Another Step in Ending Trachoma

Eliminating this public health threat exemplifies the journey toward self-reliance

Bishal Dhakal, a trachoma grader in Nepal, checks the eye of Jyoti Rayamajhi, a community health volunteer. / Nabin Baral, RTI International

The loss of sight is a tremendous hardship, especially for the residents of poor, rural communities. Blindness hinders education, and often leads to unemployment that plunges families into poverty.

Trachoma, a leading cause of blindness, is an infection that causes scarring on the inside of the eyelid from eyelashes that turn inwards and touch the eye. Every blink increases the risk of damage. This preventable disease is generally spread from person-to-person through contact with bacteria-carrying flies and contaminated hands.

But there is good news. In May, the World Health Organization (WHO) officially declared that Ghana and Nepal have achieved the milestone of eliminating trachoma as a public health problem. Their success demonstrates that sustained commitment and global partnership can lead to significant progress in the fight against Neglected Tropical Diseases (NTDs).

A trachoma grader checks young children for any sign of the disease in a rural village in Ghana. / FHI 360

USAID’s commitment to fight trachoma in both countries goes back almost a decade. We supported mapping, delivery of drugs, and program evaluations. In Ghana, the government trained ophthalmic surgical nurses, and incorporated screening and treatment of NTDs into the larger health system. In Nepal, the government provided sight-saving surgeries to reduce the number of people in debilitating pain and at risk of blindness.

But donors and national governments could not have achieved this remarkable milestone without the support of the private sector. The pharmaceutical company Pfizer Inc., donated azithromycin, which is one of the most-effective drugs available to prevent and treat trachoma, even before USAID joined the fight in Ghana and Nepal, in 2006 and 2011, respectively.

Collectively, in both countries, USAID-funded partners delivered and administered 3.5 million treatments, a highly effective private-to-public, people-to-people partnership.

Trachoma graders in Nepal check the eye of patients for clinical signs of trachoma. / Nabin Baral, RTI International, and Aryc Mosher, USAID

Caroline Roan, vice president of Corporate Responsibility at Pfizer, said the company is thrilled that both Nepal and Ghana have eliminated trachoma as a public health problem, news that brings us one step closer to our shared goal of a trachoma-free world.

Like me, she thinks this milestone is a testament to the power of partnerships.

Pfizer has also announced it will extend its drug donation through the International Trachoma Initiative, a generous pledge that will enable many other countries to make the same kind of progress. All told, U.S. and global pharmaceutical companies that work with USAID have donated more than $19 billion worth of medicines to countries where we support mass treatment campaigns.

Their contributions make NTD investments one of the best buys in public health. Every dollar USAID invests in the fight against NTDs leverages $26 in donated medicines and advances our progress toward the elimination of NTDs.

Doctors screen a patient for trachoma in a rural village in Ghana. / FHI 360

We clearly have more work ahead: Ghana and Nepal join only five other countries that have eliminated trachoma, out of the 41 known to require interventions for trachoma. And we must remain vigilant against its recurrence.

Since 2010, USAID has provided over 850 small grants worth over $65 million to local institutions, including in Ghana and Nepal, so they can sensitize communities about the benefits of the medicine, effectively distribute the donated medicine in mass campaigns, as well as measure the impact of the medicine on reducing the burden of disease.

Finally, I would be remiss not to mention the half-million community health workers trained in both countries to deliver medicines during these mass drug-administration campaigns.

They, like many other community health workers around the world, are the backbone of many public health systems. Thanks to their tireless efforts, more than 100 million people in USAID-supported countries no longer need treatment for trachoma, or live at risk of blindness.

The daughter of a trachoma community health worker in Nepal with a furry friend. / Nabin Baral, RTI International

About the Author

Mark Green is the Administrator of USAID. Follow him @USAIDMarkGreen. Our development efforts advance American interests by promoting global security, prosperity and self-reliance.