Tag Archives: Safe Strategy

Water is Crucial to Ending Blinding Trachoma

NTDs, Trachoma, WASH,

 

Photo from International Trachoma Initiative

Photo from International Trachoma Initiative

By Elizabeth Kurylo
Communications manager, International Trachoma Initiative

Every morning and every night, I turn on the hot and cold water taps, adjusting them so the temperature is just warm enough to wash my face. I take for granted that the water will flow. I would be shocked if it didn’t. This easy access to water is a luxury not enjoyed by hundreds of millions of people around the world.

As we mark World Water Day, it is worth noting that 748 million people do not have access to an improved source of drinking water and 2.5 billion do not use an improved sanitation facility. For them, the lack of water can mean poor health, disability and even death.

Water and sanitation is especially important in the prevention and control of trachoma and other neglected tropical diseases (NTDs). Trachoma is an ancient eye disease caused by a bacterial infection. Left untreated, it can lead to blindness. But we can stop it with the World Health Organization-endorsed SAFE strategy – Surgery, Antibiotics, Facial cleanliness and Environmental improvement.

Water is crucial to facial cleanliness, and key to ending blinding trachoma.  But in many places where trachoma is endemic, water is scarce, and rationed for uses other than hygiene, such as cooking. Face washing is not a priority.

The global trachoma community has made much progress since 1998, when Pfizer began donating the antibiotic Zithromax®, which treats and prevents trachoma. More than 444 million doses of Zithromax® have been shipped to trachoma endemic countries to date. And seven countries have reported reaching their elimination goals.

Under the leadership of WHO and the Alliance for the Global Elimination of Blinding Trachoma by the year 2020 (GET 2020), national trachoma programs have steadily scaled up implementation. In 2014, WHO’s Weekly Epidemiological Report (WER) said trichiasis surgeries and antibiotic distribution were tenfold higher in 2013 compared to 2004.

The International Coalition for Trachoma Control (ICTC) has galvanized the global trachoma community’s commitment to reaching elimination by 2020.  Collaboration on game-changing initiatives with governments, health officials and trachoma endemic communities has led to the mobilization of more than 150 million dollars of new funding from DFID, USAID and the Queen Elizabeth Diamond Jubilee Trust.  That is in addition to the national government domestic budget allocations and support already provided by many non-governmental development organizations as well as other donors such as the Lions Clubs International Foundation, Conrad N Hilton Foundation and the Bill & Melinda Gates Foundation.  The WASH sector also is collaborating with the NTD sector to achieve shared goals of improving health and eliminating disease.

Still, there is much work to do. An estimated 232 million people in 51 countries live in trachoma endemic areas. Globally, 31 countries are implementing the SAFE strategy to eliminate trachoma, which signifies that 20 countries are still in need of help.

In 2015, ITI plans to ship 115 million doses of Zithromax®, donated by Pfizer. That is more than twice the amount approved for shipment in 2014.  “We are doing everything we can to accelerate access to Zithromax® needed by people who are at risk of blindness from trachoma,” said Dr. Paul Emerson, Director of ITI. “We are empowering national programs so that those at risk of going blind from trachoma can be treated.”

Empowering people in trachoma endemic communities to prioritize water for hygiene also has lasting benefits. I saw this in Ethiopia, where I met Amarech Haluka, the mother of three young girls, one of whom had experienced the pain of trachoma. Health workers introduced the SAFE strategy to Amarech’s community, which received donated Zithromax® and education about the importance of using latrines and keeping their faces clean to avoid trachoma. Amarech and her husband got a loan to install a water pump in their back yard, and she now routinely washes her children’s faces twice a day. Even though she cannot adjust the temperature of the water that flows from her pump, her children’s faces are clean, and her family is free of trachoma.

SAFEly Combatting Trachoma across Africa

Africa, Trachoma,

 

END7_Malindi_MoScarpelli_web_08

By Anna Massey, Head of Strategic Government Partnerships at Sightsavers

When it comes to tackling the largest infectious cause of blindness in the world – trachoma – it is widely agreed that the SAFE strategy is key in moving towards elimination. Recommended by the World Health organization (WHO), the strategy aims to reduce the burden of the disease, especially in Africa where it is highest, by addressing: Surgery (lid surgery to correct trichiasis); Antibiotics (Zithromax® donated by Pfizer to treat and prevent active infection); Facial cleanliness (to prevent disease transmission); and Environmental change (such as the construction and use of latrines to control flies, and provision of accessible water to allow face washing).

