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Efforts aim to eliminate trachoma worldwide
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Trachoma, caused by Chlamydia trachomatis, is one of the oldest known infectious diseases. It is endemic in 49 countries, mostly in Africa but also in the Eastern Mediterranean, Southeast Asia and the Western Pacific. Currently, approximately 6 million people are blind, visually impaired or at immediate risk of going blind due to repeated infection. Another 146 million cases of active trachoma may result in severe visual impairment if left untreated.
In 1997, the World Health Organization assembled an international alliance of interested parties geared toward the global elimination of trachoma (GET 2020). GET 2020 falls under the umbrella of VISION 2020, and indeed trachoma is one of the five causes of preventable blindness that VISION 2020 has identified as immediate priorities.
International efforts toward eliminating trachoma use the WHO-recommended “SAFE” strategy — surgery (for trichiasis and entropion), antibiotic (antibiotics for active infection), facial cleanliness (three handfuls of clean water per person to reduce disease transmission) and environmental im provement (insect control and water purification). Their goal is the worldwide elimination of trachomatous blindness by the year 2020.
International Trachoma Initiative
“The International Trachoma Initiative (ITI) and its partners are not just distributing azithromycin in areas where trachoma is endemic,” said Jeffrey Mecaskey, program director of the ITI. “We are supporting the entire SAFE strategy. We help provide surgical services to people at imminent risk of blindness from entropion and trichiasis, while at the same time getting treatment and prevention to people who are vulnerable.”
ITI was founded in 1998 by the Edna McConnell Clark Foundation and Pfizer Inc. The initiative has received further financial support from several organizations, including the Bill & Melinda Gates Foundation and the Department of International Development in the United Kingdom.
“To date, Pfizer has donated more than 3 million doses of azithromycin, at a cost of more than $50 million,” Mr. Mecaskey told Ocular Surgery News. The results are tangible. In Morocco, the prevalence of trachoma was 28% when ITI began its efforts in 1998. After 1 year of intervention and support, this number dropped to 6.5%.
“We expect Morocco to be the first country in the world to use the SAFE strategy to eliminate trachoma. We hope this will happen by 2005,” Mr. Mecaskey said.
“Effecting the environmental change necessary to ultimately eliminate trachoma is the hardest part of the SAFE strategy, much more difficult than providing annual treatment with azithro mycin,” he added.
According to Mr. Mecaskey, efforts at environmental change are context sensitive; environmental risk factors differ from setting to setting. And of course the costs involved with providing clean water and better sanitation systems are often formidable.
For Your Information:
- Jeffrey Mecaskey can be reached at International Trachoma Initiative, 441 Lexington Avenue, 16th Floor, New York, NY 10017-3910 U.S.A.; +(1) 212-490-6460; fax: +(1) 212-490-6461; e-mail: mecaskey@trachoma.org; Web site: www.trachoma.org.