manufacturers in a way that ensures thermo-stability in hot-weather environments and under poor storage conditions.


River Blindness—Onchocerciasis. USAID joined other donors and national governments to establish the Onchocerciasis Control Program that began in 1974. In contributing $75 million to the Onchocerciasis Trust Fund, USAID became its largest donor. In 1974, as many as 10 percent of the people in severely affected regions were blind, and 30 percent had severe visual handicaps. Farmers had begun leaving their fields amid a growing realization that something associated with the rivers was causing blindness. The program set out to eliminate the disease and to ensure that West African countries could continue disease monitoring after its elimination; these two goals have largely been achieved. Initially the control program focused on spraying of larvicide to kill black flies, but in 1988 it began to distribute the anti-parasite drug ivermectin, which Merck offered free of charge. WHO marked the end of the Onchocerciasis Control Program in West Africa in 2002. According to WHO, 600,000 cases of the disease have been prevented under the program, allowing 18 million people to grow up free of the threat of river blindness. Thousands of farmers are starting to reclaim 25 million hectares of fertile river land—enough to feed 17 million people—in areas where they once feared being struck blind.


Safe Water System. Working with the Centers for Disease Control and Prevention (CDC) and other partners, USAID has developed systems for providing low-cost technologies to improve household drinking water. More than a billion people lack access to clean water, and many more drink water contaminated by unsafe storage and handling, as well as by unsafe treatment and distribution systems. The safe water system involves a point-of-use treatment technology, safe storage in specially designed containers, and improved hygiene practices. Trials by CDC suggest that this approach can reduce the incidence of diarrhea by about 50 percent. The program was important during the aftermath of the recent tsunami when safe water solution and storage vessels were distributed in Indonesia, India, and Myanmar. The system has also been helpful in protecting vulnerable populations in hospitals and clinics.


SoloShot Syringe. USAID supported the development by PATH (Program for Appropriate Technology in Health) of SoloShot, the first auto-disposable syringe for use in developing countries. These syringes protect against the transmission of blood-borne diseases. While other disposable syringes had been in use around the world, in developing countries they were often reused without being adequately sterilized. The SoloShot is a single-use injection device designed to inactivate automatically after a single cycle of filling and injection. The syringe has a fixed needle that automatically becomes non-reusable after a single injection. Once filled, the plunger stops and cannot be pulled back. After the vaccine



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