WHO Validates El Salvador as Trachoma-Free: A Major Public Health Milestone

The World Health Organization (WHO) has officially validated El Salvador as having eliminated trachoma as a public health problem, marking the country as the first in Central America and the second in the Americas to achieve this milestone. This certification confirms that active transmission of the bacterium Chlamydia trachomatis, which causes the disease, has been interrupted, and that the national health system maintains the necessary capacity to monitor and manage any future cases. The achievement follows a multi-year effort to conduct targeted assessments across high-risk communities and aligns with global public health goals for 2030.

Trachoma is not merely an infection; it is a disease of inequity, frequently found in environments lacking adequate water, sanitation, and hygiene (WASH) infrastructure. By successfully addressing these social determinants alongside clinical screening, El Salvador has demonstrated that the elimination of neglected tropical diseases is achievable through coordinated national and international cooperation.

The Path to Elimination and Validation

The process leading to this validation was rigorous, spanning several years of data collection and health system strengthening. Between 2023 and 2026, the Ministry of Health in El Salvador conducted targeted assessments in communities identified as having higher environmental and social risk factors. According to the World Health Organization, these assessments found no evidence of active trachoma transmission. No cases were detected among children, and no advanced, blinding cases were identified in the adult population.

This validation is defined by strict international criteria. To be certified, a country must prove that the prevalence of trachomatous trichiasis—the stage where eyelashes turn inward and cause scarring—is below 0.2% in individuals aged 15 and older. Additionally, the prevalence of follicular trachoma in children aged 1 to 9 must be less than 5% in each formerly endemic district. Finally, the country must maintain an active surveillance system to identify and treat any incident cases.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, noted in a public statement that the country’s success serves as a signal that the global target of eliminating trachoma by 2030 is within reach. The effort was supported by the Pan American Health Organization (PAHO) through the Initiative for the Elimination of Trachoma in the Americas and received critical collaboration from the Government of Canada.

Addressing the Burden of Neglected Tropical Diseases

Trachoma remains the world’s leading infectious cause of blindness. It is spread through contact with eye and nasal discharge from infected individuals, often exacerbated by poor living conditions. Because the disease is so closely tied to poverty, it is classified by the WHO as a neglected tropical disease (NTD). These conditions often persist in the most vulnerable communities, creating a cycle of health and economic hardship that is difficult to break without systemic intervention.

El Salvador’s strategy relied on a comprehensive, multisectoral approach. The government integrated eye health services into the existing primary health care framework. This included visual acuity screenings for adults and the improvement of water and sanitation infrastructure. By strengthening the national health system, the country has not only cleared current cases but has also built the capacity to prevent the re-emergence of the disease. Health personnel have been trained to manage trachomatous trichiasis, ensuring that the infrastructure for detection remains in place.

El Salvador now joins a group of 64 countries worldwide that have been recognized by the WHO for eliminating at least one neglected tropical disease. In the Americas, this list includes seven countries, with El Salvador standing alongside Mexico as one of the few to have eliminated trachoma specifically.

Current Status of Trachoma in the Americas

While El Salvador has reached this milestone, the work continues across the region. Trachoma remains a public health problem in rural and remote areas of Brazil, Colombia, Guatemala, and Peru. PAHO continues to support these nations as they work to define the epidemiological status of the disease more accurately. Other countries, including Bolivia, Ecuador, Guyana, Panama, Paraguay, and Venezuela, are also expanding their investigative efforts to determine the prevalence of the disease.

The WHO road map for neglected tropical diseases 2021–2030 provides the strategic framework for these regional efforts. The goal is to reach a point where these conditions are no longer considered public health threats. For El Salvador, the immediate next step is the maintenance of these surveillance mechanisms. The WHO emphasizes that countries that have achieved elimination must remain vigilant, ensuring that quality eye care services remain accessible to the public to prevent any potential re-introduction or undetected spread of the bacteria.

The success of the program in El Salvador, supported by the Embassy of Canada and PAHO, underscores the importance of long-term political commitment. As we look toward the 2030 goals, the focus shifts to sustaining these gains while providing technical support to the countries where the transmission of trachoma still impacts daily life and long-term vision health.

We encourage our readers to stay informed on the progress of regional health initiatives. You can find further updates on the status of neglected tropical diseases through the Pan American Health Organization official portal. If you have questions or insights regarding public health policy in your region, please share them in the comments below.