The number of people at risk from trachoma, the world's leading infectious cause of blindness, fell from 136.2 million in 2021 to 125 million in 2022, the World Health Organization (WHO) has reported in its Weekly Epidemiological Record.
The progress update presents data on the implementation of the WHO-endorsed SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement) in trachoma-endemic countries as well as summaries based on district-level prevalence estimates held in the GET2020 database as of 1 June 2022.
The record shows a total of 64.6 million people received antibiotics for trachoma in 2021. This represents a 97% increase from the 32.8 million treated in 2020. However, challenges related to COVID-19 remain, including reduced availability of healthcare personnel and decreased availability of funding for neglected tropical disease (NTD) programs, which are factors in lower numbers of people given antibiotics compared to 2019, when 95.2 million people were treated. Similarly, the number of people managed for trachomatous trichiasis (TT), the late blinding stage of trachoma increased by 65% from 42,045 in 2020 to 69,266 in 2021.
The number of people at risk of trachoma remains significantly lower than historical estimates, with a 92% reduction in the number of people at risk since 2002. The number of people requiring surgery for TT has also decreased by 76%, from 7.8 million in 2002 to 1.7 million in June 2022.
The Weekly Epidemiological Record data highlight the resilience and agility of national trachoma programs and their supporting partners, working across sectors to implement the WHO-endorsed SAFE strategy
Equity has continued to be a focus for national trachoma programs. Of the 33 countries that reported TT surgery in 2021, 30 reported gender-disaggregated data; of those operated, 69% were female. The finding is a good marker of gender equity in TT surgery delivery, as, overall, the relative risk of women for TT is 1.8 times that of men. The approximately equal numbers of women and men given antibiotics for trachoma in 2021 is an analogous indication of gender equity in antibiotic delivery.
“The Weekly Epidemiological Record data highlight the resilience and agility of national trachoma programs and their supporting partners, working across sectors to implement the WHO-endorsed SAFE strategy”, said Dr Angelia Sanders, Chair of the International Coalition for Trachoma Control. “Despite the disruption caused by COVID-19 to national health systems, progress has continued across all trachoma-endemic WHO regions. Notably, in 2022, Togo, Saudi Arabia and Vanuatu were all validated by WHO for eliminating trachoma as a public health problem. ICTC congratulates health ministries for their continued progress which is advancing progress towards the global NTD road map target of eliminating trachoma as a public health problem by 2030”.
To date, 14 countries (Cambodia, China, Gambia, Ghana, Islamic Republic of Iran, Lao People’s Democratic Republic, Mexico, Morocco, Myanmar, Nepal, Oman, Saudi Arabia, Togo and Vanuatu) have been validated by WHO as having eliminated trachoma as a public health problem. A further 3 countries (Burundi, Iraq, Tunisia) have reported having achieved the targets for elimination.
 The WER reports that 13 countries have been validated for eliminating trachoma as a public health problem. The report was published just days before Vanuatu was validated for achieving the milestone.