Eliminating Blinding Trachoma

As I mentioned in my previous two blogs about my Africa trip of last July, I had the pleasure of meeting many interesting people and learning about numerous exciting, cool projects during that three week long visit to Kenya, Tanzania and Ghana. In Ghana, I greatly enjoyed meeting Peter Ackland, CEO of the International Agency for the Prevention of Blindness. Peter is spearheading the wonderful campaign Vision 2020 “The Right to Sight”: a global initiative seeking to eliminate avoidable blindness by the year 2020. We sat under a tree and talked particularly about the race to eliminate trachoma, the world’s leading cause of preventable blindness and one of Vision 2020’s five priority diseases.

I think social entrepreneurship is all about looking at root causes and addressing them: elimination of a disease is a pretty good approach to addressing the root cause instead of just treating symptoms. And that's Peter's goal as part of this effort.

Trachoma starts with a relatively benign infection of the eye with the bacteria Chlamydia trachomatis, which leads to inflammation of the tissue lining the eyelids (this is one of the causes of conjunctivitis, or “pink eye”). The condition is highly communicable and easily spreads via contact with dirty clothes, hands and flies that are attracted to people’s eyes. In its advanced stage, called trichiasis, repeated re-infection causes scarring of the eyelid, which then turns inward, scraping the cornea with every blink. The combination of repeat cornea trauma and secondary infections is excruciatingly painful and causes diminished vision and, eventually, blindness.

Trachoma has been around for thousands of years, but as the result of development and targeted interventions, it is now limited to an estimated 57 countries, often affecting poor, rural communities that lack the tools for basic hygiene, clean water and adequate sanitation. Today, an estimated 750,000 people are blind and at least 1 million suffer low vision due to trachoma. More than 4 million experience trichiasis, steadily and painfully progressing towards blindness, and hundreds of millions need treatment or are at risk of being infected. In addition to the human cost of the disease, its economic burden on the lives of individuals, families and communities is enormous. Kenya and Tanzania, among others, are considered “high burden countries,” defined as having more than 5 million people living in trachoma-confirmed and suspected areas.

The good news is that trachoma can effectively be eliminated. In 1999, the World Health Organization (WHO) and Peter’s International Agency for the Prevention of Blindness launched the VISION 2020 campaign, which has mobilized a community of partner organizations that have been working together towards the 2020 goal. They implement the WHO-endorsed SAFE (Surgery – Antibiotics – Facial Cleanliness – Environmental Improvements) strategy that’s been proven highly successful at eliminating trachoma in vulnerable populations, and they continually improve upon it by smart innovation.

At Benetech, we apply innovative technology to create new realities for people with blindness and other print disabilities. Of course, we are huge fans of prevention and applaud the efforts to get trachoma under control so that millions of people can be spared the painful and disabling path towards low vision and blindness. Controlling trachoma also has important auxiliary benefits to public health, such as improved sanitation and per­sonal hygiene.

There’s great progress to report on: the first countries (among which is Ghana) have reached or are reaching their intervention goals and the total trachoma burden is shrinking. There are also significant challenges ahead and much more to do: reaching the 2020 milestone will depend on country leadership, international coordination, logistical and planning support, and adequate financing. But how heartening it is that the elimination of blinding trachoma – a disease that’s been recorded since Egyptian times – is now well within sight.