Multiplied many times over, the tiny bite of a black fly is powerful enough to topple the traditional social order in village after village in Africa and on other developing continents. The blindness eventually caused by the bite results in young adults, normally the caretakers of their parents, relying on their mothers and fathers to survive. Children whose parents lose their sight must drop out of school to support the family. The elderly who are blind, instead of serving as models of grace and dignity to the generations that follow, are led around by long sticks by children as young as three years old.

Onchocerciasis, or river blindness, has devastated river areas in Africa. More than 18 million people have the disease, which causes severe itching and rashes before blindness sets in. The bite of the fly unleashes worms inside the body. The worms lay eggs. An infected person may be plagued by as many 150 million first-stage larvae inside his body.

Through SightFirst, LCIF has helped to greatly reduce river blindness. Two years ago LCIF donated US$16 million and entered into a partnership with the Carter Center on a five-year initiative to control river blindness in Africa and Latin America. (About US$7 million of the grant was to combat trachoma, another frequent cause of blindness in developing nations.) In 2001, US$2.6 million was approved to control river blindness in Cameroon.  So far, 40 million treatments have been delivered in 12 nations.

The disease is controlled by annual doses of ivermectin (Mectizan®), donated by Merck & Co. Besides helping to establish a drug distribution program, Lions provide monitoring teams to ensure that those who are at risk are not infected and to control the disease in those already infected.

Africans fearful of becoming blind often abandon fertile lands near rivers. Thus another consequence of onchocerciasis is a severe drop in agricultural production in areas where resources already are few and income is low. Communities treated for river blindness have seen a doubling or tripling of economic production as people move back to fertile strips of land. The value of the treatments to family bonds, to the vibrancy of communities and to the human spirit, is, of course, incalculably high.