Blinding trachoma: progress towards Global Elimination by 2020.

Several countries are on track to eliminate the infectious eye disease, known as blinding trachoma, the World Health Organization (WHO) announced on 10 April 2006. This progress results from efforts to achieve the global goal set by the World Health Assembly in 1998 to eliminate this disabling disease by 2020.

The estimated number of people affected by trachoma has fallen from 360 million people in 1985 to approximately 80 million today--the result of a concerted effort by the WHO Alliance for the Global Elimination of Blinding Trachoma by 2020 (GET 2020), combined with socioeconomic development in endemic countries. The disease affects the poorest and most remote rural areas of 56 countries in Africa, Asia, Central and South America, Australia and the Middle East.

At a GET 2020 meeting in Geneva in April, the Islamic Republic of Iran, Mexico, Morocco and Oman reported successfully implementing national strategies of interventions for eliminating trachoma, based on the WHO-recommended SAFE strategy, which emphasizes comprehensive public health action. SAFE stands for lid surgery (S), antibiotics to treat the infection (A), facial cleanliness (F) and environmental changes (E). If implemented comprehensively, the strategy could prevent virtually all cases of blindness. Dr. Lee Jong-wook, WHO Director-General, said that "if countries continue at this rate, the global goal to eliminate blinding trachoma as a public health problem by 2020 can be achieved".

WHO is developing the specific epidemiological assessment criteria to determine whether countries have fully eliminated trachoma, to be finalized by the end of 2006, at which time WHO will be able to evaluate the effectiveness of national strategies and provide country-by-country certification that the disease has been eliminated.

Trachoma originates from an eye infection that is spread from person to person, frequently from child to child and from child to mother, especially in environmental conditions caused by water shortages, flies and crowded households. Through the discharge from an infected person's eyes, trachoma is passed on by hands, on clothing or by flies. Infections often begin during infancy or childhood and become chronic. If left untreated, it will eventually cause the eyelid to turn inward, and the eyelashes to rub on the eyeball, resulting in intense pain and scarring of the eye, which ultimately leads to irreversible blindness. Women are two to three times more often affected than men, probably due to their close contact with infected children.

Launched in 1997, GET 2020 is a partnership to support country implementation of the SAFE strategy. Alliance members include WHO, national governments, non-governmental organizations, research institutions, foundations and the pharmaceutical industry. Membership is open to all sectors willing to work with Governments to implement the strategy. Pfizer Inc. and its foundation have been key partners in the fight against trachoma. It has donated 37 million doses of azithromycin--a long-acting antibiotic used as one component of the SAFE strategy--and has committed to provide 100 million additional doses by 2008.