Is the end in sight for trachoma?
Happy World Sight Day! In honor of this day, we're featuring a guest blog post from Simon Bush of SightSavers.
By: Simon Bush, Director of Advocacy and African Alliances at Sightsavers
Trachoma is the world’s leading cause of preventable blindness, affecting an astounding 27.8 million people in Africa alone. According to the International Coalition for Trachoma Control (ICTC), trachoma blinds four people every hour. It is a disease of poverty inextricably linked to a lack of sanitation, which causes repeated eye infections that can lead to blindness if left untreated. It is known as a neglected tropical disease (NTD), meaning that it receives little attention or funding despite its heavy impact on the lives of people suffering from it.
We know from Sightsavers’ work across Africa and Asia, and from the work of other organizations that strategies for controlling blinding NTDs are already proving to be cost effective with a strong record of success, so it seems wrong that a disease like trachoma remains largely ignored and untreated.
This is why today, on World Sight Day, Sightsavers is making the biggest single commitment we have ever made - £62 million ($97.5 million) – to eradicate this terrible disease within the next ten years. We are taking unprecedented steps to ensure that trachoma is eliminated from the 14 African and Asian countries where it is endemic, by 2020.
By treating trachoma, alongside other NTDs such as onchoceriasis and schistosomiasis, we know that we can make a significant difference to people’s lives. Aside from the constant pain of later stage trachoma, called trichaisis, blindness can have a devastating blow on people’s livelihoods in developing countries. As there is often little support available to people living with disabilities in the developing world, they and their families have little chance of ending the cycle that keeps them in poverty, which is why tangible solutions to curing and preventing disability are so important.
On top of the devastating effect that NTDs can have on people’s lives, ignoring them has much wider implications for combating poverty. By not tackling trachoma and other NTDs, there is a chance that Millenium Development Goal (MDG) 6, which encompasses the treatment and prevention of HIV/AIDS, malaria and other diseases, will not be achieved. The MDGs were set out in 2000 to encourage development and proposed a set of targets, but as the deadline for the current goals (2015) draws near and debates emerge as to the future of the MDGs, it is important that we try our best to get progress on eliminating trachoma established.
In 2010 Sightsavers supported its partners to treat over 1.8 million people for trachoma with antibiotics and carry out 15,723 eyelid surgeries to treat turned-in eyelids caused by trichiasis. It is very important that we maintain what the medical professionals call ‘morbidity control’. Distributing drugs to prevent and control diseases is one thing, but we must also address those who currently have the disease and require surgery – these are the people in need of the most urgent help as they are most at risk of going blind.
That’s why we are taking an integrated and sustainable approach to tackling trachoma. Sightsavers will be up-scaling it’s World Health Organization approved SAFE strategy, which has treated over seven million people since it’s inception in 1998. The SAFE strategy stands for Surgery, Antibiotics, Facial washing and Environmental change, the four components needed to treat and prevent trachoma - surgery to reverse eyelids that have turned in, antibiotics to treat trachoma, facial cleanliness to prevent trachoma from being spread, and making changes to the environment that reduce fly population. Sightsavers plans to operate on one million trachoma patients by 2020, and expand antibiotic distribution to 84 million people.
Our work with NTDs has allowed us to let communities take charge of their own development - programs to distribute the antibiotics that treat trachoma and other NTDs are often carried out by the communities themselves. Sightsavers has found community distribution to be a highly sustainable and effective method of distribution, and we want to ensure that we continue to provide people with the tools to eradicate blinding diseases from their communities and support them in their development, so that by 2020, trachoma will be eliminated.
There are some further positive signs in the fight against NTDs. The UK Department for International Development (DFID) has already agreed to invest more than £3.7 million ($5.8 million) in Sightsavers’ program work for 2011-2012 as part of a three year Programme Partnership Arrangement (PPA) with the organization. Another high point was a project I saw in Nigeria last year is treating over half-a million people in six weeks against the prevalent and damaging NTDs – through the community directed and school-based drug distributions. A marvelous achievement in such a short space of time and the drugs were largely distributed by volunteer ‘community drug distributors,’ (CCD) who take it upon themselves to ensure their fellow townspeople were protected from disease. I met one of the CDDs who had been working as a volunteer in his community for over 16 years – he was ready to take on the challenge of distributing new medications for other diseases too.
So on World Sight Day, it is my hope that donor agencies, national governments and NGOs working in other sectors such as water and sanitation, health and development more generally, will recognize the importance of the NTDs, especially those that cause avoidable blindness and that within the years to come we will see these diseases being neglected no more.
Simon Bush is the Director of African Alliances and Advocacy at Sightsavers, an international NGO helping people with visual impairments in developing countries. Simon’s work includes travelling to monitor Sightsavers projects, advocating for changes to policy from top decision makers, and developing approaches to social inclusion and inclusive education for the blind and people with disabilities. He also has the important task of managing the relationships with Sightsavers’ public-private partnerships that concern Sightsavers work with potentially blinding neglected tropical diseases (NTDs), such as trachoma and onchoceriasis.
 The end in sight 2020 Insight, International Coalition for Trachoma Control, 2011