Progress in Trachoma Elimination: The East Mediterranean Regional Perspective

In the ongoing global effort to combat preventable blindness, trachoma has long stood as a significant challenge, closely intertwined with poverty and often overlooked as a neglected disease. Historically pervasive in the Eastern Mediterranean Region (EMR), trachoma affected approximately 10 million people as of 2012, with a staggering 80 million individuals in endemic areas requiring treatment. At that time, the EMR contributed to 12% of the worldwide burden of blinding trachoma, with Egypt and Sudan reporting the highest prevalence rates. Other countries grappling with endemicity included Afghanistan, Djibouti, Pakistan, and Yemen. 

However, the landscape of trachoma endemicity is undergoing a transformative shift due to the effective implementation of trachoma elimination programs and the positive impacts of socio-economic development. 

Since its inception in 2013, the EMR Alliance for Trachoma Control has played a pivotal role in providing operational and technical guidance. Notably, countries such as Oman, Morocco, Iran, Saudi Arabia, and, most recently, Iraq have received recognition from the World Health Organization for successfully eliminating trachoma as a public health problem. Djibouti, Somalia, Pakistan, and Libya have reached a stage where mass drug administration is deemed unnecessary, marking significant progress. Meanwhile, Afghanistan, Egypt, Sudan, and Yemen are actively implementing measures and demonstrating commendable strides towards trachoma elimination. 

This year’s EMR Alliance meeting, hosted by King Khaled Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia and co-sponsored by the Islamic Development Bank, convened a diverse group of more than twenty-five participants, including representatives from the ministries of health of Afghanistan, Djibouti, Egypt, Pakistan, and Yemen. The meeting also welcomed delegates from regional and international non-governmental organizations, along with bilateral organizations such as the World Health Organization (WHO), the International Agency for the Prevention of Blindness (IAPB) and the Islamic Development Bank (IsDB). 

Central to the discussions was a collective commitment to assess the progress achieved by endemic countries in their journey towards trachoma elimination. The meeting placed a strategic focus on planning initiatives to surmount identified barriers and offering indispensable guidance on post-elimination surveillance. With a rich mix of participants, the gathering functioned as a dynamic platform for sharing insights, aligning strategies, and fostering collective action. This collective effort was underscored by the acknowledgement of the significance of these collaborative initiatives, steering the region closer to the ultimate goal of a trachoma-free future. 

In a concerted effort, the second and third days of the meeting were dedicated to equipping country programme managers with essential skills and technical know-how necessary to develop high-quality dossiers as evidence for trachoma elimination. These dossiers, a requirement from the World Health Organization, play a crucial role in the validation of trachoma elimination as a public health problem in endemic countries. 

As we witness the collaborative efforts and progress made in the fight against trachoma, we remain hopeful that these strides will pave the way for a trachoma-free future in the Eastern Mediterranean Region.