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Recent Advances in the Global Effort to Eradicate Trachoma

The world’s most common cause of inflammatory blindness is far from the conscience of most Americans. Trachoma actively afflicts 150 million people in 55 countries across Africa, Asia, Latin America, and rural Australia. Six million have been blinded by corneal scars. By way of comparison, the number with active disease is similar to half the population of the United States; the number of blind is similar to the population of Massachusetts. The disease is believed to incur costs of some $3 billion annually. Like most diseases endemic to low-income countries, trachoma victimizes poor communities that are scarcely prepared to seek treatment or cope with the socioeconomic repercussions of disability. This is particularly unfortunate because industrialized countries possess the tools to treat people with virtually any phase of involvement. The fundamental problem posed by this communicable condition, however, is not simply how to treat individuals but rather whole communities. The unsanitary conditions and lack of infrastructure that have allowed trachoma to persist now complicate global efforts to eradicate it. Nevertheless, efforts are moving forward with unprecedented momentum. As 1 component of the VISION 2020 ‘‘Right to Sight’’ program, the World Health Organization (WHO) and its partners have endeavored to eradicate trachoma as a public health problem by 2020. The first word of success has come from Morocco, which will soon remove trachoma from its roster of public health problems. Now, as efforts proceed in other countries, a number of recent discoveries are available to guide the way. This paper will review recent progress in molecular biology, sampling methods, personal and environmental interventions, antibiotics, and surgery.