International Coalition for Trachoma Control

The World Health Organization (WHO) has validated India as having eliminated trachoma as a public health problem. It is the third country in WHO’s South-East Asia Region to achieve this milestone, following Nepal in 2018 and Myanmar in 2020.

Trachoma prevalence surveys were first conducted by the Indian Council of Medical Research from 1959–1963. They revealed that in several states in northern India, >50% of those examined had active (inflammatory) trachoma. Within these states, over 90% prevalence was observed in some villages, where there was also high rates of overcrowding as well as poor personal hygiene and environmental conditions.

To address the national burden of trachoma, the Union Ministry of Health established India’s National Trachoma Control Program in 1963. The program sought to scale up trachoma interventions in areas where it had been identified as a public health problem. In 1976, India also launched its National Program for Control of Blindness, into which the National Trachoma Control Program was integrated. Trachoma remained a priority under the Vision 2020: The Right to Sight India initiative.

Since its inception, the National Trachoma Control Program has primarily implemented surgical and antibiotic interventions through the health sector. Surgical interventions are typically available at district hospitals, medical colleges and regional centers of ophthalmology, while azithromycin and tetracycline eye ointment were included under the national list of essential medicines and made available in the routine public health system.

Additionally, in 2019, India established a Trachoma Elimination Task Force to: plan interventions focusing on identifying trachomatous trichiasis (TT) cases; coordinate the training of ophthalmologists on TT surgery; strengthen TT surgical facilities across the country; and coordinate the provision of TT surgeries. To ensure that trachoma elimination is sustained, India also established a national register to monitor case detection and document interventions provided at public health facilities.

India has also prioritized facial cleanliness, implementing health promotion activities in collaboration with community leaders, teachers, women's groups, and multi-purpose workers (community health workers), and other well-known and respected community members. Provision of safe drinking water, sanitary latrines and facial cleanliness interventions were integrated into routine school health work.

“The elimination of trachoma as a public health problem in India is a testament to the country’s dedication to strengthening its eye health systems,” said PJ Hooper, Chair of the International Coalition for Trachoma Control. “India’s longstanding investment in building human resources for eye health and robust trachoma surveillance systems has ensured that new cases are identified and treated. This milestone reflects India’s leadership in public health, and we extend our congratulations to the Government of India on this significant achievement.”

In April 2024, WHO’s trachoma elimination update reported that 103 million people are known to require interventions for trachoma globally, a 93% reduction from the number of people thought to be at risk in 2002. India is the 20^th country to achieve elimination of trachoma as a public health problem. Other countries that have reached this milestone are: Benin, Cambodia, China, Gambia, Ghana, the Islamic Republic of Iran, Iraq, the Lao People’s Democratic Republic, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Saudi Arabia, Togo, and Vanuatu.