic malaria become symptomatic a few times a year. When sick they cannot work, and it drains their already meager finances when medications and sometimes hospitalization are needed. It is hard to get ahead in life when one single disease has such negative effects. Imagine facing ALL of these diseases (and so many more) on a regular basis? It’s nearly unthinkable for us in developed countries.
So, you might be asking, what does all of this have to do with ivermectin??
And what do river blindness, malaria, and head lice have to do with each other?
Well, just one of the feared diseases of West and Central Africa is river blindness. River blindness is the result of a chronic parasitic multi-system inflammatory disease caused by a worm that inhabits fast flowing rivers. Black flies breed in these rivers and are the vector for this worm. As rivers are often the primary water source in this part of the world, thus the potential for becoming infected. Around 35 million people are currently infected with river blindness, and roughly 300,000 of them are already irreversibly blind. Approximately 140 million people in Africa are at risk of infection. Being blind in most parts of Africa is nothing like being blind in the developed world. As so many of those at risk for river blindness are from agricultural societies, being blind (or even visually impaired) can leave a person incapable of farming and providing for his/her family. It’s hard enough to get any sort of education in these countries…imagine trying to get an education in most of Africa if you are blind!
Ivermectin is one of a family of drugs called “anthelmintics or antihelminthics”. They treat worm infestations in people. Worms are an extremely common finding in many populations in Africa (and around the world). Among its other uses, ivermectin can be used off label to treat lice and scabies. Taking a single dose provides 24/7 insecticidal protection. The lice are killed when they bite and consume the now insecticidal blood of its victim. Invermectin is also used in Africa to treat the worm infestation that leads to river blindness and filariasis. In 2008 and 2009, a team of researchers to Senegal found that in communities where ivermectin was being used, the numbers of malaria carrying mosquitoes dropped off dramatically two weeks following treatment! In similar communities where ivermectin was not being used, numbers of these mosquitoes had doubled in the same time frame. To me, this is a fascinatingly unexpected and positive outcome to the use of ivermectin!!!! To treat river blindness, an individual takes a single dose of the drug annually for 10-15 years.
I have this scenario in my head where communities would be tested and treated en masse for malaria infection, given insecticide treated mosquito nets, and maybe vector spraying would be done to eliminate mosquitoes. To me, it seems, that with an aggressive multi-directional assault like this on malaria, malaria could be DRAMATICALLY reduced and maybe even eradicated. With the addition of ivermectin into the mix, it might be an even more effective war. Imagine…attacking malaria, river blindness, lymphatic filariasis, scabies, lice and other worm infestations all at the same time!
If “the west” could coordinate all of its currently disparate efforts and wage a full out assault on malaria, I think we could see a huge victory. It would take massive coordination of services and some pretty specific timing, but if one generation of mosquitoes and malaria cycles could be disrupted, imagine the effect it could have on people who live with these plagues on a regular basis.
Why can’t we do this??? Is it possible? How much DDT would be needed to spray all of the homes in affected areas of Africa? How many mosquito nets would be needed? How many doses of ivermectin would be required? And how many people on the ground would be needed to make such an assault possible? How many cycles of treatment and spraying would be needed? And perhaps the biggest quetion is would the governments of these countries even be willing to allow such a program??????
We have put men on the moon. We have built impossible dams and bridges. We built the Panama Canal. We have eradicated smallpox. Computer power that used to occupy a room now occupies nearly microscopic space. Why can we not do something spectacular like free the world from the prison of malaria?
There are organizations doing great things to combat malaria and bring hope to a sick and dying world. There are a multitude of NGOs, plus faith- and government-based operations involved in the fight. What if they all worked together, in concert to pool resources, work towards a common goal, reduce duplicated efforts, reduced waste, and increased efficiency? What an amazing thing that would be!
Is it just a dream?
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