HEALTH: New Hope for Millions Facing Blindness

By Sanjay Suri Reprint | | Print |

Sanjay Suri

LONDON, Nov 12 2003 (IPS) - A new treatment drive could halve the number of people threatened by blindness due to Trachoma.

Trachoma is the leading cause of blindness, affecting particularly the poorest countries. And in those, women and children far more than men.

Now the International Trachoma Initiative (ITI) plans to increase treatments from the current eight million to 135 million over next five years, a 15-fold expansion.

“There are currently 540 million people at risk around the world,” Dr A. Sam- Abbenyi from the ITI told IPS. The World Health Organisation (WHO) says about 140 million are already infected, and six million have become blind.

“If treatment is carried out at the projected momentum, we should have covered about half the countries with the greatest prevalence of the disease over the next five years,” Sam-Abbenyi said.

The ITI says the goal to eliminate Trachoma by 2020 could be within reach, and “it is now realistic to hope for something that was unimaginable just a few years ago.” If treatment is accompanied by improvement in water and sanitation, the goal could be reached much sooner, the ITI says.

Trachoma is a chronic and contagious infection that results in in-turned eyelashes, which then scratch and scar the cornea, leading to blindness if not treated. Trachoma is endemic in 48 countries. Women are two to three times more likely than men to be infected.

Trachoma has been a public health plague since ancient times and is currently prevalent in the poorest parts of Africa, Asia and Latin America where clean water and sanitation are scarce, the ITI says.

One expert study has estimated that the economies of developing countries lose 2.9 billion dollars a year in productivity to blindness caused by trachoma.

The ITI – a partnership among Pfizer, the Edna McConnell Clark Foundation, national governments and non-governmental organisations – was set up five years ago. Trachoma programmes are now under way in nine countries, including Morocco, Ghana, Mali, Tanzania, Vietnam, Sudan, Niger, Nepal and Ethiopia.

The results have been dramatic in some countries. “In Morocco we have reduced the incidence of trachoma by 90 percent and in Vietnam by 80 percent,” says Sam-Abbenyi. “We expect to eliminate the disease in Morocco within two years and in Vietnam within three years.”

Under the ITI initiative Pfizer donates Zithromax to countries that implement the ‘SAFE strategy recommended by WHO as the most effective way to treat trachoma. SAFE includes surgery for late-stage disease, antibiotics for active infection, improved facial hygiene, and environmental change such as improved access to clean water and sanitation.

As an oral medication, Zithromax is easier to administer than tetracycline eye ointment, which was previously the standard treatment for trachoma. A single oral dose of the drug replaces application of ointment on the eyes twice a day for six weeks, a difficult treatment to maintain.

Over the last five years more than 70,000 surgeries have been performed under the ITI to halt corneal damage and prevent blindness.

“We are winning the fight against blindness from trachoma because we have an extraordinary strategy and effective partnerships in our programme countries,” said Dr. Jacob Kumaresan, president of the ITI.

“Building on the momentum of our achievements to date, we are broadening the scope of the trachoma programmes already in place and will launch at least 10 new country programmes.”

“Trachoma has been one of humankind’s most challenging public health problems for centuries,” said Hank McKinnell, chairman and chief executive officer of Pfizer.

“Based on the progress to date, it is now realistic to hope for something that was unimaginable just a few years ago, that within the next 20 years we will ensure that no one anywhere in the world is ever blinded by trachoma again.”

The ITI is carrying out a mandate established by the WHO’s Alliance for Global Elimination of Trachoma by 2020 (GET 2020) in 1997.