Burundi Validated by WHO for Eliminating Trachoma as Public Health Problem

New Delhi: The World Health Organization (WHO) has confirmed that Burundi has eliminated trachoma as a public health problem. This makes Burundi the eighth country in the WHO African Region to receive such validation and the 24th globally. Trachoma is also the first neglected tropical disease (NTD) to be eliminated in Burundi.

"Eliminating a disease like trachoma is a major public health achievement that requires sustained effort and dedication," said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. "I congratulate the government and the people of Burundi and commend them for their hard work and commitment. It is great to see Burundi join the growing group of countries that have eliminated at least one NTD."

Trachoma is caused by Chlamydia trachomatis and spreads through contact with infected individuals, contaminated surfaces, or flies that have been in contact with infected eye or nose discharge. Repeated infections can lead to scarring, eyelid distortion, and potential blindness. It remains common in areas with poor access to clean water and sanitation.

"This validation marks a major milestone in our commitment to health equity," said Dr. Lydwine Baradahana, Minister of Public Health and the Fight Against AIDS, Burundi. "It is a collective victory made possible by nearly 20 years of national mobilization and international solidarity. I thank all the partners, community actors and institutions in Burundi and beyond who made this historic achievement possible."

Burundi began its efforts in 2007 with no formal data on trachoma prevalence. That year, the country initiated mapping for NTDs, including trachoma. Surveys in 2009–2010 confirmed that trachoma was present in some areas. As a result, interventions were launched following WHO’s SAFE strategy, Surgery, Antibiotics, Facial cleanliness, and Environmental improvements, reaching around 2.5 million people in 12 health districts.

The programme was supported by CBM Christoffel Blindenmission, the END Fund, Geneva Global, and WHO. The International Trachoma Initiative donated azithromycin (Zithromax, Pfizer, New York, USA) to assist with treatment. WHO continues to work with Burundi’s health authorities to monitor affected areas and prevent the disease from returning.

"This achievement reflects the government’s resolve to protect its most vulnerable populations. Under the leadership of the Ministry of Public Health and the Fight Against AIDS, and with the dedication of community health workers, support from key partners, and WHO’s technical guidance, this success was made possible," said Dr. Xavier Crespin, WHO Representative in Burundi. "This win inspires us to press forward with the same determination to eliminate all remaining neglected tropical diseases."

Trachoma remains a public health concern in 32 countries, affecting an estimated 103 million people. In the WHO African Region, 93 million people were still living in at-risk areas as of April 2024, down from 189 million in 2014, showing a 51% reduction.

Twenty countries in the African Region still need trachoma interventions. These are Algeria, Angola, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Eritrea, Ethiopia, Guinea, Kenya, Mozambique, Niger, Nigeria, South Sudan, Tanzania, Uganda, Zambia, and Zimbabwe.

Previously, Benin, Gambia, Ghana, Malawi, Mali, Mauritania, and Togo were validated by WHO as having eliminated trachoma in the region. Botswana, Guinea-Bissau, Namibia, and Senegal have reported meeting elimination targets but have not yet been validated.

Globally, 57 countries have eliminated at least one NTD, and 24, including Burundi have met the criteria for eliminating trachoma as a public health problem. Other countries include Cambodia, China, Islamic Republic of Iran, Lao People’s Democratic Republic, India, Iraq, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Papua New Guinea, Saudi Arabia, Vanuatu, and Vietnam.

WHO defines elimination of trachoma as a public health problem based on specific targets: less than 0.2% prevalence of trachomatous trichiasis in adults aged 15 and older that is "unknown to the health system," less than 5% prevalence of trachomatous inflammation follicular in children aged 1–9 years sustained without mass treatment for at least two years, and a functioning system to detect and manage new cases with sufficient financial and technical resources.