Context: Recently, the World Health Organization (WHO) has announced that, Iraq has now joined the league of 17 other countries that have eliminated‘trachoma’, which is world’s leading infectious cause of blindness.

• The 17 other countries that have eliminated trachoma are: Benin, Cambodia, China, Gambia, Ghana, Islamic Republic of Iran, Lao People’s Democratic Republic, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Saudi Arabia, Togo and Vanuatu.

About Trachoma

• It is a Neglected tropical disease.

• It starts as a bacterial infection caused by Chlamydia trachomatis and can be easily treated.

• Over time, it causes the eyelashes to be pushed inward into the eye. So with every blink, they brush against the eyeball.

• This advanced form of trachoma is called trichiasis. Over time, if itis not treated, trichiasis can lead to blindness.

• Cause of occurrence: The disease thrives where there are water shortages, poor sanitation and infestations of flies, which are considered physical vectors of the disease.

• The disease is still known to be endemic in six countries of the WHO’s Eastern Mediterranean Region, but there has been substantial progress in the number of people in the region requiring antibiotic treatment for trachoma elimination purposes, which has fallen from 39 million in 2013 to 6.9 million in April 2023.

What is Neglected Tropical Disease?

• NTDs are a group of infections that are most common among marginalized communities in the developing regions of Africa, Asia and the Americas.

• They are caused by a variety of pathogens such as viruses, bacteria, protozoa and parasitic worms.

• NTDs are especially common in tropical areas where people do not have access to clean water or safe ways to dispose of human waste.

• Examples of NTDs are: snakebite envenomation, scabies, yaws, trachoma, Leishmaniasis and Chagas disease etc.

• These diseases generally receive less funding for research and treatment than malaises like tuberculosis, HIV-AIDS and malaria.

How Iraq achieved it?

• Iraq established its national trachoma programme in 2012 to coordinate the final domestic push against the disease.

• A trachoma surveillance system was developed to detect and manage cases within secondary and tertiary eye care facilities, as well as through school pre-enrollment and school eye screening programmes conducted in collaboration with the Ministry of Education.

NTD burden in India

• India has the world's largest absolute burden of at least 10 major NTDs, including hookworm, dengue, lymphatic filariasis, leprosy, visceral leishmaniasis or kala-azar and rabies.

• Of the 12-13 NTDs existing in India only dengue, rabies, snakebite and leprosy are notifiable.

• The most common NTDs in India: Lymphatic Filariasis, Visceral Leishmaniasis, Rabies, Leptospirosis, Dengue and Soil-Transmitted Helminth Infections (STH).

WHO’s strategy to eliminate Trachoma

• To eliminate trachoma as a public health problem, WHO recommends the SAFE strategy, a comprehensive approach to reduce transmission of the causative organism, clear existing infections and deal with their effects

The SAFE strategy includes

• Surgery to treat the blinding stage (trachomatoustrichiasis);

• Antibiotics to clear the infection, particularly the antibiotic azithromycin;

• Facial cleanliness and Environmental improvement, particularly improving access to water and sanitation.