Despite the signing of political agreements for peace and reconciliation between the rebels and the state from 2012 to 2019, the promulgation of a new constitution in 2023 following a referendum, and the establishment of a democratically elected regime in 2016, CAR is experiencing a fragile security and economic situation. The numerous political and community crises that have plagued the country for more than a decade have accentuated the lack of social cohesion and concentration of political power, as well as social and regional disparities. Since the outbreak of the conflict in Sudan in April 2023, CAR has also been faced with significant migratory flows along its borders, which could lead to a major humanitarian and security crisis.
In this context, meeting the growing needs of the population, guaranteeing good living conditions, and equitable access to quality healthcare has become very complicated.
The Fight Against Trachoma in CAR
Trachoma is the leading cause of blindness in French-speaking Africa. The Central African Republic is one of the priority countries in the global trachoma elimination program.
To tackle the public health problem represented by trachoma, the Central African Republic’s Ministry of Public Health has set up a technical structure within the Department for the Control of Neglected Tropical Diseases (MTN): The National Trachoma Control Program (PNLT). Activities to combat trachoma began in the late 2000s, with support from the OPC and other international NGOs, focusing on the training of surgeons specializing in trichiasis, the distribution of ophthalmic ointment, and the equipping of secondary health centers.
OPC’s Role in the Fight Against Trachoma in CAR
As part of this program, the Organization for the Prevention of Blindness (OPC) has partnered with THE END FUND since 2016 to support the Ministry in developing and implementing trachoma eradication projects in endemic areas nationwide.
As we explained in our November 2023 blog, the fight against NTDs begins with the generosity of pharmaceutical giants who donate antibiotics, which are then transported to the most remote villages. The OPC is a last-mile player in the antibiotic journey, which Moumine Yaro, supply chain specialist at ITI, explained in his interview with the OPC: “Organizations, such as the OPC, play a crucial role in providing technical and financial support to countries for the final stage of getting these antibiotics to the underserved communities that need them most.” (trans.).
Recent Developments in the Project
In 2023 were scheduled:
- A new wave of massive antibiotic distributions against trachoma in five health districts of the Ouham Pendé and Nana Mambere regions, targeting a total of over 980,000 children aged 5 to 14 with a geographical coverage target of 100% – these will finally take place during the 1st quarter of 2024 due to delays in the availability of medicines worldwide.
- A wave of impact surveys to measure the decline in trachoma prevalence following several years of drug distributions in the regions of Mambere-Kaddein, Sangha Mbaere and Kemo, Ouaka, and Ombella Mpoko, targeting a total of around 1.7 million people. Detailed results are still being analyzed, but we can already say that in most of the areas concerned, the prevalence rate seems to have fallen below the 5% threshold of the population, in line with objectives. In Ombella Mpoko, however, the prevalence rate is still above 5%, making it necessary to plan and budget for a new distribution in 2024.
The management of storage facilities and the safe transport of medicines represent major challenges in the fight against NTDs. On this subject, we had the opportunity to interview Moumine Yaro, supply chain specialist at the International Trachoma Initiative (ITI). He explained in greater detail what these challenges might be, and what steps are being taken to meet them.
He explained in greater detail what these challenges might be, and what steps are being taken to meet them.
“When it comes to medicines, safety and efficacy are paramount. (…) The process of storing, transporting and distributing medicines over the last mile is a challenge. (…) So, before countries receive donations, we carry out an integration process, meetings with stakeholders, and assessments to ensure that countries are ready to receive, store, transport, and distribute azithromycin (the molecule used in antibiotics to treat trachoma). (…) However, there have been cases where donated medicines have been stolen due to a lack of adequate security measures. In this case, after investigation, recommendations were made to improve the efficiency of the system. Another case involved medicines left over after a mass distribution of antibiotics, underlining the need for physical counts and reverse logistics planning.”
(trans.).
As Moumine Yaro explains, these challenges underline “the complexity of the process and the importance of collaboration and capacity building to ensure safe and effective distribution of medicines to those who need them.”
The OPC helps French-speaking African countries such as CAR to comply with the standards set by international institutions for the storage, transport, and distribution of antibiotics. Last November, we attended the national review of the CAR Ministry of Health’s program to combat NTDs and helped select and finance a new storage facility belonging to the NGO Première urgence.
Going the Extra Mile
In line with our commitment to leave no one behind, we intend to continue expanding our geographical coverage in the fight against trachoma in CAR.
In 2024, we intend to carry out epidemiological surveys in more health districts, particularly border districts where trachoma remains persistent or on the increase despite the distribution of medication.
Above all, we will be carrying out baseline surveys in the Nana-Gribizi and Bamingui-Bangoran regions, which insecurity has hitherto made inaccessible, to gain an overview of the trachoma prevalence rate and anticipate needs in terms of therapeutic coverage.
To help us continue our activities, please visit our donations page.
