International Coalition for Trachoma Control

In September, Australia's Minister for Rural Health Fiona Nash announced new funding specifically for trachoma health promotion. This is wonderful news, particularly for the many different stakeholders who have worked hard to keep the pressure on the Australian government to step up action on tackling this preventable disease. But those of us working to raise the profile of trachoma in Australia never dreamed the journey would take this long and be as complicated.
 
You may have heard Australia has had quite a few Prime Ministers lately. Five in about five years, not something to aspire to…. This has been disruptive and proven to be an extra challenge in attracting funds for trachoma elimination and getting on with the job.
 
Despite this, there have been a few wins along the way. When he was Health Minister, the recently ousted Prime Minister Tony Abbott established the National Trachoma Reporting and Surveillance Unit in 2006. This was an important start because it started to give authoritative data on the presence and severity of trachoma. In 2009, Prime Minister Kevin Rudd funded screening and antibiotic treatment activities for the trachoma elimination program.

Then, in 2012, Minister Warren Snowdon, who was Minister for Indigenous Health at the time, funded health promotion resources we developed at the University of Melbourne in partnership and in close consultation with Aboriginal communities, which were also distributed for free by the government.

This was an important activity as health promotion is a crucial part of the approach to eliminating trachoma. Most Aboriginal houses, at least in theory, have solar hot water for example, so the water needed to keep clean and keep infection at bay is generally available. Nevertheless, infection rates in children in Indigenous communities are about 20% which means that raising awareness of the importance of hygiene behaviours, particularly face washing, to breaking those cycles of infection, is critical.

Examples of support and interest like these have been encouraging while the delays have been frustrating. However, thanks to a large number of people that have been involved in advocating around trachoma in Australia, in 2014, the prevalence of trachoma decreased to 4.7% from 14% in 2009 so there is some good news and we are getting there. Despite these advances, in 2015, Australia still has remote communities living with trachoma even though the disease was eliminated within the rest of its population more than 100 years ago. To its international shame, Australia remains the only developed country in the world with trachoma.

Trachoma disappeared from all other developed countries last century as a result of general improvements in living and hygiene standards. Finally, the accumulation of data and persistent advocacy together with the success of programs in developing countries has led the Australian government to prioritise trachoma, although there is still a way to go and we cannot afford to take the pressure off.
 
Luckily, there are many partners and stakeholders involved in keeping the pressure up. These include Vision 2020 Australia, which represents around 50 member organisations working to eliminate avoidable blindness and vision loss by the year 2020. Without drive and commitment from this diverse group private supporters and stakeholders, we could not have seen the progress made so far or be as prepared to close the final mile and make trachoma in Australia history once and for all.

By Professor Hugh R. Taylor AC, Melbourne Laureate Professor & Harold Mitchell Chair of Indigenous Eye Health, Melbourne School of Population and Global Health, The University of Melbourne and Emma Stanford, Research Fellow, Indigenous Eye Health, Melbourne School of Population and Global Health, The University of Melbourne