#KaiserPoll; #MedicareForAll
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​United States, July 31 (Canadian-Media): During the second presidential elections debate in the United States (U.S.) on "Medicare for All Plan" on Tuesday, the two progressives, Bernie Sanders, longest serving independent in U.S. congressional history and a member of the Democratic caucus,  and Elizabeth Warren,  senior U.S Senator from Massachusetts, found themselves fighting off the moderates on the stage, media reports said.

According to a Kaiser poll -- which provides up-to-date information on the public’s opinions, knowledge, and experiences with the health care system -- with 83% saying it is “very important” for the candidates to discuss about health care system in U.S. in recent elections.

Bernie Sanders (left) and Elizabeth Warren (right)/Twitter

Sanders, who had traveled to Canada this week with about a dozen Type 1 diabetes patients over the border from Michigan to purchase cheaper insulin, took the opportunity to slam the drug industry, saying that insulin makers are price-fixing, and if he’s elected he will hold these companies accountable. ​
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Tim Ryan, Representative for Ohio's 13th congressional district accused Sanders of not knowing what impact the bill would have on union workers.

“I do know. I wrote the damn bill!” Sanders snapped back.

(Reporting by Asha Bajaj)

UNICEFToTripleItsBudget; #CombatingEbolaVirusInDRC

New York, July 30 (Canadian-Media): With an unprecedented number of children affected by the Ebola virus outbreak in the eastern Democratic Republic of Congo (DRC), the United Nations Children’s Fund (UNICEF) on Tuesday said it would need to triple its budget to tackle the complex crisis, which included intensifying the overall public health response and launching measles vaccinations, UN reports said.

On 6 December 2018, at a UNICEF supported crèche in Beni, in the eastern DRC, Kavira Langa Jemima, an Ebola survivor, bathes 6 month old Josue, who's mother is undergoing treatment for Ebola. Credit: UNICEF/Hubbard

“This Ebola response is far more complex because it is in an active conflict zone,” Jerome Pfaffmann, a UNICEF health specialist, told reporters in Geneva, just back from his third visit to the country. 

He underscored that “people in the (eastern Congolese) provinces of North Kivu and Ituri are facing humanitarian and public health crises,” and in addition, half the health facilities in Ituri had been damaged or destroyed over the last two years. 
The UNICEF expert said there were 2,671 confirmed cases of Ebola as of 28 July, including more than 700 children, more than half of whom – some 57 per cent – were under five years of age.  
“When I left, there were 12 new confirmed cases, five were alive and will have the chance to access treatment, but seven had died in the community. This is bad. Having this number of community deaths means we are not ahead of the epidemic,” he said.  
“It is unprecedented to have such a [high] proportion of affected children,” Mr. Pfaffmann continued, adding that both provinces were also facing a measles outbreak. 
So far, UNICEF has vaccinated more than 40,000 children against measles, but a massive scale-up was needed to protect them from various health risks. 
With all this in mind, UNICEF planned to carry out a new strategic response plan to address acute humanitarian and social needs. 
“UNICEF will need to triple its budget to respond to this crisis,” said Mr. Pfaffmann, stressing that “we need desperately the international community to back us up.” 
This budget would include about $70 million for epidemic control activities, $30 million to build community capacities in at-risk areas, and another $70 million to deliver essential services. 
Meanwhile, the UN agency was continuing operations with “colleagues and communities on the ground who are fighting the outbreak tirelessly.” 
Just two days away from the one-year milestone of the Ebola virus disease outbreak in the DRC, the UNICEF expert said it was critical to make the investment to keep the epidemic under control. 
“This is a wake-up call. There must not be a second-year milestone,” Mr. Pfaffmann declared, stressing that community mobilization was critical to curbing the spread of the disease because “they are capable of best doing the things that matter.” 

The report, Start Free, Stay Free, AIDS Free, shows that the pace of progress in reducing new HIV infections among children and expanding access to treatment for children, adolescents and pregnant women living with HIV has slowed significantly and that global targets set for 2018 have been missed, despite important gains being made in some countries.  

