At the start of Nigeria’s trachoma elimination efforts in 2001, an estimated 37.3 million people were at risk of blindness from the disease, making the country one of the most endemic in the world. By 2016, when most baseline surveys were completed, more than 21.8 million people were living in districts where the prevalence of the disease required mass antibiotic treatment. Limited access to clean water, sanitation, and hygiene, combined with gaps in awareness, allowed the disease to persist, particularly in underserved and rural communities.

To combat trachoma’s impact on the country, the Nigerian government led a nationwide effort to eliminate trachoma as a public health problem in 2010, guided by its National Trachoma Task Force. Surveys conducted with the support of the Global Trachoma Mapping Project (2012-2016) and Tropical Data (2016 onward) allowed for the national program to identify which communities were most in need of intervention.

With support from The Task Force for Global Health’s International Trachoma Initiative (ITI), Nigeria scaled up implementation of the WHO-recommended SAFE (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements) strategy. Since 2010, Nigeria has received more than 67 million doses of donated azithromycin to treat trachoma from Pfizer, enabling mass drug administration (MDA) to at-risk populations. Strong national and state-level coordination, alongside ITI, has ensured timely forecasting, delivery, and distribution of medicine, allowing communities to be reached efficiently, even those in hard to reach areas.

Despite challenges—including insecurity in parts of the country that limited access to affected populations—Nigeria continued to push forward. Notably, in 2023, the program completed conducting surveys to identify areas where trachoma exists in previously inaccessible areas of Borno State. This marked a critical milestone in reaching underserved communities.

Nigeria has made remarkable progress toward eliminating trachoma. In 2025, the number of people living in areas needing MDA had dropped to 5.5 million, down from 37.3 million at the start of the country’s trachoma efforts. Of the 134 districts that were endemic, more than 80% have now reduced Trachomatous inflammation—follicular (TF) prevalence—an early sign of active trachoma in children ages 1–9 to below the 5% elimination threshold. This reflects both improved health outcomes and a strengthened, coordinated health approach. Nigeria is now on track to eliminate trachoma as a public health problem by 2030.

This progress contributes to a historic global milestone: for the first time since trachoma mapping began, fewer than 100 million people worldwide require interventions for trachoma. From an estimated 1.5 billion people at risk globally in 2002, the number has dropped to 97.1 million as of November 2025, representing a 94% reduction.

“Nigeria’s progress toward eliminating trachoma demonstrates what is possible when strong national leadership, community engagement, and global partnerships come together” said Dr. Nicholas Olobio, Director and Program Manager of the National Trachoma Elimination Programme, Federal Ministry of Health, Nigeria. “Through close collaboration with partners, including the International Trachoma Initiative (ITI), which has consistently supported the donation of azithromycin to the national programme, we have scaled up life-saving interventions and reached underserved communities across the country. As we move closer to elimination, we are not only eliminating trachoma as a public health problem, but also strengthening health systems to deliver broader health impacts.”

The country’s progress also demonstrates how investments in disease-specific programs can create a broader impact. Evidence from azithromycin distribution for trachoma has shown added benefits in reducing child mortality. Building on this, Nigeria is now one of four countries participating in the REACH child survival program, adapting the existing platform and lessons learned to deliver azithromycin for child survival.

Nigeria’s journey highlights the power of sustained national leadership, community engagement, and strong partnerships. With continued commitment, the country is well positioned not only to eliminate trachoma, but to also sustain these gains and apply lessons learned to other pressing public health challenges.