Morocco eliminates trachoma – the leading infectious cause of blindness
Today, the World Health Organization (WHO) acknowledged the elimination of trachoma as a public health problem1 in Morocco.
Trachoma is the leading infectious cause of blindness worldwide. Transmitted through contact with eye and nose discharge of infected people, particularly young children, it affects populations in 42 countries, and is responsible for blindness or visual impairment in around 1.9 million people.
“This is an impressive public health achievement for Morocco,” said Dr Margaret Chan, WHO Director-General. “It demonstrates how strong political will, education, awareness, surveillance and most importantly community engagement, can work to defeat a debilitating disease.”
In the 1990s, Morocco began to implement the WHO-endorsed SAFE strategy, which contains a comprehensive package of interventions, including surgery for trichiasis – the blinding stage of trachoma, antibiotics to treat infection, facial cleanliness and environmental improvement to limit transmission.
Thousands of seriously affected people in the provinces of Errachidia, Figuig, Ouarzazate, Tata and Zagora underwent surgery and the vast majority were treated by health workers with the antibiotic azithromycin, donated through the International Trachoma Initiative.
“Availability of azithromycin spurred control activities and with the involvement of local communities and the mobilization of health professionals we managed to reach almost every individual be it in villages or schools,” said HE Dr El Houssaine Louardi, Minister of Health, Morocco.
To date, 8 countries2 have reported achieving elimination targets and most countries endemic for trachoma are now accelerating the implementation of the SAFE strategy to achieve their elimination targets supported by the WHO Alliance for the Global Elimination of Trachoma by 2020 (GET2020). In 2015, more than 185 000 people with trichiasis received corrective surgery worldwide, and 56 million were treated with azithromycin.
It is estimated that funding of up to US$ 1 billion is required globally to expand and sustain activities to 2020 in order to eliminate the disease as a public health problem.
“Morocco has made a significant contribution to our goal to achieve global elimination of trachoma.” said Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean. “This success in Morocco gives us hope that similar achievements are possible in our Region to eliminate other neglected tropical diseases.” Validation of the elimination of trachoma as a public health problem
In 2015, the WHO Strategic and Technical Advisory Group on Neglected Tropical Diseases endorsed standardized processes for confirming and acknowledging success for all neglected tropical diseases targeted for eradication, elimination of transmission, or elimination as a public health problem. The process for diseases targeted for elimination as a public health problem has been defined as “validation”.
Validation of elimination of trachoma as a public health problem
1. Elimination of trachoma as a public health problem is defined as: (i) a prevalence of trachomatous trichiasis “unknown to the health system” of less than 0.2% in adults aged 15 years and older; and (ii) a prevalence of trachomatous inflammation-follicular in children aged 1–9 years of less than 5%, in each formerly endemic district.
2. China, Gambia, Ghana, the Islamic Republic of Iran, Mexico, Morocco, Myanmar and Oman.