Globally, around 160 000 children aged 0–14 years became newly infected with HIV in 2018. This is a major decrease from 240 000 new infections in 2010. However, the bold and important target set for 2018 was fewer than 40 000 new infections.

“The failure to reach the 2018 targets to reduce new HIV infections among children and adolescents and to widen access to life-saving treatment is both disappointing and frustrating,” said Gunilla Carlsson, UNAIDS Executive Director, a.i.  “We need to act quickly to turn this situation around and honour the commitment to end the AIDS epidemic for the next generation.”

Around 82% of pregnant women living with HIV now have access to antiretroviral medicines. There has been considerable progress among countries in eastern and southern Africa, with more than 90% of pregnant women accessing antiretroviral medicines in Ethiopia, Kenya, Uganda, United Republic of Tanzania and Zimbabwe and 95% or higher in Botswana, Malawi, Mozambique, Namibia and Zambia. This has resulted in a 41% reduction in new HIV infections among children, with remarkable reductions achieved in Botswana (85%), Rwanda (83%), Malawi (76%), Namibia (71%), Zimbabwe (69%) and Uganda (65%) since 2010. The progress made by these countries shows what can be achieved through strong political leadership, rapid policy adoption and concerted efforts by all stakeholders.

The report throws light on where gaps need to be filled to prevent new HIV infections occurring among children. For example, in eastern Africa, 10 000 of 26 000 new HIV infections among children in 2018 were the result of women not being retained on treatment throughout pregnancy and breastfeeding. In southern Africa, 17 000 of 53 000 new infections among children were the result of the mother becoming infected with HIV during pregnancy or breastfeeding. A total of 16 000 new infections could have been averted in southern Africa by retaining mothers on treatment throughout pregnancy and breastfeeding. In western and central Africa, almost 27 000 of the 44 000 new infections could have been averted if their mothers had accessed antiretroviral medicines.

“These new data show that many countries have made important progress toward reaching the 2020 targets, and yet others are lagging significantly behind,” said Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy. “These stark disparities highlight the critical role of political commitment, rapid policy implementation and data-driven investments in accelerating impact.”

Country-level analysis of how mother-to-child transmission of HIV happens can provide vital information to shape national responses.

“Ending AIDS and achieving universal health coverage means leaving no one behind. Yet, too many children and adolescents with HIV are still missing out on the chance to grow up in full health as they can’t access treatment,” said Ren Minghui, the World Health Organization’s Assistant Director-General for Universal Health Coverage/Communicable and Noncommunicable Diseases. “We need to intensify our efforts to and keep our promise to these children.” 

Children living with HIV are also being left behind in HIV treatment scale-up and are not being diagnosed and treated early enough. An estimated 940 000 children aged 0–14 years were accessing treatment in 2018, double the number that were on treatment in 2010 but far short of the target of 1.6 million set for 2018.
Children living with HIV are still less likely to have access to HIV treatment than adults living with HIV, a disparity that is widening in some countries, especially in western and central Africa. As a result, the AIDS epidemic is still claiming the lives of many children aged 0–14 years. Children in this age group comprised 5% of all people living with HIV in 23 focus countries but accounted for 15% of people who died from AIDS-related illnesses in those countries in 2018. 
"We know how to prevent children from contracting HIV, and we know how to prevent the onset of AIDS in children if they do become infected. They need to be tested and linked to care and treatment as a matter of urgency, but we are missing these opportunities,” said Henrietta Fore, Executive Director of the United Nations Children’s Fund. “Knowing what to do is not enough. We must come together and act with renewed commitment to children and adolescents living with HIV and give them the best chance to survive and thrive.”    

For optimal outcomes, children who become infected with HIV must access treatment as quickly as possible. However, in 2018, only 63% of the 1.1 million infants exposed to HIV in the 23 countries worst affected by the epidemic were tested for HIV by the age of two months.

