Abstract
Onchocerciasis (river blindness) control in West Africa has been described as the most successful disease control program of its type. This article examines the potential risk of resurgence of onchocerciasis in light of ongoing efforts to transfer disease control responsibilities to the participating countries. This article describes the risk of the disease as a recurring phenomenon and the ramifications of recurrence for the goals of settlement and economic development in the Volta River Basin. The environmental and public health risks of chemical control of the disease are explored. This article further examines the potential capacity of the host countries to sustain disease control operations and develop disease-free zones following disengagement of the donor commu nity. It discusses factors required to sustain disease control and recommends, among other things, the establishment of early warning systems through continuing monitoring activities to prevent disease recrudescence. Further, the framework for a new regional health agency is proposed.
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