International Coalition for Trachoma Control

"The ability to defeat this disease is for us, and us alone, to accomplish" – this inspirational message, shared by Ethiopia’s Vice President for the Oromia region set an empowering tone at an event in November celebrating Pfizer’s 500 millionth donated dose of the antibiotic Zithromax.

The event celebrated the fantastic progress we’ve seen in recent years, the power of partnership and the positive impacts being made by Pfizer’s antibiotic donation. But the icing on the cake was to hear Ethiopian leaders emphasize the critical importance of water, sanitation and hygiene (WASH) for the elimination of trachoma and talk about the concrete ways in which the Ethiopian government and Ethiopian people can play their part ensuring the elimination of trachoma as a public health problem.

WASH plays an essential role in this important public health goal. Trachoma is caused by the bacterium chlamydia trachomatis, which thrives where there is poor sanitation and limited access to water for personal hygiene. We know this not least because trachoma disappeared in Europe, the United States and many other countries given improved living standards and before antibiotics were widely available. WASH is also essential to sustaining the positive health improvements gained through antibiotic treatment and for preventing reinfection. Despite this, trachoma programs have largely focused on providing medical interventions for treatment and prevention (the Surgical and Antibiotic components of the WHO SAFE strategy), rather than on addressing the Facial cleanliness and Environmental changes needs for sustainable health outcomes. 

For these reasons, advocating for the important role of WASH for trachoma elimination is a key advocacy priority for ICTC so it was incredibly exciting to hear both Dr Kebede Worku, State Ministerof Health, and Oromia’s Vice President Ato Dessie call for Ethiopia’s ONE WASH initiative to be expanded to all trachoma endemic districts and become the central strategy to fight trachoma. The initiative is a government-led WASH coordination mechanism involving water, health, education and finance and economic development ministries as well as development partners. Fully integrating Ethiopia’s trachoma elimination program with this cross-ministerial initiative would be a game changer and provide an excellent model to other countries on how integration can be achieved.

Dr Worku also addressed Ethiopian citizens to ask what if there were no drugs available, what part could ordinary people themselves play in their day to day lives? He responded himself, with "We control our fates. We can defeat this disease simply by washing our faces and the faces of our children and keeping our compounds clean."

These empowering messages underscore the significant progress being made at scale in the world's most trachoma endemic country.  

Whilst large-scale trachoma programs were under way in the Amhara region, the extent of the disease burden in huge swathes of the country was unknown prior to the Global Trachoma Mapping Project. Since 2012, all suspected endemic districts in the country have been mapped. Now there is a national Trachoma Action Plan and the government requires all implementing partners to follow the full WHO-endorsed SAFE strategy to treat and prevent trachoma. This approach includes WASH-related elements on face washing and improved sanitation as well as surgery and antibiotics.

Ethiopia provides a strong role model for trachoma elimination. We welcome such clear leadership on supportive messaging for the facial cleanliness and environmental components of the SAFE strategy. 

This blog was written by Virginia Sarah, ICTC Chair