Trachoma has a long and painful history, causing irreversible vision loss and blindness in populations around the world as far back as the Ice Age and ancient Egypt. In 2002, trachoma was estimated to affect 1.5 billion people globally. Sustained progress in combating trachoma, however, has resulted in a 92% reduction in the number of people at risk, to 125 million in 42 countries.
The scale-up of trachoma interventions has intensified over the last two decades, in large part, because of establishment of the World Health Organization (WHO)-endorsed SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement) and a global donation program for the antibiotic Zithromax®, which has been made available by Pfizer Inc. to all trachoma endemic countries through the International Trachoma Initiative (ITI).
Pfizer’s commitment to the antibiotic donation program has been both transformative and steadfast. Since 1999, antibiotic donations have enabled the treatment of more than 270 million individuals, making it one of the largest drug donation programs in history.
This support continued throughout the COVID-19 pandemic. Despite the postponement of many community-based interventions, including mass drug administration for trachoma, ITI and its partners stood ready to ship antibiotics and support MDA implementation as soon as countries determined that they were ready to restart.
Successful delivery of antibiotics requires continued disease assessments to identify where trachoma interventions are needed and complex logistics to access the hardest to reach areas. More importantly, it requires engagement with partners at all levels, from the international NGOs to the recipient communities, to ensure that the interventions are delivered in an inclusive, equitable and accessible approach
In June 2022 at the Kigali Summit on Malaria and Neglected Tropical Diseases, Pfizer extended its support to the ITI and the global health community’s target of elimination of trachoma as a public health problem by 2030.
Speaking at the Kigali Summit on Malaria and Neglected Tropical Diseases, Caroline Roan, Senior Vice President, Global Health & Social Impact, Pfizer Inc., said “trachoma affects the poorest of the poor and traps millions in a cycle of poverty. We are grateful for our partnership with the global health community over the past 20 years, and recognize the importance of our donation in achieving our shared goal of a trachoma-free world… We know elimination, globally, is in sight, and I am so proud to announce Pfizer’s extended commitment to the International Trachoma Initiative through the year 2030.”
The donation of antibiotic is supported by a diverse group of partners, including the Trachoma Expert Committee, which reviews applications for the medicine from health ministries, and receives guidance from WHO. During this process, countries are required to demonstrate: 1) the prevalence of trachoma calculated through population-based prevalence surveys, 2) an appropriate treatment strategy for the designated population group, 3) sufficient resources, such as well-trained staff, transportation, and appropriate storage facilities, are available to continue treatment until such time as the WHO can certify that trachoma has been eliminated as a public health problem; and 4) financial and technical support for implementation of the full SAFE strategy.
Following successful applications, the distribution of the donated antibiotic is supported by a range of partners, including members of the International Coalition for Trachoma Control, who support health ministries to ensure the antibiotic delivered in country reaches endemic communities.
“The antibiotic drug donation program is built on partnership”, said PJ Hooper, Vice Chair of the International Coalition for Trachoma Control and Deputy Director of the International Trachoma Initiative. “Antibiotics donated by Pfizer Inc., and managed by the International Trachoma Initiative, are available to health ministries following applications through the Trachoma Expert Committee. However, this is only one part of the journey. Successful delivery of antibiotics requires continued disease assessments to identify where trachoma interventions are needed and complex logistics to access the hardest to reach areas. More importantly, it requires engagement with partners at all levels, from the international NGOs to the recipient communities, to ensure that the interventions are delivered in an inclusive, equitable and accessible approach”.
The global drug donation program has played a significant role in reducing the burden of trachoma and has enabled international partners to transition from a control strategy to a strategy of elimination as a public health problem. Combined with the scale up of access to surgery for trachomatous trichiasis, facial cleanliness, and environmental improvement, these interventions will be crucial to help prevent trachoma and its complications in future generations. This World Sight Day, we are celebrating the partnership between communities, global health stakeholders, and Pfizer, who together are accelerating progress towards a world free from the pain, vision loss, and blindness caused by this ancient disease of poverty. The elimination of trachoma as a public health problem is within sight and can be achieved through sustained collaboration across sectors and industry.
This blog is by:
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Jeremiah Ngondi, Senior NTD Advisor, RTI International, and Trachoma Expert Committee member.
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Julie Jenson, Global Health and Social Impact, Pfizer Inc.
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PJ Hooper, Vice Chair International Coalition for Trachoma Control, and Deputy Director, International Trachoma Initiative.