“In many ways, we as a community have settled for a substandard quality of care for children living with HIV,” said Chip Lyons, President and Chief Executive Officer, Elizabeth Glaser Pediatric AIDS Foundation, “We must not allow children to perpetually receive less than the basic standard of care we demand for adults. Especially when the ultimate consequence of that approach is that children and young people are dying of HIV at disproportionally and unacceptably high rates.”

The report also shows that the target of reducing the annual number of new HIV infections among young women and adolescent girls aged 15–24 years to less than 100 000 by 2020 is unlikely to be reached. Globally, new HIV infections among young women and adolescent girls were reduced by 25% between 2010 and 2018, to 310 000. While new HIV infections among adolescent girls and young women aged 15–24 years have declined by over 40% in Botswana, Burundi, Lesotho and South Africa, missing the global target has meant that 6000 adolescent girls and young women are still becoming infected with HIV every week.

The root factors driving the vulnerability of young women and girls to HIV infection are social, structural and behavioural and must be addressed in order to achieve sustainable prevention outcomes. Gender discrimination, gender-based violence, restricted access to opportunities and a lack of tailored services all compound their vulnerability to HIV. Effective responses prioritize an approach combining access to HIV and sexual and reproductive health services with social, structural and behavioural programmes.

“The disparity in viral load suppression rates among adolescents with HIV compared to adults is unacceptable and behoves the global community to advocate for more robust, potent antiretroviral therapy regimens for adolescents as well as to hasten efforts to prevent new infections in this critically vulnerable population,” said Fatima Tsiouris, Deputy Director of the Clinical and Training Unit and Prevention of Mother-to-Child Transmission Lead at ICAP, Columbia University.

The number of voluntary medical male circumcisions undertaken between 2015 and 2018 stood at over 11 million among all age groups, which means that at least 13 million procedures need to be carried out by 2020 in order to reach the target of voluntarily circumcising 25 million men and boys between 2015 and 2020.

UNAIDS and the United States President’s Emergency Plan for AIDS Relief launched the Start Free, Stay Free, AIDS Free framework in 2016 to build on the achievements of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive, which ended in 2014.      

UNAIDS
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The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. ​

#UnitedNationshealthagency; #treatmentOfHIV/AIDS

United Nations, July 22 (Canadian-Media): Based on new evidence, the United Nations health agency on Monday announced it was recommending the use of the antiretroviral drug dolutegravir (DTG) – which, with other medication, treats HIV/AIDS – as the preferred first- and second-line treatment for all cases, including pregnant women and those who have the potential to give birth, UN reports said.  

Moisés Maciel da Silva, 19, from São Paulo, Brazil, found out he was living with HIV when he turned 18 years old. © UNICEF/Danielle Pereira

According to the World Health Organization (WHO), initial studies had highlighted a possible link between DTG and birth defects of the brain and spinal cord, that cause conditions like spina bifida in infants born to women who used the drug at the time of conception.
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This safety concern came from a May 2018 study in Botswana, that found four cases of such so-called neural tube defects, out of 426 women who became pregnant while taking DTG.

Based on these preliminary findings, many countries advised pregnant women and those of childbearing potential, to take an alternative antiviral medication called efavirenz (EFV).
However, new expanded evidence-based data from two large clinical trials comparing the efficacy and safety of DTG and EFV in Africa, reveal that the risks of neural tube defects are significantly lower than initial studies had suggested.

The guidelines group also considered mathematical models of the benefits and harms associated with the two drugs; the values and preferences of people living with HIV; factors related to implementing HIV programmes in different countries; and cost.

DTG is more effective, easier to take and has fewer side effects than alternatively prescribed drugs, said WHO. It also has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and other regimens.

In 2019, 12 out of 18 WHO-surveyed countries reported pre-treatment drug resistance levels exceeding the recommended threshold of 10 per cent. These findings combined, informed the decision to update the 2019 guidelines.

Making ‘informed’ choices

In 2019, 82 low- and middle-income countries reported that they would be transitioning to DTG-based HIV treatment regimens. And the new updated recommendations aim to help even more countries improve their HIV policies.

