20 years later: How the World Health Assembly catalysed momentum to end trachoma

13 Jun 2018 
by Serge Resnikoff
| Chair, International Coalition for Trachoma Control
Serge Resnikoff, Chair, ICTC

The International Coalition for Trachoma Control joins the World Health Organization and other partners in congratulating Ghana and Nepal for having eliminated trachoma as a public health problem.

Trachoma, the world's leading infectious cause of blindness, is a disease that dates back thousands of years. Evidence of trachoma has been found in ancient Nubian tombs in Sudan and has been a known public health problem in at least 46 countries. In the last 20 years however, leadership from WHO has helped to build a global movement and increase political will to eliminate trachoma once and for all.

World Health Assembly Resolution 51.11, adopted in May 1998, committed member states to taking action towards the elimination of trachoma. Resolution 51.11 capped a period of increasing momentum for the trachoma community and was a significant boost for those working on the disease who had limited support until the late 20th century. Stemming from the 1st WHO Global Scientific Meeting, the resolution was the result of a small number of highly committed individuals working together under WHO's leadership to include trachoma elimination on the WHA agenda – a proposal that was adopted with enthusiasm. 

Since the WHA Resolution, there have been several key further developments. The establishment of the International Coalition for Trachoma Control (ICTC) in 2004 brought together non‐governmental, donor, private sector and academic organizations to support the GET2020 Alliance. By working together, sharing data and ensuring different stakeholders expertise are used strategically; donors recognized that the trachoma community had a real plan and the expertise to achieve elimination.

The trachoma elimination target was re-emphasised in 2012 when the London Declaration on NTDs was signed. The London Declaration helped mobilise resources and commitments for trachoma elimination work worldwide. In parallel, work was commencing on the Global Trachoma Mapping Project, which was jointly funded by the UK Department for International Development (DFID) and the US Agency for International Development (USAID). The GTMP is the largest infectious disease survey completed to date. In it, 2.6 million people in 29 countries were examined. Data collected have provided health ministries with the evidence needed to plan and implement interventions effectively and efficiently. Most significantly, these data have informed the work of the UK aid funded DFID Safe Program and The Queen Elizabeth Diamond Jubilee Trust's Trachoma Initiative, two ICTC-led partnership initiatives with over US $100 million funding to scale up the SAFE Strategy.

Coordinated, evidence-based advocacy efforts have been essential to achieve the increased funding and endemic country buy-in over the last twenty years. They continue to drive progress today. Advocacy helped mobilise resources during the 2018 Commonwealth Heads of Government Meeting, which included the announcement of a £20 million DFID-supported Commonwealth Fund to support trachoma elimination efforts in ten countries. In the final communiqué of the meeting, 53 heads of government across the Americas, Europe, Africa, Asia and the Pacific committed to "take action towards achieving access to quality eye care for all, including eliminating blinding trachoma by 2020", thanks to advocacy efforts driven by the Vision for the Commonwealth platform, including ICTC.

While significant progress has been made over the last 20 years with several countries achieving validation of elimination, we must now maintain momentum in order to reach our global goal of elimination. The trachoma community will continue to build on these successes and mobilise resources to deliver comprehensive and sustained progress against trachoma, positioning our work alongside other government priorities and commitments, such as universal health coverage and the Sustainable Development Goals.

The upcoming World Report on Vision is an opportunity for the trachoma community to make a case for eye health investment to donor governments beyond the UK and US. To achieve the Sustainable Development Goals, we need new donors to work in partnership with endemic countries to strengthen health systems. This will help to ensure equitable access of eye health care to all people, with no one left behind.