Across the globe, there are 200 million people at risk of trachoma, a preventable, blinding infectious disease. More than three million people are in need of immediate surgery to avoid blindness due to trichiasis, a manifestation of trachoma that causes eyelashes to turn inward, scraping the cornea with each blink. We blink 19,000 times a day.
One of the WHO-designated neglected tropical diseases, trachoma threatens the prosperity of families, communities, and nations, and fighting it greatly advances the Sustainable Development Goals addressing poverty, hunger, health, education, gender equality, water and sanitation, economic growth, and inequality. Trachoma primarily affects impoverished communities, and women — the pillars of society — are up to four times more likely than men to have trichiasis.
When I began working on trachoma nine years ago, the fight to seriously seek disease elimination was just getting off the ground. We couldn’t yet say exactly how many cases existed or where the greatest implementation needs were, and most trachoma-endemic countries lacked the resources to reach the huge numbers of people in need of prevention and treatment services.
How different the picture is now!
Thanks to massive advocacy efforts, a coordinated mobilization of resources by multiple major donors has enabled countries to put in place a package of WHO-endorsed interventions to reach elimination known as the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvement). Global epidemiological mapping of all areas suspected to have trachoma has been completed in what was the largest infectious disease mapping initiative ever. Based on lessons from countries far along in their SAFE Strategy implementation, preferred practices have been identified and shared widely to ensure all countries have the frameworks critical for effective programming.
With measureable daily progress, those of us working in trachoma understand that our collective efforts are making public health history.
The most powerful motivation of all
At the individual level, this means that millions of people will no longer face a future in which they can’t see well enough to work, care for their families, and live independently. Generations of children will not be taken out of school to care for their blind parents, breaking the cycle of poverty.
Something that has struck me most poignantly is the way people describe how trichiasis feels. “Like grains of sand in the eye.” “A sharp pain.” “A constant stinging sensation.” “A living death.” No one can describe life with trichiasis — and the dramatic change that treatment brings — more movingly than those who have lived it.
I invite you to listen to and share the remarkable stories of three individuals who recently received sight-preserving trichiasis surgery in Burkina Faso. For me, the heartfelt words of people like Sabine, Salfo, and Namalgbsom (pictured above) provide the most powerful motivation of all to continue pushing toward elimination of this terrible disease.
Today on World Sight Day, we have good reason to celebrate the achievements so far. Let’s also make it an occasion to recommit for those who still need our support, those who will go blind if we don’t act now, those who have not yet been reached as Sabine, Salfo, and Namalgbsom have. Remarkably, the World Health Organization goal of eliminating trachoma as a public health problem by 2020 is within reach, but $700-800 million is still urgently needed to finish the job.
Describing her near lifetime of pain from trachoma, Namalgbsom said, “There is no specific time it occurs. It’s when the sun rises and the wind blows.” Together, we can make this a world where people like her do not fear the respite of a cool wind on a hot day or warm beams of sunlight on their face. We know what to do, we know where to do it, and we know how to do it.
We need to act with urgency, quality, and efficiency to meet the 2020 targets. Those not yet reached are depending on us.
Emily Toubali is Director of the MMDP Project, which helps countries provide high-quality treatment and care for people suffering from the debilitating effects of trachoma and lymphatic filariasis. The MMDP Project is funded by USAID and managed by Helen Keller International.