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176 THIRD WHO REPORT ON NEGLECTED TROPICAL DISEASES
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Progress towards Roadmap targets
In 1998, the World Health Assembly resolved to eliminate blinding trachoma as a publichealth
problem by 2020. Elimination as a public-health problem is defined as a reduction in
the prevalence of trichiasis “unknown to the health system” to less than 1 case per 1000 total
population (“known” cases are those in whom trichiasis has recurred after surgery, those who
refuse surgery, or those yet to undergo surgery whose surgical date is set) (5); and a reduction
in the prevalence of the active trachoma sign “TF” in children aged 1–9 years to less than 5%.
Elimination of blinding trachoma is technically feasible through implementation of the SAFE
strategy, comprising Surgery for individuals with trichiasis; Antibiotics to reduce the reservoir
of ocular chlamydial infection; and Facial cleanliness and Environmental improvement to
reduce transmission.
Significant progress has recently been made in generating data for programme planning
purposes, thanks to strong partnerships anong ministries of health, nongovernmental
organizations and research institutions within the Global Trachoma Mapping Project. This
ambitious project aims to complete baseline mapping of the global distribution of trachoma in
2015 by completing population-based prevalence surveys in all districts in which trachoma is
suspected but where prevalence data are unavailable (6). As of April 2014, 1033 districts in 19
countries had been mapped through this project, providing data for an underlying population
of 124 million people. Most countries endemic for trachoma have now set target dates for
eliminating blinding trachoma (3) and have agreed with partners to accelerate implementation
of the SAFE strategy. In 2012, 169 121 patients had surgery for trichiasis and nearly 48 million
people received antibiotics for trachoma (3) (Fig. 4.17.2).
Fig. 4.17.2 Number of people treated and global coverage of
azithromycin for trachoma, by WHO region, 2008–2012
Number of people treated
Millions
60
50
40
30
20
10
25
20
15
10
5
Global ocverage (%)
0
2008 2009 2010 2011 2012
Year
0
African Region Region of the Americas Eastern Mediterranean Region
South-East Asia Region
Western Pacific Region
Global coverage