India has eliminated Trachoma as a public health problem
Oct. 13, 2024

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.