Carter Center Drug Delivery Integration - Multiple Disease Intervention

The Carter Center has pioneered the integration of multiple disease interventions in some of the world's poorest communities - building health care infrastructure where it didn't exist before as well as saving time and program costs.

In the world's most impoverished and isolated communities, many people suffer from multiple preventable diseases simultaneously. For this reason, interventions that help address more than one illness can make a significant impact on a person's quality of life.

For example, Mectizan®, medicine for the debilitating disease river blindness, when combined with the drug albendazole, also can be used to help treat the disfiguring infection lymphatic filariasis. And bed nets can prevent transmission of both malaria and lymphatic filariasis.

Recognizing that a permanent health care delivery infrastructure is key to lifting the high disease burden of many villages, The Carter Center actively looks for opportunities to integrate its disease prevention efforts into one effective delivery system. Community health care networks strengthened or created as part of the campaign to eradicate Guinea worm disease now can be used to prevent other diseases.

The Carter Center, for example, pioneered the concept of combining treatments for lymphatic filariasis, river blindness, and schistosomiasis in Nigeria to help state ministry of health programs reach communities more efficiently, an approach now endorsed by the World Health Organization. Read Integrated Drug Treatment Saves Time, Money in Nigeria.

In Ethiopia, the Center's malaria control efforts not only work in coordination with the national malaria control program but also with Ethiopian programs that fight trachoma and river blindness. Thanks to these village-based interventions, in place for more than 15 years in some locations, the Center is working to help make health care delivery as effective and efficient as possible.

Initial studies have shown that the integrated approach can save approximately 40 percent of program costs, such as gasoline and training expenses. It also saves time for community members, who appreciate spending less time on drug distribution days so they can return to their fields and cattle.

How Triple Treatment Works

The medicines Mectizan® (ivermectin), albendazole, and praziquantel in combinationtreat three parasitic diseases:

• River blindness is treated with an annual dose of Mectizan (donated by Merck & Co., Inc.).
• Lymphatic filariasis is treated with an annual dose of a combination of Mectizan and albendazole.
• Schistosomiasis is treated with an annual dose of praziquantel.

In addition to drug treatment, community members receive health education about the diseases and their causes.