Excitingly, the situation will now change dramatically in six Sub-Saharan countries over the coming five years with the UK government announcing an investment of £39 million to help support the elimination of trachoma in countries like Ethiopia, Zambia and Tanzania through the SAFE strategy. Being implemented by a consortium of International Coalition for Trachoma Control (ICTC) members and managed by NGO Sightsavers, programme work will begin on the ground in Autumn.

The burden of the disease has already largely been surveyed in these countries, through the UK government supported Global Trachoma Mapping Programme (GTMP). For example Ethiopia, where the GTMP has supported the Ministry of Health to examine 430,000 people across seven regions, has approximately 30 per cent of the known global trachoma burden, so this support is much needed.

For countries such as Chad this crucial investment will see a rapid expansion of the nascent trachoma programmes and will hopefully be a catalyst for further support in fighting trachoma and stopping people needlessly living in pain and ultimately losing their sight.

Whilst this project will see 165,000 trichiasis surgeries performed and almost 10 million people treated with antibiotics, in addition to increasing access to water and instigating behavioural changes to reduce transmission of the disease, there is further good news for the broader NTD community. The implementation of the SAFE strategy and particularly the F&E components will also yield broader benefits including potential reductions in the burden of other infectious diseases, including cholera, typhoid and other NTDs (schistosomiasis, STH, Guinea worm), plus other diarrheal illnesses.

Through the programme, links will be made with other NTD projects in these countries to ensure a holistic push to make a dent in the significant and debilitating burden placed on these poor communities by NTDs such as trachoma. The provision of infrastructure around this planned scale-up of SAFE activities will support control of trachoma and provide a platform for strengthening other NTDs and health interventions.

The ICTC programme Advisory Committee will be providing technical and quality assurance guidance for the programme, which will include support from a series of structured working groups on technical programmatic practices.

Sightsavers itself will be drawing on its expertise of working with partners and Ministries of Health in African nations through other trachoma-related projects such as GTMP, The Queen Elizabeth Diamond Jubilee Trust Trachoma Initiative and a DFID-funded UNITED programme to tackle NTDs in Nigeria to ensure efficiencies, collaborations and ultimately success!

A Global Strategy to Eliminate Blinding Trachoma, A Disease Targeted by END7

Blindness, NTDs, Trachoma, Vision, , , , , ,

By: Elizabeth Kurylo, Communications manager, International Trachoma Initiative

Eliminating a disease is no small task. It helps to have a detailed plan. Partners working to eliminate blinding trachoma, one of the seven neglected tropical diseases targeted by , have such a plan. It’s called 2020 INSight: The End in Sight.

Produced by the International Coalition for Trachoma Control (ICTC), 2020 INSight is a global strategic plan with crucial next steps toward trachoma elimination by 2020.More than 2 million people are either blind or suffer excruciating pain because of trachoma. It makes one person experience severe sight loss every four minutes and blinds four people every hour.  Over 4.6 million are in the final, painful stages of this eye disease and require surgery to prevent them from going blind. It is endemic in at least 59 countries, in areas with limited access to water and sanitation.

A coordinated effort by governments, nongovernmental organizations, donors and other stakeholders is urgently needed to achieve the goal. Crucial next steps include the following:

  • Survey districts where trachoma is suspected to be endemic, so intervention can begin;
  • Dramatically improve access to clean water and latrines;
  • Increase global funding for trachoma control, including implementation of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvement);
  • Train teachers and other community leaders about facial cleanliness and better hygiene so they can spread the message in their communities;
  • Quickly address the backlog of 4.6 million people who need surgery to prevent blindness;
  • Identify support for more mass drug administration (MDA) programs to provide about 380 million more antibiotic treatments.

More than 80 percent of the burden of active trachoma is concentrated in 14 countries, where immediate action is needed. Eliminating the disease in Africa alone would boost the continent’s gross domestic product (GDP) 20-30 percentage points based on conservative annual productivity loss estimates.

Since 1998, Pfizer Inc has donated more than 225 million doses of the antibiotic Zithromax® to treat and prevent blinding trachoma. The International Trachoma Initiative (ITI) manages the distribution of the medicine.

Get your copy of 2020 INSight at the ICTC website.