“As for any medications, informed choice is important”, WHO stressed. “Every treatment decision needs to be based on an informed discussion with the health provider weighing the benefits and potential risks”.
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Because WHO underscores the significance of providing information and options to help women make an informed choice, it has convened an advisory group of women living with HIV from diverse backgrounds to advise on policy issues. During these discussions surrounding health - including sexual and reproductive health - WHO highlights the need to continually monitor the risk of neural tube defects that could be associated with DTG.

#Ebola; #DemocraticRepublicoftheCongo

Geneva, July 17 (Canadian-Media/WHO):WHO Director-General Dr. Tedros Adhanom Ghebreyesus today declared the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) a Public Health Emergency of International Concern (PHEIC).

“It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system,” said Dr. Tedros. “Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders -- coming from not just WHO but also government, partners and communities -- to shoulder more of the burden.”

The declaration followed a meeting of the International Health Regulations Emergency Committee for EVD in the DRC. The Committee cited recent developments in the outbreak in making its recommendation, including the first confirmed case in Goma, a city of almost two million people on the border with Rwanda, and the gateway to the rest of DRC and the world.
This was the fourth meeting of the Emergency Committee since the outbreak was declared on 1 August 2018. 

The Committee expressed disappointment about delays in funding which have constrained the response. They also reinforced the need to protect livelihoods of the people most affected by the outbreak by keeping transport routes and borders open. It is essential to avoid the punitive economic consequences of travel and trade restrictions on affected communities.

“It is important that the world follows these recommendations. It is also crucial that states do not use the PHEIC as an excuse to impose trade or travel restrictions, which would have a negative impact on the response and on the lives and livelihoods of people in the region,” said Professor Robert Steffen, chair of the Emergency Committee.

Since it was declared almost a year ago the outbreak has been classified as a level 3 emergency – the most serious – by WHO, triggering the highest level of mobilization from WHO. The UN has also recognized the seriousness of the emergency by activating the Humanitarian System-wide Scale-Up to support the Ebola response.

In recommending a PHEIC the committee made specific recommendations related to this outbreak.
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“This is about mothers, fathers and children - too often entire families are stricken. At the heart of this are communities and individual tragedies,” said Dr. Tedros. “The PHEIC should not be used to stigmatize or penalize the very people who are most in need of our help.”

To date, there have been more than 2,500 cases of infection and nearly 1,670 people have died in the DRC provinces of Ituri and North Kivu, making it the worst outbreak the country has ever faced and the second largest epidemic on record.
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Meanwhile, the World Health Organization (WHO) confirmed that an emergency meeting on the outbreak will take place on Wednesday afternoon in Geneva to decide whether the situation warrants declaring an international emergency.

#FoodSafetyStandards; #WHO
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Geneva, Jul 12 (Canadian-Media/WHO): New International Food Safety Standards protecting consumer health and ensuring fair practices in trade were adopted by 42nd session The Codex Alimentarius Commission (CAC), in Geneva on Jul 8-12, 2019, WHO reports said.

WHO official logo

The Codex strategic plan (2020-2025) provides high level guidance and direction to the work of the CAC. It builds on the current document and continues to emphasise the importance of addressing critical and emerging issues, underpinning standards with risk analysis and scientific evidence and promoting and facilitating participation of all Members in its standard setting work. 

The plan contains a new goal focussing on the use and impact of Codex standards which aims to raise awareness and explore how the use and impact of Codex standards could be measured and how standards could be better tailored to Members’ needs. Implementation plans will be discussed at the FAO/WHO Coordinating Committees which will meet in the six Codex regions between September and November 2019.

WHO/Facebook

WHO’s Essential Medicines List and List of Essential Diagnostics are core guidance documents that help countries prioritize critical health products that should be widely available and affordable throughout health systems.
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“Around the world, more than 150 countries use WHO’s Essential Medicines List to guide decisions about which medicines represent the best value for money, based on evidence and health impact,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “The inclusion in this list of some of the newest and most advanced cancer drugs is a strong statement that everyone deserves access to these life-saving medicines, not just those who can afford them.”

