Blitz Bureau
IN a significant public health achievement, India has been officially declared free from trachoma by the World Health Organisation (WHO). The milestone came after years of dedicated efforts by the Government to protect the vision of millions, emphasising the importance of healthy eyesight for every individual.
Trachoma is a devastating eye disease caused by infection with the bacterium Chlamydia Trachomatis. The primary source of trachoma infection is the eye secretions of infected individuals, it can be transmitted through several routes, including: close physical contact; sharing towels, handkerchiefs, pillows, and other personal items; houseflies; and coughing and sneezing. Environmental risk factors that promote the transmission of trachoma include: poor hygiene practices; overcrowded living conditions; water scarcity; and inadequate latrines and sanitation facilities.
Transmision cycle
Addressing these risk factors is crucial to breaking the cycle of transmission and preventing the further spread of the disease.
As children experience repeated infections, scarring can occur on the inner surface of their upper eyelids. This scarring leads to a painful condition known as trachomatous trichiasis, where the eyelid margin turns inward, causing the eyelashes to constantly rub against the eyeball, but the hazards don’t end there. If left untreated, this condition can lead to visual impairment.
During the 1950s and 1960s trachoma was a significant public health concern in India. States like Gujarat, Rajasthan, Punjab, Haryana, Uttar Pradesh, and the Nicobar Islands were heavily impacted, with over 50 per cent of their populations affected during that period.
By 1971, trachoma was responsible for 5 pc of all blindness cases in the country. In response to this pressing issue, India implemented a series of measures aimed at eradicating the problem. Recogniing the urgent need to combat the trachoma health crisis, India implemented several key interventions under the National Programme for Control of Blindness and Visual Impairment (NPCBVI). A pivotal moment in this effort was the adoption of the WHO SAFE strategy, which aimed not only to treat existing cases but also to prevent future infections through improved hygiene practices.
National initiative
In 1963, the Government, with support from WHO and Unicef, launched the National Trachoma Control Programme. This initiative laid the groundwork for comprehensive trachoma management. In 1976, trachoma control efforts were integrated into the broader NPCBVI framework, ensuring sustained focus. In 2005, trachoma accounted for 4 pcof all blindness cases, and remarkably, by 2018, this figure declined to just 0.008 per cent.
Significant strides
Through these continuous efforts, India has made significant strides toward eradicating trachoma. By 2017, the country was declared free from infective trachoma. This announcement came during the release of the National Trachoma Survey Report (2014-17) by the then-Minister of Health and Family Welfare JP Nadda. The survey findings indicated that active trachoma infections had been eliminated among children in all surveyed districts, with an overall prevalence of only 0.7 pc – well below the WHO elimination threshold of 5 per cent.
Despite this remarkable progress, the commitment to public health did not end there. From 2019 to 2024, India continued its vigilant surveillance for trachoma cases across all districts to ensure that the infection did not re-emerge.
WHO Director-General Dr Tedros Adhanom Ghebreyesus praised India’s commitment to alleviating the suffering caused by trachoma, emphasising the vital collaboration among the Government, healthcare professionals, and international partners that made this milestone possible.