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Is the end in Sight for Trachoma?

Posted: 15/10/11 01:00

Did you know that the world's leading cause of preventable blindness can be spread by the common fly? Called trachoma, this potentially blinding condition affects 27.8 million people across Africa, and around 84 million people worldwide. Known as a 'neglected tropical disease', trachoma is linked to extreme poverty and poor sanitation. On World Sight Day, October 13th, my colleagues and I at Sightsavers wanted to raise awareness of this devastating disease, one of the two neglected tropical diseases (NTDs) that lead to blindness, and of our plans to hopefully eliminate it within the next ten years.

Though non-existent in most developed countries, trachoma remains a significant public health threat in the developing world. Trachoma is an infection spread by flies and by direct contact with an infected person's eyes, or nose. Triggered by bacteria that cause repeated conjunctivitis, trachoma is easily spread and most common in children. Repeated infections scar the inside of the eyelid so severely that it turns inward and the lashes rub on the eyeball, scratching it and scarring the cornea. This is can lead to blindness and is known as trichiasis. The pain of this condition means sufferers often use tweezers to pull out their eyelashes, to prevent the scratching. According to the International Coalition for Trachoma Control (ICTC), trachoma blinds four people every hour.

Aside from the agonising pain of trichaisis, in developing countries blindness can have a devastating blow on people's livelihoods. This means that people living with disabilities and their families have little chance of ending the cycle that keeps them in poverty.

By treating trachoma, alongside other NTDs, we know that we can make a significant and tangible difference to people's lives. In 2010 Sightsavers supported its partners to treat over 1.8 million people for trachoma, with antibiotics and carry out 15,723 eyelid surgeries to turn the affected eyelids back out so the eyelashes do not scratch the cornea anymore. However trachoma, like other NTDs, often receives far less attention from policy makers and funding bodies than more prominent global health issues such as malaria or HIV, despite their heavy burden on communities.

I have always found this frustrating, considering that strategies for controlling many of the NTDs are already proving to be cost effective and have a strong record of success. This is why Sightsavers has taken the unprecedented step in order to eliminate trachoma from the 14 African and Asian countries where it is endemic, by 2020. To do this, the organisation has pledged to raise an additional £62 million to tackle trachoma for the next ten years and will expand its WHO approved SAFE strategy for eliminating trachoma.

SAFE stands for Surgery, Antibiotics, Facial washing and Environmental change, the four components needed to treat and prevent trachoma - surgery to reverse eyelids that have turned in, antibiotics to treat trachoma infections, facial cleanliness to prevent trachoma from being spread, and making changes to the environment that reduce the fly population. Sightsavers also plans to operate on one million trichiasis patients by 2020, and expand antibiotic distribution to 84 million people. This is a massive scale-up, but is needed to ensure we reach our goal of eliminating blinding trachoma.

We are investing money in treating and preventing NTDs because we know that it is cost effective, and programs to distribute the antibiotics that treat trachoma and other NTDs are often carried out by the communities themselves. Sightsavers has found community distribution to be a highly sustainable and effective method of distribution, and want to ensure that we continue to provide people with the tools to eradicate blinding diseases from their communities and support them in their development, so that by 2020, trachoma will be eliminated.

We are not alone in the fight against NTDs. The UK Department for International Development (DFID) has already agreed to invest more than £3.7 million in Sightsavers' program work for 2011-2012 as part of a three-year Program Partnership Arrangement (PPA) with the organisation. A project I saw in Nigeria last year is treating over half a million people in six weeks against the prevalent and damaging NTDs - through the community directed and school-based drug distributions. A marvellous achievement in such a short space of time and the drugs were largely distributed by volunteer 'community drug distributors,' (CCD) who take it upon themselves to ensure their fellow townspeople were protected from disease. I met one of the CDDs who had been working as a volunteer in his community for over 16 years - he was ready to take on the challenge of distributing new medications for other diseases too.

So on World Sight Day, it is my hope that donor agencies, national governments and NGOs working in other sectors such as water and sanitation, health and development, will recognise the importance of the NTDs. especially those that cause avoidable blindness. We hope that within the years to come, we will see these diseases being neglected no more.

 

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