Fighting Disease:  Ethiopia

Controlling Trachoma

The leading cause of preventable blindness in the world, trachoma is an excruciating bacterial disease endemic to the poorest countries of the world. Although not typically a fatal disease, severe trachoma is disabling, debilitating, and eventually leads to blindness. The Carter Center supports trachoma control in six African countries in partnership with trachoma-endemic communities, ministries of health, the Lions Clubs International Foundation, Pfizer Inc., and the Conrad N. Hilton Foundation. Learn more about the Carter Center's Trachoma Control Program >

The prevalence of blindness in Ethiopia is thought to be the highest in the world. After cataract, the preventable bacterial infection trachoma was the second-leading cause of blindness in Ethiopia (afflicting 1.2 million people), placing the vast majority of the 75 million population at risk.

In October 2000, The Carter Center, with funding from the Lions-Carter Center SightFirst Initiative, accepted the Ethiopian government's invitation to work on controlling trachoma in the Amhara region in the north. The Amhara region is the most trachoma-endemic among all 10 regional states in Ethiopia.

In Ethiopia's population of almost 18 million people, Carter Center-supported surveys found trachoma affected 39 percent of children, and the advanced stage of the disease, which requires surgery to prevent blindness, affected an estimated 5 percent of people.

Since 2007, the Carter Center-supported program has been able to reach the entire at-risk population. The program is able to implement at scale through a deep partnership with the local Ethiopian Lions Clubs. The Ethiopian Lions Clubs play a key role in the implementation and advocacy of trachoma control in Ethiopia.

To reduce the number of people currently living with trichiasis, The Carter Center works with the Amhara Regional Health Bureau to provide corrective eyelid surgery. Since 2001, the Carter Center-supported national program has achieved more than 193,000 trichiasis surgeries throughout the country. However, the national program estimates that there remains a backlog of approximately 1 million cases that require operations to be relieved of the dreadful pain associated with this condition.

In 2010, 93 new surgeons were trained by the program to conduct surgery during regular health center visits, surgery camps, and outreach surgical campaigns and 33,021 persons were operated on to prevent blindness from advanced trachoma.

The Carter Center also supports the Ministry of Health to conduct mass distribution of antibiotic for trachoma control. Zithromax® (azithromycin), donated by Pfizer Inc., and tetracycline eye ointment, purchased by The Carter Center, are distributed through outreach campaigns to prevent and stop the transmission of trachoma infection. Adults and children older than 6 months of age are treated with azithromycin while infants and self-reporting pregnant women receive tetracycline eye ointment.

In 2003, The Carter Center began coordinating mass distribution of antibiotics to trachoma-endemic communities in one pilot district, reaching approximately 100,000 people. Since the first district, the geographic coverage of antibiotic distribution has expanded, with more than 14.7 million people receiving azithromycin in 2010. As of 2010, more than 51 million doses of azithromycin and 2 million doses of tetracycline have been distributed in Ethiopia alone.

MALTRA Weeks Big Success in Amhara Region, Ethiopia

Impoverished communities in Amhara region, Ethiopia — the world's most trachoma-endemic area — are harnessing an innovative and far-reaching approach to treating and preventing this blinding bacterial infection. Approximately every six months, rotating between the eastern and western halves of Amhara, The Carter Center, in partnership with the Ethiopia Ministry of Health and Lions Clubs International Foundation, mobilizes millions of people in one week to receive treatments of the antibiotic azithromycin (Zithromax®, donated by Pfizer Inc.) and participate in health education workshops on preventing trachoma and malaria. This efficient and cost-effective public health strategy is freeing time and resources for health workers to address other critical needs throughout the year. Learn more about the MALTRA weeks >

To ensure sustainable progress toward trachoma control, The Carter Center and the Amhara Regional Health Bureau work in tandem to deliver health education to communities and schools. A total of 3,428 communities currently benefit from health education activities as of 2010.

To strengthen community health education, The Carter Center and the regional health and education bureaus developed a trachoma prevention curriculum and corresponding health education materials to cover all components of the SAFE strategy with an emphasis on "facial cleanliness" and "environmental sanitation." Each lesson encouraged students to identify other problems related to hygiene in their own communities and come up with their own solutions. In 2004, the curriculum was translated into Amharic and printed with support from local Lions Clubs.

To improve environmental sanitation and control the flies that can transmit trachoma, the program promotes household latrine construction and use. This is accomplished through several channels: routine latrine promotion during health education led by health extension workers and the construction of model latrines in public gathering places.

Since 2002, more than 1.8 million household latrines have been constructed in the Amhara region with Carter Center assistance. This incredible achievement has been possible due to Ethiopia's leaders' vision and the commitment of the entire community.

This hard work continues to benefit millions of Ethiopians at risk of trachoma. The Carter Center, Amhara Regional Health Bureau, the federal Ministry of Health, and the Ethiopian Lions Clubs continue to work together to control trachoma.

Read the feature and watch the slideshow: MALTRA Success Measured in Millions >

Read the Associated Press story: In Ethiopia, Fighting Blindness May Prevent Deaths >

Read the press release: Efforts To Control Blinding Trachoma Reduce Child Mortality in Ethiopia, JAMA Study Finds >

Watch the CNN Impact Your World feature on the Carter Center's Trachoma Control Program >

Learn more about the Carter Center's trachoma work in Ethiopia (in search result format) >