Benin and Mali eliminate trachoma as a public health problem

In May 2023, Benin and Mali were validated by the World Health Organization (WHO) for eliminating trachoma as a public health problem. They became the fifth and sixth countries in the WHO African Region to be validated for trachoma elimination after Ghana, Gambia, Togo, and Malawi, marking a significant milestone in the fight against the disease that is the leading infectious cause of blindness worldwide.

The Chlamydia trachomatis bacterium causes trachoma, which can be transmitted from one person to another through dirty fingers, objects or flies that have touched the eye or nose discharge of someone who has the infection. The risk of getting trachoma is higher when people have poor hygiene, live in crowded houses, or lack water or proper sanitation facilities. Trachoma mainly affects children and becomes less frequent with age. If children get infected many times, they may develop serious problems years or decades later. The WHO recommends the SAFE strategy to prevent and treat trachoma, which includes surgery for the late stage of trachoma, antibiotics to get rid of the infection, facial cleanliness, and environmental improvement, especially better access to water and sanitation to lower the risk of spreading the disease.

What has ESPEN done over the years to support countries against trachoma?

"While great progress continues to be made in trachoma elimination, we still face challenges from persistent and recurring trachoma. We remain strongly committed to providing the required technical assistance to both countries and NTD partners to ensure we stay on track towards elimination,” says Dr Elizabeth Juma the Team Lead for the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) at the WHO Regional Office for Africa. “This significant achievement by Benin and Mali is yet another indication that we can eliminate Neglected Tropical Diseases with strengthened commitment and action”.

Over the years, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) has played a crucial role in providing technical assistance to countries and their partners in the fight against trachoma. More recently, ESPEN has provided capacity building to health workers and technical assistance to countries like Burundi in dossier development, ensuring that African nations can be certified as trachoma-free. By integrating interventions into national health programs for other neglected tropical diseases, countries like Benin have taken a holistic approach to tackling trachoma, leading to significant progress in elimination efforts.

Benin began trachoma elimination activities in 2014 and 2015 when all the 26 districts suspected to be trachoma-endemic were surveyed. With the support of WHO and partners, the country rolled out the WHO-recommended SAFE strategy to control trachoma. Trachoma is the third neglected tropical disease to be eliminated in Benin. The country was certified free of transmission of dracunculiasis, otherwise known as Guinea-worm disease, in 2009. In 2021, it was validated for eliminating the gambiense form of human African trypanosomiasis, also known as sleeping sickness.

Mali started trachoma control activities in 1996-97 by conducting national level mapping for trachoma, which demonstrated that all districts of the country were endemic. It was among the first endemic countries to have benefitted from Zithromax donation programme by Pfizer in 1999. With the support of WHO and partners, Mali rolled out the WHO-recommended SAFE strategy to control trachoma throughout the country. Mali has done an exemplary work in conducting trachoma impact and surveillance surveys as well as TT surgeries by adopting appropriate strategies to achieve its elimination targets despite security crisis in endemic northern regions of the country (Gao, Tombouctou, Kidal, Ménaka) and socio-political upheavals in recent years.

Globally, Benin and Mali join 15 other countries that have been validated by WHO for having eliminated trachoma as a public health problem.

WHO continues to support the health authorities of Benin and Mali to closely monitor communities where trachoma was previously endemic to ensure there is no recurrence of the disease.