Visions Fulfilled -- How individual philanthropists influenced global treatment of river blindness

How does a husband and wife team in Texas leverage the solution to a centuries-old health problem in 37 countries in Africa and Latin America -- and why? And why is their story relevant for philanthropists today?

If you ask John and Rebecca Moores, graduates of the University of Houston with no business interest in those regions, they would say that it was because they found a problem that they thought they could impact and took action because it existed. And that many ongoing problems could be solved with the intervention of like-thinking philanthropists.

River Blindness: treatment is found -- but no way to deliver it

Perhaps you remember seeing a news photo some 15 years ago showing a young boy leading a blind adult by means of a stick. The adult's affliction, onchocerciasis, commonly known as river blindness, had a treatment, but getting it to the millions of sufferers and following up were major challenges. The numbers are startling. Some 100 million people are at risk in Africa, Latin America, and Yemen. An estimated 18 million people are infected; one million have serious vision impairments, and 400,000 of these are blind.

In the 1980s, Merck & Co. discovered that one of its products, ivermectin (known also as Mectizan), administered annually, could prevent sufferers from going blind. Merck CEO Roy Vagelos agreed to donate the Mectizan in perpetuity but needed a way to implement distribution. Vagelos met with then-executive director Dr. William Foege at The Carter Center in Atlanta and formed an expert committee that proved the drug's effectiveness. But how do you distribute millions of treatments when there is no mechanism or budget to do so?

Enter John and Rebecca Moores. John Moores had founded an enormously successful software firm and the couple was seeking a philanthropic outlet for their wealth. Mr. Moores had read in The Houston Chronicle about how William Baldwin, retired dean of the optometry school at University of Houston, was raising funds to buy a van so that he could travel through Central America and distribute ivermectin. He contacted Baldwin, who had prior experience treating river blindness in Nigeria, to see how he and Mrs. Moores might help. They agreed not only to make a donation but established the River Blindness Foundation in Sugar Land, Texas, to jump-start the distribution efforts. John Moores estimates that he donated $25 million to make this possible.

Partnerships are key

Over time, it became clear to the Mooreses that the foundation had served its purpose. They transferred its key assets to The Carter Center (on whose board John Moores sits). The Carter Center, in turn, set about forging strategic partnerships to continue -- and expand -- the drug distribution and community education necessary to make it succeed. These collaborations have been essential for program success, says Dr. Frank Richards of The Carter Center, since no single entity could handle drug delivery, treatment and follow-up.

In 1996, The Carter Center launched the Global 2000 River Blindness Program as part of an international coalition that includes the World Health Organization, Lions Clubs International Foundation, The World Bank, and other non-governmental organizations. Under its auspices, villagers and health workers in all of the affected countries are trained to create and oversee community-based distribution of ivermectin. A separate entity, the Mectizan Expert Committee, screens proposals for medicine donations to groups that have the capacity to deliver and administer it. A critical goal of this comprehensive effort is to eradicate river blindness as a public health problem by 2007.

Some battles are won -- but others remain to be fought

There is no dearth of diseases that would benefit from input similar to that of John and Rebecca Moores. Dr. Donald Hopkins, associate executive director and head of health programs at The Carter Center, notes that two major diseases -- lymphatic filariasis and schistosomiasis -- are disabling or killing millions of people in Africa, Asia and Latin America, and "the rate of fatalities is many times the cost of the drugs," he says. "So the world is paying more by not doing something about them." However, he says, low-cost treatments exist for both.

In the case of lymphatic filariasis -- a mosquito-borne disease that results in painful swellings, disfigurement and internal organ malfunction -- the Bill & Melinda Gates Foundation has provided initial financial support for a global campaign to provide health education and treatment, and GlaxoSmithKline and Merck & Co. have made generous commitments of two drugs needed to prevent the disease. But it is still very new and much needs to be done. As for schistosomiasis, a parasitic disease that infects -- and ultimately disables -- 200 million people, providing treatment has been a challenge; the manufacturers of the generic drug proven effective against the disease are too small to donate it, and even if it were provided at cost (about six cents per pill), Dr. Hopkins says that interest in controlling the disease has waned. The second most prevalent tropical disease after malaria, schistosomiasis (also called bilharzia) is transmitted through fresh water activities such as swimming, fishing and rice cultivation, and initially manifests itself through itching and muscle pain but can lead to chronic bladder, kidney or liver problems.

"It's not your money anymore"

Despite his legacy, Mr. Moores says, "If you're really true to yourself, it's not your money anymore. It can't be mine and someone else's, in my mind anyway. Once you've given it away, you have the responsibility, like in a business, to find the highest and best return on your capital." But the returns on this particular investment are unique: "To save someone's eyesight for one dollar or less is amazing," John Moores told Global Giving Matters.

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