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THE GLOBAL ELIMINATION OF BLINDING TRACHOMA: PROGRESS AND PROMISE

Trachoma is the world’s leading cause of preventable blindness. It affects approximately 150 million people living in the world’s poorest, rural communities and causes an estimated loss of $2.9 billion in productivity annually. In 1985, the Edna McConnell Clark Foundation joined with the World Health Organization to support studies on trachoma epidemiology and control, resulting in the elaboration of the surgery, antibiotics, facial cleanliness and environmental improvement (SAFE) strategy as the basis for the elimination of this blinding disease. Founded in 1998 by the Clark Foundation and Pfizer, Inc., the International Trachoma Initiative (ITI) is the only organization dedicated to eliminating blinding trachoma through support to national control programs. The availability of donated Zithromax^® (azithromycin) by Pfizer, Inc. has been paramount to the support of the ITI for implementation of SAFE in 10 country programs. The program has made considerable progress in four years. More than seven million individuals have received treatment, resulting in a cumulative reduction of 50% in active disease rates in children. More than 60,000 have also benefited from lid surgery that has halted progression to blindness. Morocco is expecting to attain the elimination of blinding trachoma by 2005. However, the challenges facing the goal of global elimination by 2020 involve a vital program expansion, increased financial and technical support, environmental improvement, and continued advocacy efforts.

Received July 30, 2003. Accepted for publication September 20, 2003.

Acknowledgments: The work of the International Trachoma Initiative would not be possible without the generous financial and organizational support of numerous organizations including the Edna McConnell Clark Foundation, Pfizer, Inc., the Bill and Melinda Gates Foundation, the Starr Foundation, the Rockefeller Foundation, and the United Kingdom Department for International Development. The programs reported in this paper thrive with leadership from Drs. Wondu Alemayehu, Abdou Amza, Gamal Ezz El Arab, Youssef Chami-Khazraji, Maria Hagan, Mamoun Homeida, Simon Katenga, Nguyen Huy Nga, Ram Prasad Pokhrel, and Doulaye Sacko. The programs reported in this paper also benefit from the guidance of numerous advisors including Drs. Deborah Dean, Charles Knirsch, Andre Dominique Negrel, Sheila West, and Serge Resnikoff of the World Health Organization. Special thanks go to the Ministries of Health and other partners working in support of the global effort to eliminate blinding trachoma.

Authors’ address: Jacob A. Kumaresan and Jeffrey W. Mecaskey, International Trachoma Initiative, 441 Lexington Avenue, 16th Floor New York, NY 10017, Telephone: 212-490-6460, Fax: 212-490-6461, E-mails: jkumaresan{at}trachoma.org and mecaskey{at}trachoma.org.