In 2018, 53 Commonwealth leaders made a commitment at the Commonwealth Heads of Government Meeting (CHOGM) to take action to achieve quality eye care for all, including the elimination of trachoma as a public health problem by 2020. This was a successful outcome contributed to by advocacy efforts supported by Vision for the Commonwealth, an advocacy initiative started by The Queen Elizabeth Diamond Jubilee Trust* and supported by Clearly, the International Agency for the Prevention of Blindness, International Coalition for Trachoma Control, Peek Vision, Sightsavers and The Fred Hollows Foundation. During the 2018 summit leaders recognised the “significant socio-economic impact” of eye health issues and agreed to accelerate progress towards universal health coverage, eye health system strengthening and to integrate services which promote prevention, screening, diagnosis and treatment. Now, as Commonwealth countries prepare for CHOGM 2020, hosted by the Government of Rwanda, in Kigali, the eye health community including trachoma stakeholders are assessing what progress has been made and the challenges that must be overcome to achieve our shared goal of ‘quality eye care for all’.
Since CHOGM 2018, multiple countries have made advancements towards trachoma elimination targets. In 2018, Ghana became the first Commonwealth country to be validated by the World Health Organization for eliminating trachoma as a public health problem. Other Commonwealth countries have also seen remarkable progress, including:
- Malawi: has reached elimination thresholds and has entered into a surveillance period;
- Nigeria: has reduced the number of people at risk of trachoma by almost 50% from 20 million in 2018 to 11 million in 2019;
- Australia, Fiji and Solomon Islands are on track to reach elimination thresholds in 2020;
- The number of people at risk of trachoma across the Commonwealth has reduced from 42 million in 2018 to 30 million in 2019 – reducing its proportion of the global burden of trachoma from 25% – 21%.
Progress across the Commonwealth has been accelerated as a result of extraordinary government leadership, partnerships between implementing partners, donor coordination, an effective Zithromax donation program and guidance from WHO to scale up all components of the SAFE strategy through national trachoma programs. Several national programmes, including Chad, Ethiopia, Fiji, Kenya, Kiribati, Malawi, Nigeria, Mozambique, Solomon Islands, Tanzania, Uganda, Vanuatu and Zambia, have received catalytic support from programs including the United Kingdom’s Department for International Development (DFID) SAFE Program and The Queen Elizabeth Diamond Jubilee Trust Trachoma initiative. These two programs operated from 2014-2019 and supported all components of the SAFE strategy. Donor countries outside of the Commonwealth have also been instrumental in advancing progress. Most notably, the United States Agency for International Development’s ENVISION program (2011-2019) scaled up activities in Nigeria, which is being continued through its Act to End NTDs East program.
The Commonwealth Fund, launched by the UK Government in response to the 2018 CHOGM summit, committed a further £20 million pounds to accelerate progress towards the elimination of trachoma in ten Commonwealth countries, including Kenya, Kiribati, Nauru, Nigeria, Pakistan, Papua New Guinea, Solomon Islands, Tanzania, Tonga, and Vanuatu. From 2018 – 2020, this new program is expected to deliver antibiotics to more than 6.6 million people, provide surgery for up to 60,000 people, train more than 11,000 local heath volunteers, conduct more than 130 surveys and improve hygiene and sanitation practices for communities at risk.
This year, the Vision for the Commonwealth campaign is leading advocacy efforts to build upon the success of CHOGM 2018 on eye health, supported by recommendations from the World Report on Vision, launched by WHO in 2019. The World Report on Vision provides critical policy recommendations to achieve ‘quality eye care for all’.
Ahead of CHOGM 2020 at the 73rd World Health Assembly in May, two complimentary resolution’s will further advance this agenda in the political sphere and commit all Member States to take action: the resolution for ‘integrated people-centered eye care’, which among other things specifically highlights trachoma elimination as an issue for health systems; and the resolution ‘Ending the neglect to attain the Sustainable Development Goals – A road map for neglected tropical diseases 2021–2030’, firmly aligning NTDs with the 2030 Agenda for Sustainable Development in support of the upcoming WHO 2021-2030 NTD Roadmap. The roadmap, which will be launched by WHO at the Kigali Summit on Malaria and NTD on the eve of CHOGM, will serve as a guiding document to address key challenges for NTDs over the next decade. Together with the landmark 2019 high-level United Nations Political Declaration on universal health coverage, which includes a commitment to ‘address eye health conditions […] and neglected tropical diseases, as part of universal health coverage’ (para 34 of the political declaration), global momentum is accelerating to ensure all aspects of eye health and blinding NTDs like trachoma and onchocerciasis effectively contribute to the universal health coverage agenda.
ICTC remains a committed member of the Vision for the Commonwealth initiative. The work carried out supports integrated eye health care as a crucial mechanism to support the sustainability of trachoma interventions beyond WHO validation of elimination and ensures investments for trachoma continue to support health systems strengthening through human resource capacity and technical skills.
With Commonwealth leaders meeting under the theme ‘Delivering a common future: Connecting, innovating, transforming’, CHOGM 2020 provides countries a platform to share lessons and commitment to transform eye health services through integrated people-centred eye care. More than ever before, governments have the tools, knowledge and partnerships to ensure that all people across the Commonwealth can access interventions they need, which will be critical to achieve and sustain impact towards national, regional and global targets for eye health and the global elimination of trachoma as a public health problem.
* The Queen Elizabeth Diamond Jubilee Trust, was a time-limited charitable foundation established in 2012 to mark and celebrate Her Majesty The Queen’s Diamond Jubilee. In January 2020, the Trust successfully completed its programs and ceased operating as a grant-making organisation having achieved a significant, sustainable reduction in avoidable blindness across the Commonwealth in honour of Her Majesty The Queen.
- The World Report on Vision, October 2019
- Vision for the Commonwealth
- Ending the Neglect to Attain the Sustainable Development Goals: A Roadmap for Neglected Tropical Diseases 2021-2030 (Draft)
- United Nations Political Declaration on universal health coverage, September 2019
- Trachoma Elimination in Africa: Lessons from Two Multi-country Initiatives – Available in English, French and Portuguese
- Keeping the Commonwealth SAFE from trachoma infographic