After decades of fighting, India has finally eliminated trachoma as a public health problem.

According to the World Health Organization (WHO), it has become the third country in the Southeast Asia Region to achieve this milestone.

The disease is one of the leading causes of blindness globally and has been a public health concern.

Here’s all we know about the disease.

About trachoma

Trachoma is a bacterial infection that affects the eyes.

It is caused by the bacterium Chlamydia Trachomatis.

Termed as a neglected tropical disease, the eye condition is found in underprivileged communities living in poor environmental conditions.

Women are reportedly up to four times more likely to be blinded due to the disease than men, due to their more frequent contact with infected children.

The global health agency estimates that 150 million people worldwide are affected by trachoma and six million of them are blind or at risk of visually disabling complications.

Today, it remains a significant public health problem in 39 countries.

Transmission

The disease is contagious, spreading through contact with infected people’s eyes, eyelids, nose or throat secretions or indirectly through flies that have been in contact with these secretions.

Other environmental factors that can lead to trachoma transmission are poor hygiene, crowded living conditions, lack of access to clean water and inadequate sanitation facilities.

Symptoms

Trachoma begins with conjunctivitis, also known as “pink eye.”

Its symptoms include itching and irritation of the eyes and eyelids, discharge from the eyes, and sensitivity to light.

According to WHO, in advanced stages, this scarring leads to a condition called trichiasis, where the eyelashes turn inward.

The constant irritation and rubbing of the eyelashes against the eye can cause corneal scarring and result in visual impairment or blindness if left untreated.

In severely endemic countries, blindness can occur in childhood, though it typically appears between 30 and 40 years of age.

Prevention and treatment

Trachoma is preventable and treatable in its initial stages, with the help of antibiotics such as azithromycin.

The WHO has even recommended implementing SAFE strategy in endemic countries:

• Surgery for infected people to prevent blindness.

• Antibiotic treatment to eliminate the infection.

• Facial cleanliness promotion to reduce transmission risk.

• Environmental improvements, especially in water and sanitation access.

To combat the eye disease, healthcare providers in 2021 offered surgical treatment to over 69,266 infected people and provided antibiotics to 64.6 million people (44 per cent globally).

Despite its preventability, reversing blindness caused by trachoma is extremely challenging.

Trachoma in India

Trachoma was one of the leading causes of blindness in India during 1950–60.

The Government of India launched the National Trachoma Control Programme in 1963 and later on trachoma control efforts were integrated into India’s National Programme for Control of Blindness (NPCB).

In 1971, blindness due to trachoma was five per cent.

Today, owing to the various interventions and implementation of the WHO SAFE strategy in 2019, it has come down to less than one per cent.

Elimination of the eye disease

In 2017, India was declared free from infective trachoma.

However, surveillance continued for trachoma cases in all the districts of India from 2019 onwards till 2024.

The National Trachomatous Trichiasis (TT only) Survey was also carried out in 200 endemic districts of the country under NPCBVI from 2021-24, which was a mandate set by WHO in order to declare that India has eliminated trachoma as a public health problem.

All the reports were compiled in a specific dossier format by the NPCBVI team and were shared with the WHO country office for final scrutiny.

Finally, after years of fighting against trachoma, WHO declared that India has eliminated the condition as a public health problem.

The award for the citation was received by Aradhana Patnaik, Mission Director for National Health Mission.

“India’s elimination of trachoma as a public health problem is a testimony to the country’s commitment to alleviating the suffering that millions have faced from this debilitating disease,” WHO Director-General Dr Tedros Adhanom Ghebreyesus, said on Tuesday, adding that the organisation worked closely with India to realise this achievement.

With this achievement, India has joined Nepal and Myanmar in the WHO South-East Asia Region and 19 other countries that have ridden themselves of trachoma.

For those uninitiated, the elimination of trachoma is part of the 2021-2030 neglected tropical disease roadmap led by the WHO, which aims to prevent, control, eliminate, and eradicate about 20 diseases and their groups by 2030.

Meanwhile, as per The Times of India, alongside India, Bhutan was also felicitated for achieving interim targets for cervical cancer elimination; Timor-Leste for eliminating lymphatic filariasis; the Maldives and Sri Lanka for hepatitis B control in children; and six countries for achieving SDG and global targets for reducing under-five mortality and stillbirth rates.

With inputs from agencies