Why in news?

World Health Organisation (WHO) has declared that the Government of India has eliminated Trachoma as a public health problem. With this, India has become the third country in the South-East Asia Region to achieve this milestone.

What’s in today’s article?

• Trachoma
• Why was trachoma such a challenge in India?
• How did Indian govt address the issue of Trachoma?
• What does WHO declaring India trachoma-free mean?

Trachoma

• About
  • Trachoma is the leading infectious cause of blindness globally.
  • It caused by Chlamydia trachomatis, and is spread by direct or indirect contact with eye or nose discharges, especially in young children.
  • In endemic areas, up to 90% of preschool-aged children can be affected, with infection declining with age.
• Symptoms
  • Repeated infections over time can lead to scarring inside the eyelid, causing the eyelashes to rub against the eye (trachomatous trichiasis), which leads to pain, corneal scarring, and ultimately blindness.
  • Women are at higher risk due to frequent contact with infected children.
• Transmission factors and prevalence
  • Transmission factors include inadequate hygiene, crowded living conditions, and limited access to clean water and sanitation.
  • WHO has termed Trachoma as a neglected tropical disease.
  • WHO estimates suggest that 150 million people worldwide are affected by Trachoma and 6 million of them are blind or at risk of visually disabling complications.
  • It remains prevalent in rural areas of Africa, Asia, Central and South America, and the Middle East, with Africa being the worst affected.
• Efforts to eliminate trachoma
  • Global efforts to eliminate trachoma are driven by WHO’s SAFE strategy, which includes:
    • Surgery for trichiasis,
    • Antibiotics like azithromycin for mass treatment,
    • Facial cleanliness, and
    • Environmental improvements, such as better water and sanitation access.
  • WHO adopted the SAFE strategy in 1993 and launched the WHO Alliance for Global Elimination of Trachoma in 1996.
  • The World Health Assembly has set 2030 as the new target date for eliminating trachoma as a public health issue globally.
    • By October 2024, 20 countries had eliminated trachoma as a public health problem.
    • Economic losses from blindness and visual impairment due to trachoma are estimated at $2.9–5.3 billion annually.

Why was trachoma such a challenge in India?

• High Prevalence in Specific States
  • Trachoma posed a significant challenge in India as it frequently resurfaced in new communities.
  • It was a leading cause of blindness in hyper-endemic regions like Punjab, Rajasthan, Western Uttar Pradesh, and Garhwal (Uttarakhand) between 1971 and 1974, where the prevalence exceeded 50%.
  • These areas were heavily impacted by the disease, making control efforts difficult.
• Reduction in Trachoma Prevalence
  • By 2005, trachoma accounted for only 4% of blindness cases in India.
  • A survey conducted in 2006-2007 indicated a significant decline in prevalence, prompting the Indian government to conduct a rapid assessment in hyper-endemic states.

How did Indian govt address the issue of Trachoma?

• Trachoma was amongst the leading cause of blindness in the country during 1950-60.
• The Government of India launched the National Trachoma Control Program in 1963 and later on Trachoma control efforts were integrated into India’s National Program for Control of Blindness (NPCB).
• In 1971, blindness due to Trachoma was 5% and today, owing to the various interventions under the National Programme for Control of Blindness & Visual Impairment (NPCBVI), it has come down to less than 1%. 
• WHO SAFE strategy was implemented throughout the country wherein SAFE stands for adoption of surgery, antibiotics, facial hygiene, environmental cleanliness etc.
• As a result, in 2017, India was declared free from infective Trachoma.
• However, surveillance continued for trachoma cases in all the districts of India from 2019 onwards till 2024.
  • Programs like Swachh Bharat Mission and Jal Jeevan Mission played a vital role in eradicating the disease and ensuring a trachoma-free future.
• Validation and Elimination
  • The National Trachomatous Trichiasis (TT only) Survey was conducted from 2021 to 2024 across 200 endemic districts as part of the NPCBVI, following WHO's guidelines for trachoma elimination.
  • The NPCBVI team compiled all findings into a dossier, which was submitted to the WHO for final review.
  • After years of dedicated efforts, WHO officially declared that India had successfully eliminated trachoma as a public health problem.

What does WHO declaring India trachoma-free mean?

• WHO declaring India trachoma-free signifies a major public health achievement, marking an improvement in the country's water, sanitation, and hygiene standards.
• According to experts, trachoma is often linked to poor sanitation, a common issue in developing countries.
• With its elimination, India has reached "gold-tier" public health status, demonstrating significant progress in addressing these challenges and enhancing overall health conditions.