In This Review

Riverblindness in Africa: Taming the  Lion’s Stare
Riverblindness in Africa: Taming the Lion’s Stare
By Bruce Benton
Johns Hopkins University Press, 2020, 328 pp.

River blindness, or onchocerciasis, is caused by a parasitic worm that is spread by the bites of a small black fly that is common around rivers in much of Africa. The disease still afflicts some 15 million to 20 million Africans, of whom around a million have suffered vision loss. Benton, who ran the World Bank’s river blindness project for over 20 years, has written a very useful history of the efforts by African governments and a consortium of donors to control and eventually eradicate the disease. He ably documents the policy process, the bureaucratic politics, and the individual actions that such a complex effort required. No vaccine is available yet, and so policymakers have no alternative but to support the slow and laborious work of trying to eradicate the disease-carrying fly with insecticides. Also, since 1981, the drug ivermectin has been found to be effective in killing the larvae of the worms inside the human body. Campaigns to provide two injections of the drug a year to affected populations have played a key role in controlling the disease.