title: Delivery systems and cost recovery in Mectizan treatment for onchocerciasis.
abstract: The efficiency of on-going delivery systems and cost recovery in Mectizan (ivermectin, MSD) treatment for onchocerciasis are reviewed. The search is on for an effective system of Mectizan delivery, involving drug procurement, delivery from port to districts and distribution to eligible persons, which can be sustained by the endemic countries for many years. The mechanisms for procuring and clearing the drug at the ports, and the drug's integration into the existing delivery systems of each national health service, need to be improved. Although large-scale treatments by mobile teams or community-based methods evidently achieve high and satisfactory rates of coverage, they also incur high recurrent costs which have to be covered by external partners and are not sustainable by national health services. Cost-sharing is considered an important factor in a sustainable delivery system and community-directed treatment, in which the community shares the cost and ownership of local distribution and is empowered to design and implement it, is likely to be more cost-effective and sustainable.
authors.affiliation: World Health Organization/African Programme for Onchocerciasis Control, Ouagadougou, Burkina Faso. amazigo@ocp.oms
authors.forename: U
authors.initials: U
authors.lastname: Amazigo
authors.forename: M
authors.initials: M
authors.lastname: Noma
authors.forename: B A
authors.initials: BA
authors.lastname: Boatin
authors.forename: D E
authors.initials: DE
authors.lastname: Etya'alé
authors.forename: A
authors.initials: A
authors.lastname: Sékétéli
authors.forename: K Y
authors.initials: KY
authors.lastname: Dadzie
mesh_terms: D000349:Africa; D005369:Filaricides / Q000191:economics* / Q000600:supply & distribution*; D017048:Health Care Costs; D006296:Health Services / Q000191:economics* / Q000600:supply & distribution*; D006801:Humans; D007559:Ivermectin / Q000191:economics* / Q000600:supply & distribution*; D009855:Onchocerciasis / Q000188:drug therapy / Q000191:economics
chemical_list: D005369:Filaricides; D007559:Ivermectin