Validation of Trachoma elimination

Overview

In 1996, WHO launched the WHO Alliance for the Global Elimination of Trachoma by the year 2020 (GET2020). GET2020 is a partnership that advocates for and supports implementation of the SAFE strategy in endemic countries, which comprises surgery for trachomatous trichiasis, antibiotics to clear infection, and facial cleanliness and environmental improvement to reduce transmission.

In 1998, the Fifty-first World Health Assembly adopted resolution WHA51.11 on the global elimination of blinding trachoma. WHO later standardized the terminology to 'elimination of trachoma as a public health problem'. 

TT surgery in Burkina Faso (2016)

In 2016, WHO published standard operating procedures (WHO/HTM/NTD/2016.8) defining the criteria for the elimination of trachoma as a public health problem and dossier requirements for validating trachoma elimination. The WHO criteria for elimination of trachoma as a public health problem are:

1. Trachomatous trichiasis (TT) prevalence “unknown to the health system” of <0.2% among people aged >15 years, in each formerly endemic district,
2. Trachomatous inflammation—follicular (TF) prevalence of <5% among children aged 1-9yrs that is maintained for at least two and half years without antibiotic pressure, in each formerly endemic district, plus
3. Evidence that the health system can continue to identify and manage incident cases of TT.

These standard operating procedures are intended to be used when a Member State wishes to request validation of national elimination of trachoma as a public health problem following implementation of the SAFE strategy. 

Current situation 

In the WHO African Region, 18 countries are endemic and known to require interventions for trachoma. Six countries have claimed to have eliminated trachoma and have submitted their trachoma dossier for validation to WHO/AFRO. Nine countries have been validated to have achieved elimination of trachoma as a public health problem. It is encouraging to note that more endemic countries are reaching the elimination thresholds for trachoma and are preparing their dossiers for submission.

Role of ESPEN 

ESPEN’s role in supporting countries for validation includes:

• Provision of technical assistance for dossier development and finalization.
• Review of draft dossiers for informal feedback to countries
• Convening of Regional Dossier Review Groups for formal review of each officially submitted dossier
• Provision of technical support in addressing comments made by Regional Dossier Review Group during the revision of the submitted dossier should this be required.

Contact Section: ESPEN Trachoma focal point: kelloa@who.int