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Participants of the 31st MEC/AC
Whitehouse Station, New Jersey USA
28-30 October 2003
The 31st Meeting of the Mectizan Expert Committee/Albendazole Coordination
The 31st Meeting of the Mectizan Expert Committee/Albendazole Coordination (MEC/AC) took place from 28-30 October 2003 at the Merck & Co., Inc. headquarters in Whitehouse Station, New Jersey, USA. Several critical issues pertinent to onchocerciasis control worldwide and lymphatic filariasis (LF) elimination in Africa were addressed including integration and sustainability, the challenges faced in areas where Loa loa is co-endemic with one or both of these diseases, and when to stop mass treatment with Mectizan for onchocerciasis control in Africa.
Lymphatic Filariasis
Strategic considerations within the Program to Eliminate Lymphatic Filariasis (PELF) in Africa were presented by the national program managers of the PELFs in Burkina Faso, Ghana, and Uganda. All three programs reported very good progress with the mass drug administration (MDA) of Mectizan and albendazole achieving treatment coverages of 70-75% of the total population targeted. LF disability prevention programs have been initiated but are not yet as widespread as the MDA. The major challenge expressed by all three program managers was the financial constraint to upscaling their programs rapidly enough to achieve the elimination goal in a reasonable timeframe. More generally, they also highlighted the urgent need for funding in all countries that have initiated LF elimination programs, and in countries that wish to launch new programs. The meeting participants, concerned over the lack of external financial resources for LF elimination, recommended that mechanisms for mobilizing resources for LF elimination specifically in Africa must be urgently investigated. Resources are also needed to purchase immunochromatographic (ICT) cards to allow mapping to proceed. Consideration should also be given to the development of an alternative tool for the epidemiologic assessment of LF.
Integration and sustainability of disease control programs was another major theme of the meeting. Presentations on the progress being made to integrate the PELFs in Burkina Faso, Ghana, and Uganda into other disease control programs such as onchocerciasis control, schistosomiasis control, and Roll Back Malaria stimulated discussion on the topic. Participants concluded that integration is key to sustainability with the caveat that integration strategies must be tempered against the need for rapid upscaling and high coverage critical to the success of the PELFs. Current integration activities at the community and district levels were recognized as successful. Although there are some good examples of coordination at the national level, there is opportunity for more integration both at the national and international levels.
On the day before the MEC/AC meeting, a consultation was convened at
Merck's headquarters by WHO's Special Programme for Research and Training
in Tropical Diseases (TDR) to address the safety of administration of
ivermectin with albendzole for LF elimination in loiasis endemic areas.
After a review of available data, the consultation participants formulated
a research plan to address safety concerns, which is to be led by TDR
in collaboration with all interested parties. The plan and other conclusions
and recommendations made during the consultation were presented and
later endorsed by the MEC/AC.
