“Years ago, no one came here to give us medicine. It is too rural,” says Pitasia Gonzales, 78. Because no government agency, no NGO, traveled the steep, rutted roads to Pitasia’s village near the Mexican border with Guatemala, river blindness (onchocerciasis) was a constant threat. Pitasia knows this well. She is one of the few remaining people in Latin America to have lost their sight to that painful, parasitic disease which once blinded millions.

Today, things are different. Twice each year workers come to Barrio Brasil in Chiapas, Mexico, to distribute Mectizan, an anti-parasitic drug that keeps children and adults safe for up to one year. The medicine, donated by Merck & Co., kills the larvae of the black fly that causes the disease.

They come because Lions made it possible. Through SightFirst, the Lions Clubs International Foundation has invested more than US$20 million in the worldwide fight against river blindness. Combating river blindness in Latin America is just one part of Lions’ SightFirst program, which has granted US$185 million to fund 758 projects in 89 countries – but it has achieved some of the most dramatic results. World health experts can now predict that river blindness can be totally eliminated in the Americas by the end of the decade.

“What a wonderful day that will be,” says International President Dr. Ashok Mehta. The accomplishment, on par with the great public health successes of the late 20th Century, “is clear evidence of the power in Lions’ hands when we work together toward a common goal,” emphasizes President Mehta.

But the work is not yet done, President Mehta cautions, and Lion Dr. Florencio Cabrera, SightFirst Advisor in Mexico agrees. “The worst that can happen is to interrupt all the programs we have already been doing with a lot of success. We have to keep going – keep going to our goal,” he said. Maintenance treatments of target populations will also be needed to prevent the re-emergence of the disease even after no new cases are reported.

Since 2003, six countries in Latin America have succeeded in treating 85 percent of the targeted population, the level needed to achieve elimination by the end of the decade. “Twice annual doses of Mectizan will not only improve the health of those infected, but also quickly halt transmission by reducing the presence of river blindness larvae,” according to a report of the Conference on the Eradicability of Onchocerciasis, a meeting of 64 public health and vision experts convened by The Carter Center in 2002.

The people of Barrio Brasil are counting on it. There has been a sea-change in this tiny village and others like it across Latin America. “People are very sensitive to the need to come get the medicine,” said Dr. Cabrera. In Barrio Brasil, there is a keen awareness of the problem. One of the first things a visitor sees when entering the village is a mural reminding children of the need to take their medicine. There is good cooperation with the program and gratitude for all that is done, according to Dr. Cabrera.

“I can only say thank you to the people who now come to help us and go house to house to give us medicine,” said Pitasia Gonzales. She is relieved that her grandchildren receive Mectizan so that they grow to be “strong and healthy.”

Dr. Cabrera is proud that his country will be the first to be free of river blindness. “We hope to not have any more patients after 2007,” he said, but points out that the final assault will be more difficult in other places. “There are far distances to travel in Venezuela and Brazil,” he says.
In particular, maintaining the required treatment regimen with the nomadic Yanomami people who live deep in the Amazon basin will be difficult. All the more reason that continued effort and funding is needed to reach the goal of an entire hemisphere free of river blindness, Dr. Cabrera said.

“LCIF has been helping with money from the first Campaign SightFirst. We are now all working to receive donations for Campaign SightFirst II because that money is nearly gone. All Lions have to be involved. It is very important and very necessary,” he said. SightFirst is also making inroads against river blindness in Africa, the other area of the world where the most cases exist. One of the largest grants ever made by LCIF – US$16 million in 1999 – was to establish the Lions-Carter Center SightFirst initiative, which targets river blindness in Nigeria, Uganda and Ethiopia. SightFirst has also been battling river blindness in Cameroon since 2001, and since 2002, has partnered with the Organization for the Prevention of Blindness to combat the disease in Guinea and Senegal. In 2003 alone, Lions supported more than 10 million Mectizan treatments on the continent. As in all SightFirst projects, a large part of the effort in Africa has been training local health workers and empowering communities to sustain long-term blindness prevention programs.

That battle will require continued attention and funding through Campaign SightFirst II as well. Current social and political conditions in Africa make it unrealistic to target river blindness for continental elimination at this time. However, world health experts say that it is possible to control the spread and advancement of the disease within 10 years.

“Regional eradication is possible in the Americas, Yemen and some sites in Africa,” concluded the Conference on the Eradicability of Onchocerciasis in 2002. “In the remaining endemic areas, continued annual distribution of Mectizan will keep onchocerciasis controlled to a point where it is no longer a public-health problem, nor a constraint to economic development,” it said.

“Lions intend to continue to lead in the regional eradication effort,” said Past International President Dr. Tae-Sup Lee, chairperson of Campaign SightFirst II. “Reaching Campaign SightFirst II fundraising goals will enable Lions to provide yearly Mectizan treatments for as many as 15 million people. The fundraising goals of Campaign SightFirst II are challenging, but that pales in comparison with what can be accomplished with these funds,” explained Past International President Lee. “If we can eliminate river blindness in Latin America in five years and control it in Africa in 10, think about what we can do when we focus our attention on the problems of childhood blindness, low-vision services and education for the blind,” he said.

In these new areas, Campaign SightFirst II will enable the SightFirst program to:

• Expand successful programs that screen and provide eyeglasses to children
• Create new eyeglass distribution clinics
• Train hundreds of low-vision specialists
• Create vision clinics to serve populations of 10 to 20 million people
• Establish centers of excellence in pediatric eye care
• Fund especially promising research initiatives at Lions Eye Centers

“It seems like a tall order, but consider what we thought we could do when we launched SightFirst in 1990. Our accomplishments have far outpaced our expectations,” said Past International President Lee. "What new accomplishments will be possible with US$150 million raised through Campaign SightFirst II that we can imagine only dimly today? Will it be a great advance in research? Will a Lions Eye Research Center play a crucial role in curbing diabetic retinopathy?”

Lions do not know where the greatest accomplishments will occur. But SightFirst’s history of extraordinary success shows that Lions are doing what is necessary to make those accomplishments possible. “We know what to do and we know how to do it,” said Past International President Lee. “We have a plan with an established track record of success. We Lions have already changed the world, and even greater achievements are within our grasp.”