Trachoma is the leading infectious cause of blindness in the world. It is caused by an obligate intracellular bacterium called Chlamydia trachomatis. The infection is transmitted through contact with eye and nose discharge of infected people, particularly young children who are the principal reservoir of infection. It is also spread by flies that have been in contact with the eyes and noses of infected people.
In 1996, WHO launched the WHO Alliance for the Global Elimination of Trachoma by the Year 2020 (GET2020). GET2020 is a partnership which supports country implementation of the SAFE strategy and the strengthening of national capacity through epidemiological assessment, monitoring, surveillance, project evaluation and resource mobilization for elimination of trachoma.
WHO adopted the “SAFE” strategy as an integrated approach to prevent and control blinding trachoma. Guided by the acronym, the strategy outlined the following combination of interventions:
- surgery to treat the blinding stage of the disease (trachomatous trichiasis);
- antibiotics to treat infection, particularly mass drug administration of antibiotics, which are donated by the manufacturer to elimination programmes through the International Trachoma Initiative;
- facial cleanliness, and
- environmental improvement, particularly improving access to water and sanitation.
In 1998, the World Health Assembly passed the resolution (WHA 51.11) targeting trachoma for elimination as a public health problem by the year 2020. Since then a significant progress has been made and an increasing number of endemic countries are approaching the target and initiating development of a dossier to document elimination of trachoma as a public health problem in the country.
In the Western Pacific Region, Cambodia and Lao People’s Democratic Republic were the first countries to be validated by WHO as having achieved elimination of trachoma as a public health problem in 2017. China has developed a dossier to claim elimination of trachoma as a public health problem, which is currently being reviewed by WHO. Trachoma remains endemic in seven other countries (Australia, Fiji, Kiribati, Papua New Guinea, Solomon Islands, Vanuatu and Viet Nam). Although trachoma transmission is suspected in Nauru, this situation needs to be confirmed.