The Essential Medicines List (2019) Cancer treatments: While several new cancer treatments have been marketed in recent years, only a few deliver sufficient therapeutic benefits to be considered essential. The 12 medicines WHO added to the new Medicines List for five cancer therapies are regarded as the best in terms of survival rates to treat melanoma, lung, prostate, multiple myeloma and leukemias cancers.

For example, two recently developed immunotherapies (nivolumab and pembrolizumab) have delivered up to 50% survival rates for advanced melanoma, a cancer that until recently was incurable.

Antibiotics: The Essential Medicines Committee strengthened advice on antibiotic use by updating the AWARE categories, which indicate which antibiotics to use for the most common and serious infections to achieve better treatment outcomes and reduce the risk of antimicrobial resistance.  The committee recommended that three new antibiotics for the treatment of multi-drug resistant infections be added as essential. 

Other updates to the medicines list include:

• New oral anticoagulants to prevent stroke as an alternative to warfarin for atrial fibrillation and treatment of deep vein thrombosis. These are particularly advantageous for low-income countries as, unlike warfarin, they do not require regular monitoring;
• Biologics and their respective biosimilars for chronic inflammatory conditions such as rheumatoid arthritis and inflammatory bowel diseases;
• Heat-stable carbetocin for the prevention of postpartum haemorrhage. This new formulation has similar effects to oxytocin, the current standard therapy, but offers advantages for tropical countries as it does not require refrigeration;

Not all submissions to the EML Committee are included in the list. For example, medicines for multiple sclerosis submitted for inclusion were not listed. The Committee noted that some relevant therapeutic options currently marketed in many countries were not included in the submissions; it will welcome a revised application with all relevant available options. The EML Committee also did not recommend including methylphenidate, a medicine for attention deficit hyperactivity disorder (ADHD), as the committee found uncertainties in the estimates of benefit.

The List of Essential (in vitro) DiagnosticsThe first List of Essential Diagnostics was published in 2018, concentrating on a limited number of priority diseases – HIV, malaria, tuberculosis, and hepatitis. This year’s list has expanded to include more noncommunicable and communicable diseases.

Cancers: Given how critical it is to secure an early cancer diagnosis (70% of cancer deaths occur in low- and middle-income countries largely because most patients are diagnosed too late), WHO added 12 tests to the Diagnostics List to detect a wide range of solid tumours such as colorectal, liver, cervical, prostate, breast and germ cell cancers, as well as leukemia and lymphomas. To support appropriate cancer diagnosis, a new section covering anatomical pathology testing was added; this service must be made available in specialized laboratories.

"The 12 medicines WHO added to the new Medicines List for five cancer therapies are regarded as the best in terms of survival rates to treat melanoma, lung, prostate, multiple myeloma and leukemias cancers." Previous version of this sentence stated the following: "The five cancer therapies WHO added to the new Medicines List are regarded as the best in terms of survival rates to treat melanoma, lung, blood and prostate cancers."

Infectious diseases: The list focuses on additional infectious diseases prevalent in low- and middle-income countries such as cholera, and neglected diseases like leishmaniasis, schistosomiasis, dengue, and zika.

In addition, a new section for influenza testing was added for community health settings where no laboratories are available.

General test: The list was also expanded to include additional general tests which address a range of different diseases and conditions, such as iron tests (for anemia), and tests to diagnose thyroid malfunction and sickle cell (an inherited form of anemia very widely present in Sub-Saharan Africa).    

Another notable update is a new section specific to tests intended for screening of blood donations.  This is part of a WHO-wide strategy to make blood transfusions safer.

“The List of Essential Diagnostics was introduced in 2018 to guide the supply of tests and improve treatment outcomes,” said Mariângela Simão, WHO Assistant Director-General for Medicines and Health Products. “As countries move towards universal health coverage and medicines become more available, it will be crucial to have the right diagnostic tools to ensure appropriate treatment.”

