On the heels of a recent Lancet report illustrating the dramatic reduction of blinding trachoma in Africa, Pfizer extends its donation of antibiotics to the International Trachoma Initiative (ITI) through 2030, in line with the WHO’s 2021-2030 Neglected Tropical Disease (NTD) road map. The company, which announced the news during the Kigali Summit on Malaria and NTDs in Rwanda on June 23, had previously committed donations through 2025.
Pfizer’s extension builds upon momentum in fighting the disease, such as:
- Nearly 100% treatment coverage of at-risk communities in 38 countries out of the 56 ever-endemic countries.
- Elimination in more than half of endemic districts.
- Trachoma is on track to be eliminated by 2030.
The Task Force’s ITI contributes to the elimination of trachoma by stewarding Pfizer’s donation of antibiotics to help treat and prevent the condition; building and strengthening partnerships to accelerate progress; and developing innovative tools to share data.
“The global trachoma program enables countries to mobilize resources including donated drugs, operational costs and human resources,” said Fikre Seife, National NTD Program Coordinator in Ethiopia, one of the countries with the highest prevalence of trachoma. “The impact of this is that the program has saved the sight of millions of people.”
Since 1998, Pfizer has donated azithromycin, an antibiotic used to treat the bacteria that causes trachoma, which is spread by flies and person-to-person contact. Azithromycin helps prevent the spread of the disease and also stops the disease from progressing to the stage where it can cause blindness.
“All people deserve the right to live healthy, productive lives without the risk of a preventable and debilitating infectious disease,” said Caroline Roan, Pfizer’s Chief Sustainability Officer, Senior Vice President of Global Health & Social Impact, and President of The Pfizer Foundation. “Pfizer remains committed to supporting global efforts to eliminate trachoma and thanks to ITI’s data-driven and community-based approaches, we are better able to engage the most-at-risk communities and adapt to their unique and ever-changing needs.”
The combination of prevention and treatment, along with increased access to clean water and sanitation for hygiene, and improved medical services, has eliminated trachoma in 13 countries and reduced people at risk of the disease by more than 91% globally.
However, looking at how many countries have been validated for elimination by the World Health Organization (WHO) is “a very binary goal,” said Kristen Renneker, ITI’s Senior Data Analyst and lead author on new data analysis published in the Lancet. While a necessary goal, “that really kind of masks a lot of the progress that’s being made at the individual district level, so with this analysis, we wanted to show a finer picture of what’s going on.”
Out of 38 countries from Latin America, Africa, Asia, and the Pacific Islands, more than 1,400 districts demonstrated a decline in trachoma by at least half and nearly 1,200 reached their elimination targets. That’s 300 million people protected.
Maps in the Lancet article illustrated the dramatic reduction across Africa, with districts flipping from red to green from 1990s to 2021 to show the reduction in prevalence.
“If a picture says a thousand words, this dot map comparison of prevalence does just that,” said ITI Director Paul Emerson. “Formerly endemic West and Southern Africa (left map) are now largely trachoma free (right). We are shrinking the map of trachoma.”
Partnerships like ITI, which involves The Task Force, Pfizer, ministries of health, the WHO and nongovernmental organizations, keep the hundreds of moving pieces required for a disease elimination program in sync, according to Renneker.
“We found that most districts are getting the treatment they need and, of those, districts that are receiving treatment are reducing their disease burden,” said Renneker who cited the importance of using data for decision making.
Such data “has helped countries to know the real burden of trachoma in their respective countries,” said Seife. Through disease surveillance surveys collected by countries with support from Tropical Data (formally the Global Trachoma Mapping Project), the WHO- and ITI-managed GET2020 database and Trachoma Atlas, countries and all elimination stakeholders can access timely, high quality data from every endemic country.
This allows countries to visualize both the problem and success thus far and conduct deeper analysis like that in the recent Lancet publication to inform evidence-based decision making.
Reflecting on the remaining challenges Ethiopia needs to overcome for elimination, Seife highlighted the need for strong partnerships like those described by Renneker.
“There is a high chance of achieving the 2030 targets,” said Seife. “To do this, there should be strong commitment from the government, from implementing partners and donors to implement more comprehensive surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE) strategy.”
Header photo: Community drug distributors pack antibiotics for trachoma treatment at a district health facility for transportation to a mass drug administration in Ethiopia. Credit: Brent Stirton/Getty Images for ITI.