ComDT empowers communities themselves to play a large role in determining their own health outcomes. Each community collectively appoints a Community-Directed Distributor (CDD), who becomes the contact person for APOC and is provided annually with supplies of ivermectin. The Community collects ivermectin from the nearest health facility and decides how and when to distribute ivermectin and reports back to the Health Services. The CDD then works within his or her own community to ensure that the medicine is dosed properly and delivered to those who need it. Communities themselves in turn determine what compensation, if any, the CDD is to receive. The CDDs are trained and supervised by staff in the national public health systems and by NGDO partners.

By 2000, National Riverblindness Task Forces (NOTFs) and communities, assisted by other partners, had established ComDT of ivermectin systems in 91% of its projects. Building the capacity of local endemic communities, government personnel, and local NGDO staff through training helps to ensure sustainability of APOC's activities. From 1995 to 2000, a total of 117,757 people acquired additional knowledge and skills through training supported by APOC.

There was also an awesome scaling up of projects across APOC countries. Starting with only 4 projects in 1996, APOC scaled up operations to 62 projects by 2000, and then to a total of 113 established projects in 16 countries by 2004. The increase in the number of projects directly translated to the treatment of over 46 million people per year in 80,000 communities, which are actively involved in planning and managing the distribution of ivermectin. By 2007, APOC is expecting to add an additional 9 projects to the program, making a total of 122 projects. Given this estimate, the number of people treated per year should rise to 65 million in 100,000 communities. From the programs long-term efforts, it will ultimately reach 90 million people per annum; thereby achieving the eventual elimination of riverblindness as a public health problem throughout Africa, and preventing them from the terrible consequences of the disease .

APOC's strategy of ComDT with ivermectin is one that can be used as a model in developing other community based programs, and as a potential entry point to combat other diseases of public health importance in Africa. The program has developed several useful and new techniques, tools, and models, which have the potential for wider application, such as participatory monitoring, cost recovery, and a strategy of proper handling of side effects in mass distribution programs.

Further, ComDT becomes a necessity for many low-income countries under stress because of the paucity in trained health staff of these countries, particularly in the oncho-endemic rural areas. The WHO estimates that there were greater than 300 physicians and 700 nurses per 100,000 population per average per year in industrial countries from 1994-1998. In sub-Saharan countries, excluding those in OCP or APOC, the numbers decrease to 28.3 and 140.7, for physicians and nurses respectively. These figures for OCP and APOC countries are extremely low at 9.2 physicians and 60.7 nurses per population average per year in OCP countries, and 7.7 and 39.0 in APOC. Because ComDT works even without existing infrastructure and through community involvement and volunteerism, ComDTis a sure way to increase health treatment coverage. Studies show that ComDT clearly out performs regular health service treatment by approximately 36-41% coverage in sub-Saharan Africa . Moreover, ComDT promotes sustainability, which is the single most important factor in APOC's success.