Note to editors:

The updated Essential Medicines List adds 28 medicines for adults and 23 for children and specifies new uses for 26 already-listed products, bringing the total to 460 products deemed essential for addressing key public health needs.  While this figure may seem high, it corresponds to a fraction of the number of medicines available on the market.  By focusing the choices, WHO is emphasizing patient benefits and wise spending with a view to helping countries prioritize and achieve universal health coverage.  

The updated List of Essential Diagnostics contains 46 general tests that can be used for routine patient care as well as for the detection and diagnosis of a wide array of disease conditions, and 69 tests intended for the detection, diagnosis and monitoring of specific diseases.

The List is divided into two sections depending on the user and setting: one for community settings, which includes self-testing; and a second one for clinical laboratories, which can be general and specialized facilities.  

Both WHO lists are models for countries to develop their own national lists.  National lists based on local disease burden and existing healthcare delivery infrastructure provide an excellent framework from which countries can plan and implement the laboratory services and the medicines they need.  Access to these health products requires good procurement practices, effective supply chains, quality management protocols and qualified health care workforces.

The delivery of effective diagnostic services, because they are based on technologies, also depends on robust technical specifications, the availability of carefully designed laboratory networks, adequate supporting infrastructure and appropriate education of users (patient or health worker) to ensure safety.

#AfricanSwineFever; #FAO; #EastAsia; #SouthEastAsia

UN, Jul 2 (Canadian-Media): The rapid spread of African Swine Fever (ASF) across East and Southeast Asia is threatening the food security and livelihoods of millions of households in the region which rely on pig farming, The UN’s Food and Agriculture Organization, FAO, reported on Tuesday.

African Swine Fever is a highly contagious disease that can cause a devastating impact on small-scale pig farmers and can be transmitted from pigs to humans. (file March 2017)/IAEA/Laura Gil Martinez

Small scale farmers account for a significant proportion of pig meat production in the vast region, and the outbreak is of particular concern for these producers, who may lack the expertise and funds necessary to protect their herds from the disease.

Higher prices, lower incomes

FAO has received reports that ASF has led to income losses in the affected countries, where tens of millions of households are engaged in pig farming – in China, the world’s largest pig meat producer, the figure is some 130 million – both because of the animal losses, and attempts by governments to stem the spread of the disease, which include limitations on the transportation and sales of live pigs and pork products.

The diets of many vulnerable people living in east and south-east Asian countries are expected to be adversely impacted: pork is one of the world’s most widely consumed animals in many countries in the region, and the decline in production, as well as concerns about the future impact of ASF, has already led to price hikes.

Continued spread of disease likely

Since the first reported outbreak of ASF in the northern Chinese province of Liaoning in August 2018, the disease has swept through the country, and 32 of the country’s 34 mainland provinces have since been affected. Despite actions taken by the Chinese Government, including the culling of 1.13 million pigs, ASF continues to spread, and has been reported in Viet Nam, Cambodia, Mongolia, South Korea and Laos.

The current failure to curb the disease is being attributed to several factors. Firstly, many small-scale farmers have not put in place measures to adequately protect their herds from disease. Secondly, pigs on small farms are often fed with table scraps, or uncooked organic refuse, which may contain the virus. The cross-border trade of pigs, some of which may be contaminated, has also contributed to the prevalence of ASF.

For these reasons, experts believe that the disease will inevitably spread further in the coming months, with far-reaching implications. These include a large decline in the number of farmed pigs, impacting the global market.
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ASF is a contagious viral disease that affects pigs and wild boars causing high fever, internal bleeding, and is almost always fatal within a few weeks, as there is no treatment or vaccine available. The disease is harmless for humans. It spreads easily between domestic and wild pigs through direct contact, the feeding of contaminated food and materials that come into contact with the animals, including shoes, clothes, vehicles and equipment.

