Trachoma

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Trachoma Control Program

The Trachoma Control Program works with ministries of health in five African countries to eliminate blinding trachoma, the world's leading cause of preventable blindness.

What is Trachoma?

Trachoma is a bacterial eye infection found in poor, isolated communities lacking basic hygiene, clean water, and adequate sanitation.

Trachoma is easily spread from person to person through eye-seeking flies, hands, and clothes. Repeated infection over time leads to scarring and inward turning of the eyelid, causing the eyelashes to scratch the cornea — a very painful condition called trachomatous trichiasis — which eventually causes blindness if left untreated.

  • A doctor in Niger examines a young patient for eye damage associated with trichiasis.

    Dr. Abdou Ousseini, a public health physician in Niger’s Zinder region, examines a patient's eyelids for trichiasis, a turning of the eyelashes that can permanently scar a trachoma sufferer’s corneas. (Photo: The Carter Center/S. Phelps)

How Widespread is the Disease?

Trachoma can be found in 44 countries, mostly in Africa and the Middle East, and a few in the Americas and Asia.

Globally, 136.2 million people are at risk for trachoma, which represents a 12.8% reduction from 156.6 million in 2018. However, 2.5 million are still at immediate risk for blindness from trachomatous trichiasis, also known as TT.

The Carter Center works to control and prevent blinding trachoma in Ethiopia, Mali, Niger, South Sudan, and Sudan. Ethiopia has the highest known burden of active trachoma infection in the world. The Carter Center supports Ethiopia’s (and thus the world’s) most affected region, Amhara.

  • A health worker in Ethiopia pours a dose of the antibiotic syrup of Zithromax ® (azithromycin), which is used to treat the eye disease trachoma.

    A health worker in Ethiopia pours a dose of the antibiotic syrup of Zithromax® (azithromycin, donated by Pfizer Inc.), which is used to treat the eye disease trachoma. (Photo: The Carter Center)

Our Strategy

The Carter Center's Trachoma Control Program was established in 1998. As a global leader in the fight against trachoma, the Center and partners implement the World Health Organization (WHO) endorsed SAFE strategy for trachoma control. SAFE is a multipronged approach to trachoma prevention that comprises Surgery, Antibiotics, Facial cleanliness, and Environmental improvement.

  • In the Amhara region of Ethiopia, a boy washes his face to prevent trachoma infection.

    In the Amhara region of Ethiopia, a boy washes his face to prevent trachoma infection. (Photo: The Carter Center)

Results and Impact

  • The Carter Center has trained and equipped local health workers to surgically correct eyelids deformed by trachomatous trichiasis (TT), the scarring that results from multiple trachoma infections. In 2020, the Center supported 8,274 corrective eyelid surgeries, 19.6% of the global total. Over the course of 21 years (1999 to 2020), the Center has assisted national programs in providing 854,496 TT surgeries in Ethiopia, Mali, Niger, Nigeria, South Sudan, and Sudan.
  • Since 1999, The Carter Center has assisted in the distribution of over 215 million doses of Zithromax® (donated by Pfizer Inc.), an effective trachoma-fighting antibiotic. Over 20 years, this represents approximately 25% of all the Zithromax® distributed worldwide in the fight against trachoma. In 2020, 15,670,751 million people received antibiotics.
  • The Carter Center has ongoing health education efforts in over 6,000 villages each year across Ethiopia, Mali, Niger, South Sudan, and Sudan. For more than 20 years, The Carter Center has assisted in the training and retraining of more than 398,000 persons, including teachers and principals, in conducting health education against trachoma.
  • The Carter Center continues to support the construction of household latrines. Since 2002, more than 3.6 million household latrines have been built to help to reduce breeding sites for flies, a principal source of infection transmission.
  • Ghana in 2018 became the first sub-Saharan African country to be validated by the WHO for eliminating trachoma as a public health problem. Ghana reached its goal by 2010, but the WHO had not yet developed a process or criteria to evaluate the country’s achievement. The WHO created a process in 2016 to allow Ghana and other countries to be validated as having met the targets. The Center's Trachoma Control Program assisted Ghana’s Ministry of Health from 1999 through 2011.
  • Two states in Nigeria, Plateau and Nasarawa, eliminated trachoma as a public health problem in 2018. The Carter Center Trachoma Control Program worked with both states’ health ministries from 2000 through 2015.
  • In 2019, Mali began drafting the WHO validation dossier to demonstrate the elimination of trachoma as a public health problem. Mali is aggressively working to conduct its final surveillance surveys to achieve elimination despite significant access issues caused by insecurity.
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Antibiotic distribution to treat children's active trachoma infections brings auxiliary benefits to public health and may reduce child mortality, since antibiotics can help cure common childhood killers like diarrheal diseases. Read more >

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