Vision 2020 - World Health Organization

VISION 2020 GLOBAL INITIATIVE FOR THE ELIMINATION OF AVOIDABLE BLINDNESS: ACTION PLAN 2006–2011
TRACHOMA
2.2 DISEASE CONTROL AND PREVENTION OF VISUAL IMPAIRMENT
Trachoma
Trachoma, which is the commonest infectious cause of blindness, is caused by Chlamydia trachomatis.
Children who have the active stages of the disease are the reservoir of infection, while blindness, which
occurs after repeated episodes of infection, principally affects adults. Boys and girls are equally affected
by active infection, while blindness is more common in women. Trachoma is a condition of poverty
and is a focal disease, affecting communities that have poor water supplies and sanitation and poor
health services. The organism is transmitted from person to person through direct and indirect contact
and by fl ies. Blindness can be prevented by surgery to correct inturning of the upper lid (trichiasis),
while the infection and its transmission can be reduced with surgery, antibiotics, facial cleanliness
and environmental change (the SAFE strategy).
Current situation
Trachoma is endemic in 55 countries: Afghanistan, Algeria, Australia, Benin, Brazil, Burkina Faso,
Cambodia, Cameroon, Central African Republic, Chad, China, Côte d’Ivoire, Djibouti, Egypt, Eritrea,
Ethiopia, Fiji, Gambia, Ghana, Guatemala, Guinea, Guinea-Bissau, India, Islamic Republic of Iran, Iraq,
Kenya, Kiribati, Lao People’s Democratic Republic, Libyan Arab Jamahiriya, Malawi, Mali, Mauritania,
Mexico, Morocco, Mozambique, Myanmar, Namibia, Nepal, Niger, Nigeria, Oman, Pakistan, Papua New
Guinea, Senegal, Solomon Islands, Somalia, Sudan, Togo, Uganda, United Republic of Tanzania, Vanuatu,
Viet Nam, Yemen, Zambia and Zimbabwe. The estimated number of affected people has fallen from
360 million in 1985 to about 80 million today. Trachoma affects the poorest and most remote rural
areas of Africa, Asia, Central and South America, Australia and the Middle East (30). Updated reports
on 36 countries are available (31), while 19 endemic countries have not yet reported data.
There are approximately 10.6 million people with inturned eyelashes (entropion trichiasis), for which
eyelid surgery is needed to prevent blindness. The majority of these people are women. An estimated
5.9 million adults are irreversibly visually impaired from corneal scarring due to trachoma.
Achievements
At national level, political support for trachoma control has increased continually since 1997, the year
the WHO Alliance for the Global Elimination of Blinding Trachoma (GET 2020) was created; intersector
collaboration is growing, and use of the SAFE strategy for eliminating the disease is increasing.
GET 2020 is active at the global level. It is a public–private partnership, bringing together WHO, national
coordinators, nongovernmental organizations, donors and international experts, with support from the
pharmaceutical industry. Launched in 1997, it was endorsed by WHA Resolution 51.11, adopted in 1998.
A nongovernmental organization task force, the International Coalition for Trachoma Control, has been
working since 2004 within the framework of GET 2020 to improve information exchange with governments
and to coordinate the efforts of international nongovernmental organizations in countries. The
GET 2020 secretariat is responsible for trachoma within the WHO department focusing on neglected
tropical diseases. The WHO GET 2020 secretariat is also coordinating the drawing up of guidelines for
certifi cation of elimination of blinding trachoma, as requested by several WHO Member States.
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