#trachoma; #GlobalEliminationofTrachomaby2020; #WHO; #lightintolerance; 
#DrMweleceleNtuliMalecela; #ScottMcPherson; #GET2020; #SAFE

Geneva, Jul 1 (Canadian-Media): The number of people at risk of trachoma – the world’s leading infectious cause of blindness – has fallen from 1.5 billion in 2002 to just over 142 million in 2019, a reduction of 91% World Health Organization (WHO) has reported.

Trachoma is a disease of the eye caused by infection with the bacterium Chlamydia trachomatis. Transmission occurs through contact with infective discharges from the eyes and nose, particularly in young children who harbour the main reservoir of infection. It is also spread by flies which have been in contact with the eyes and noses of infected people.

The immune system can clear a single episode of infection, but in endemic communities the organism is frequently reacquired. After years of repeated infection, the inside of the eyelid can become so severely scarred (trachomatous conjunctival scarring) that it turns inwards and causes the eyelashes to rub against the eyeball (trachomatous trichiasis), resulting in constant pain and light intolerance. This and other alterations of the eye can lead to scarring of the cornea. Left untreated, this condition leads to the formation of irreversible opacities, with resulting visual impairment or blindness.

New data presented today at the 22nd meeting of the WHO Alliance for the Global Elimination of Trachoma by 2020 (GET2020) also show that the number of people requiring surgery for trachomatous trichiasis – the late, blinding stage of trachoma – has dropped from 7.6 million in 2002 to 2.5 million in 2019, a reduction of 68%.

“Eliminating trachoma contributes to the ocular health and quality of life of the poorest,  most disadvantaged people worldwide and thereby moves us a step closer to achieving universal health coverage,” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases.

“Ridding the world of this painful, debilitating disease is being made possible through generous donations of the antibiotic azithromycin, sustained contributions from a network of dedicated funding agencies and partners, and the efforts of hundreds of thousands of front-line workers who work tirelessly to engage communities and deliver interventions.”

Trachoma remains endemic in 44 countries and has blinded or visually impaired around 1.9 million people worldwide. Mapping of trachoma has been completed to identify its distribution and target control measures through the SAFE strategy, namely: surgery for trichiasis, antibiotics to clear infection, and facial cleanliness and environmental improvement to reduce transmission. The disease is caused by infection with a bacterium.

“Eliminating trachoma has immediate benefit in preserving vision for people at risk. But work against trachoma has required the creation of innovative partnerships, which will help ensure that the most remote and marginalized people are not left behind as more comprehensive health services are strengthened,” said Mr Scott McPherson, Chair, International Coalition for Trachoma Control.

In 2018 alone, 146112 cases of trichiasis were managed and almost 90 million people were treated with antibiotics for trachoma in 782 districts worldwide.

Since 2011, eight countries have been validated by WHO as having eliminated trachoma as a public health problem1. At least one country in every trachoma-endemic WHO Region has now achieved this milestone, demonstrating the effectiveness of the SAFE strategy in different settings.

“This is great progress, but we cannot afford to become complacent,” said Dr Anthony Solomon, Medical Officer in charge of WHO’s global trachoma elimination programme.

“We should be able to relegate trachoma to the history books in the next few years, but we will only do so by redoubling our efforts now. The last few countries are likely to be the hardest.”

The significant reduction in the global prevalence of trachoma has resulted from increased political will in endemic countries, expansion of control measures and generation of high-quality data. The global programme has been supported by the world’s largest infectious disease mapping effort – the Global Trachoma Mapping Project (2012–2016) – and, since 2016, by Tropical Data, which has assisted health ministries to complete more than 1500 internationally-standardized, quality-assured and quality-controlled prevalence surveys.

GET2020

In 1996, WHO launched GET2020, and with other partners in the Alliance, supports country implementation of the SAFE strategy and strengthening of national capacity for epidemiological assessment, monitoring, surveillance, project evaluation and resource mobilization.

Elimination of trachoma is inexpensive, simple and highly cost–effective, yielding a high rate of net economic return.