Burundi Eliminates Trachoma: A Major Victory in the Global Fight Against Neglected Tropical Diseases
A landmark achievement for public health, Burundi has been officially recognized by the World Health Organization (WHO) for eliminating trachoma as a public health problem. This success story underscores the power of strategic intervention, international collaboration, adn dedicated local efforts in tackling neglected tropical diseases (NTDs).
For years, the true extent of trachoma’s impact within Burundi remained largely unknown. This changed in 2008 with the launch of a national initiative to comprehensively map NTDs, including soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis, and crucially, trachoma. Subsequent investigations by the Ministry of Public Health and the Fight Against AIDS, bolstered by baseline surveys conducted in 2009-2010, definitively confirmed trachoma’s endemic presence in specific regions of the country.
This confirmation triggered the swift implementation of the WHO-recommended SAFE strategy – Surgery for trachomatous trichiasis (in-turned eyelashes), Antibiotics (primarily azithromycin mass drug management), Facial cleanliness, and Environmental improvement - targeting 2.5 million individuals across 12 health districts. The program’s success wasn’t achieved in isolation.it was a collaborative effort,receiving vital technical and financial support from organizations like CBM Christoffel Blindenmission,the END Fund,geneva Global,and the WHO. The International Trachoma Initiative, through the Task Force for Global Health, generously donated the critical antibiotic azithromycin (Zithromax, Pfizer).
“This achievement reflects the government’s resolute commitment to protecting its most vulnerable populations,” stated Dr. Xavier crespin, WHO Representative in Burundi. “Under the leadership of the Ministry of Public Health and the Fight Against AIDS, and with the unwavering dedication of community health workers, alongside the support of key partners and WHO’s technical guidance, this success was made possible. this win inspires us to press forward with the same determination to eliminate all remaining neglected tropical diseases.”
Understanding the Global Trachoma Burden
Trachoma, a preventable eye infection, remains a critically important public health concern in 32 countries worldwide. it disproportionately affects impoverished, rural communities in Africa, Central and South America, Asia, the Western Pacific, and the Middle East.
The WHO African Region bears the heaviest burden, with an estimated 93 million peopel living in areas requiring intervention as of April 2024 - representing 90% of the global trachoma cases. Though, significant progress is being made. Since 2014, the number of individuals needing antibiotic treatment in the African Region has decreased by 51%, falling from 189 million to 93 million.
Current Status in the African Region (April 2024):
Countries requiring Intervention: Algeria, Angola, Burkina Faso, Cameroon, Central Africa Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Eritrea, Ethiopia, Guinea, Kenya, Mozambique, Niger, nigeria, South Sudan, United Republic of Tanzania, Uganda, zambia, and Zimbabwe.
Countries Validated for Elimination: Benin, Gambia, Ghana, Malawi, Mali, Mauritania, and Togo.
Countries Claiming Elimination Targets achieved: Botswana, Guinea-Bissau, namibia, and Senegal.
A Growing List of success Stories: global Progress Towards Trachoma Elimination
Burundi’s success adds to a growing global momentum.To date, 57 countries have eliminated at least one NTD, and 24 – including Burundi – have successfully eliminated trachoma as a public health problem. This notable list includes: Benin, Cambodia, China, Gambia, Ghana, India, Islamic Republic of Iran, Iraq, Lao People’s Democratic Republic, Malawi, mali, Mauritania, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Papua New Guinea, Saudi Arabia, Togo, Vanuatu, and Viet Nam.
What Does “elimination as a Public Health Problem” Mean?
The WHO defines elimination of trachoma as a public health problem as achieving a prevalence of trachomatous trichiasis “unknown to the health system” of less than 0.2% and a clinical trachoma prevalence of less than 5% in children. This signifies a level of disease control where it no longer poses a major public health threat.
The SAFE Strategy: A Multi-Pronged Approach
The cornerstone of trachoma elimination is the WHO’s SAFE strategy:
Surgery: Corrects the inward turning of eyelashes (trachomatous trichiasis) to prevent corneal damage
