Fig. 1

Improving weak onchocerciasis (oncho) elimination programmes. At the core of this effort is the recognition that some of these programmes may not reach elimination goals in the 2020/2025 time horizons but, if strengthened, they can still achieve substantial reductions in morbidity and mortality due to onchocerciasis. This requires (clockwise) the identification of under-performing programmes and investigation of the causes for this, with particular emphasis on improving the geographic (and therapeutic) coverage as well as treatment uptake and compliance. Monitoring and evaluation approaches should be improved with optimised use of current and novel tools; one such tool could be the recognition of early stage morbidity (e.g. prevalence of epilepsy in children) linked with serological markers of exposure