Investing in Onchocerciasis Control: Financial Management of the African Programme for Onchocerciasis Control (APOC)

The African Programme for Onchocerciasis Control (APOC) has been described as one of the most successful public-private partnerships for health in Africa [1]. The Programme helps the governments of 20 onchocerciasis-endemic countries to develop sustainable delivery of ivermectin treatment in order to control and eliminate river blindness [2]. APOC is one of a very few programs that the WHO implements directly, in this case through the Regional Office for Africa (AFRO) and the APOC Secretariat established in Ouagadougou, Burkina Faso. As the Executing Agency of APOC, WHO is responsible for the development of procedures for implementing community-directed treatment with ivermectin (CDTi), approving funding to countries, maintaining surveillance, and ensuring monitoring and evaluation [3]. The Executing Agency supports governments directly in this role, aided by a group of 15 Non-Governmental Development Organizations (NGDOs), operating nationally, regionally, and globally [4]. The 15 NGDOs include Charitable Society for Social Welfare, Christoffel-Blindenmission (CBM), Helen Keller International (HKI), Light the World, Mectizan Donation Program (MDP), Mission to Save the Helpless (MITOSATH), Organisation pour la Prévention de la Cécité (OPC), Sightsavers International, United Front Against Riverblindness (UFAR), Interchurch Medical Assistance (IMA)World Health, Lions Clubs International Foundation, Malaria Consortium, Schistosomiasis Control Initiative, The Carter Center, and The United States Fund for UNICEF. The funding for national onchocerciasis control comes from the countries and civil society, with additional funding from APOC through contributions frommore than 30 development partners to a Trust Fund that theWorld Bank manages in its role as Fiscal Agent. Scheduled to close in 2015, the main governing body of APOC decided to set up a new programme for a ten-year period from 2016, actively seeking to eliminate river blindness from most of Africa by 2025 and, by strengthening the same health system that successfully delivered treatment for river blindness, seeking to also eliminate lymphatic filariasis and co-implement treatments for the five other major preventable neglected tropical diseases (NTDs) that can be addressed through mass drug administration. Plans are underway to transform APOC beyond 2015 and transition from a single-disease entity to an expanded regional NTD initiative [5]. This article is one of a series developed by the partnership of agencies, institutions, and individuals that make up APOC. This article is written from the perspective of the Fiscal Agent (the APOC Team at the World Bank) and should be read in conjunction with the corresponding articles in this series that examine the depth and diversity of the river blindness partnership,