HEALTH: Successful Public-Private Alliance Prevents Blindness

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Dec 6 2000 (IPS) - The spread of trachoma, an infectious eye disease that causes irreversible blindness in millions of people around the world, has run up against a major obstacle: the anti- trachoma efforts of an association between the public and private sectors.

The World Health Organisation (WHO) Alliance for the Global Elimination of Trachoma coordinates a series of programmes to fight the disease through joint efforts at the national and international levels.

The Alliance includes the interested countries, 20 non- governmental organisations (NGOs), research centres and the pharmaceutical industry.

The WHO reports that trachoma is responsible for at least 15 percent of blindness in the world, there are about six million people worldwide irreversibly blinded by the disease, and an estimated 146 million cases are in need of treatment to prevent impending blindness.

The application of the public-private model in Morocco and Tanzania has already produced unprecedented results, building hopes for the individuals suffering active cases in those countries where trachoma is endemic.

In Morocco, after just three weeks of implementing the new strategy, the prevalence of active trachoma plummeted 75 percent, and the serious forms of the disease have practically disappeared among the child population.

The project has also meant that 56 percent of the 15,500 operations needed for those with advanced cases of the disease could be carried out, says Youssef Chami-Khazraji, of the Moroccan Health Ministry.

In Tanzania, meanwhile, education campaigns included in the initiative – which extend to the schools – have already reached hundreds of thousands of children and adults, stated Tanzanian doctor Peter Kilima.

The Alliance proposes to eliminate the disease – most prevalent in developing countries – by 2020, and provides an excellent example of the power of an association between civil society and the different groups working in all areas of the world, commented Serge Resnikoff, coordinator of the WHO programme to prevent blindness and deafness.

Trachoma is an infection of the upper eyelid caused by the bacterium ‘Chlamydia trachomatis,’ and usually begins in early childhood. Through the discharge from children’s eyes, trachoma is spread easily from person to person by hands, clothing, or by flies that are attracted to eyes and runny noses, according to WHO.

“Blindness usually occurs in adulthood, after repeated infections have turned the eyelashes inward and painfully abraded the cornea,” says the United Nations agency’s programme for Global Elimination of Blinding Trachoma.

Because women tend to have more frequent and direct contact with children, they are two to three times more likely to become infected and lose their sight than are men.

In addition, the economic consequences of trachoma can be devastating for families and communities, because it affects individuals during the most productive period of their lives.

The disease is endemic in parts of Africa, Asia, the Middle East, Latin America and Australia. An estimated 540 million people are at high risk of blindness or of severe sight impediments.

The WHO developed a strategy to confront trachoma known as S.A.F.E., which consists of: ‘Surgery’ to correct advanced-stage trachoma, ‘Antibiotics’ to treat active infection, ‘Face-washing’ to reduce disease transmission, and ‘Environmental’ change to increase access to clean water, improved sanitation, and health education

One of the NGOs participating in the campaign, the International Trachoma Initiative (ITI), presented “groundbreaking advances” achieved through efforts in five countries where blindness caused by the disease is most widespread: Ghana, Mali, Morocco, Tanzania and Vietnam.

The ITI is sustained with financial contributions from the Edna McConnell Clark Foundation and the Bill and Melinda Gates Foundations, and Zithromax antibiotics from Pfizer pharmaceutical labs, a medication used successfully against trachoma, reported Joseph Cook, director of the civil society group.