WHO announces hundreds of millions of people are no longer at risk of trachoma

The World Health Organization has today announced that the number of people at risk of trachoma – the world’s leading infectious cause of blindness – has fallen from 1.5 billion in 2002 to just over 142 million in 2019, a reduction of 91%.

New data presented today at the 22nd meeting of the WHO Alliance for the Global Elimination of Trachoma by 2020 (GET2020) also shows that the number of people requiring surgery for trachomatous trichiasis – the late, blinding stage of trachoma – has dropped from 7.6 million in 2002 to 2.5 million in 2019, a reduction of 68%.

In 2014, the Trust launched its Trachoma Initiative to tackle the disease in 12 Commonwealth countries: Kenya, Malawi, Mozambique, Nigeria, Tanzania, Uganda and Zambia in Africa; and Australia, Fiji, Kiribati, Solomon Islands and Vanuatu in the Pacific. The Trust worked with members of the International Coalition for Trachoma Control to implement the World Health Organization-endorsed “SAFE” strategy to provide people with Surgery to correct the position of in-turned eyelashes and prevent the scarring of the eye; Antibiotic distribution to reduce the spread of infection; Facial cleanliness promotion to reduce reinfection and to help to prevent transmission from person to person; and introduce Environmental improvements to increase access to safe water and sanitation.

As a result of the Trust’s efforts, 26.6 million people in Africa have been provided antibiotic eye treatments and 102,400 have received sight-saving operations to help eliminate trachoma in seven countries. Malawi and Vanuatu are on track to be validated by the WHO as having officially eliminated blinding trachoma, and Kiribati and Solomon Islands are set to follow suite.

Speaking from GET2020, the Trust’s Director of Advocacy and Commonwealth Engagement, Eleanor Fuller OBE, said:

“The Trust is proud to have contributed to the huge progress made in the last few years towards the elimination of blinding trachoma as a public health problem.  Millions of people across the world are now free of the risk of this cruel and painful disease. Behind this achievement lies an extraordinary story of partnership and collaboration.  Our congratulations and thanks go to all involved.  We wish them continued success as they tackle the final phases towards global elimination.”

“Eliminating trachoma contributes to the ocular health and quality of life of the poorest, most disadvantaged people worldwide and thereby moves us a step closer to achieving universal health coverage,” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases. “Ridding the world of this painful, debilitating disease is being made possible through generous donations of the antibiotic azithromycin, sustained contributions from a network of dedicated funding agencies and partners, and the efforts of hundreds of thousands of front-line workers who work tirelessly to engage communities and deliver interventions.”

Trachoma is caused by a bacterium called Chlamydia Trachomatis which leads to repeated conjunctivitis, and is spread by close contact with an infected person. It is most commonly found in poor, rural communities where people have limited access to clean water and healthcare. Each infection causes scar tissue to develop under the eyelid which eventually causes them to turn inwards. With every blink, their eyelashes scrape the surface of the eye, scarring the cornea and if left untreated, can lead to irreversible blindness. This final stage is known as trichiasis.

The significant reduction in the global prevalence of trachoma has resulted from increased political will in endemic countries, expansion of control measures and generation of high-quality data. The global programme has been supported by the world’s largest infectious disease mapping effort – the Global Trachoma Mapping Project (2012–2016) – and, since 2016, by Tropical Data, which has assisted health ministries to complete more than 1500 internationally-standardized, quality-assured and quality-controlled prevalence surveys.

“This is great progress, but we cannot afford to become complacent,” said Dr Anthony Solomon, Medical Officer in charge of WHO’s global trachoma elimination programme. “We should be able to relegate trachoma to the history books in the next few years, but we will only do so by redoubling our efforts now. The last few countries are likely to be the hardest.”

Trachoma remains endemic in 44 countries and has blinded or visually impaired around 1.9 million people worldwide. Mapping of trachoma has been completed to identify its distribution and target control measures through the SAFE strategy, namely: surgery for trichiasis, antibiotics to clear infection, and facial cleanliness and environmental improvement to reduce transmission.

The Trust has over the past year helped secure further funding to eliminate trachoma and is sharing its learning to ensure that all the countries where its Trachoma Initiative has worked can continue their efforts to eliminate trachoma in the coming years.