Trachoma Control Program: Jim Zingeser Profile

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Trachoma Control Program: Jim Zingeser Profile
1 Jun 2002

Securing Hope in Disease-Ravaged Nations
Excerpted from The Carter Center News, Jan -June 2002.
"Despite all the success The Carter Center has had in the eradication of Guinea worm disease, what chance does hope have in an environment where another debilitating disease hangs over the people?"
That is a question Dr. James Zingeser, senior epidemiologist at The Carter Center, asked himself in developing the Center's plan to control trachoma, the world's leading cause of preventable blindness. Dr. Zingeser believes he has an answer that will ensure his plan's success, and results to date are proving him right.

Dr. Zingeser proposed The Carter Center apply the experiences and knowledge gained from Guinea worm eradication and river blindness control efforts to achieve control of blinding trachoma. Working with governments and other partners, the Trachoma Control Program now uses community-based interventions, research, and advocacy to fight trachoma in countries where the Center has eradicated, or is working to eradicate, Guinea worm disease.
In the 1990s, the World Health Organization developed the SAFE strategy to prevent and/or treat trachoma. Some organizations began by focusing on the surgical and antibiotic parts of the strategy, as there was little knowledge of how to achieve behavioral and environmental changes to prevent trachoma. The Conrad N. Hilton Foundation knew of the Carter Center's success in changing behavior in the Guinea worm program and asked the Center experts to see if they could apply their knowledge to the fight against trachoma. In 1998, The Carter Center took on the challenge of the "F" and "E" of SAFE.

The SAFE strategy to control trachoma:
"S" stands for surgery,
"A" for antibiotics,
"F" for facial cleanliness to prevent transmitting the disease and
"E" for environmental changes to improve hygiene and sanitation

Trachoma is a chronic bacterial infection that spreads easily from person to person. Repeated infections result in scar tissue on the inside of eyelids, eventually turning eyelashes inward which causes abrasions of the cornea and, finally, irreversible blindness. "I've been in villages in Africa where virtually every person suffers from trachoma," said Dr. Zingeser, "older people unable to work and young people plagued by repeated eye infections, many of whom will go blind unless treated. "The tragedy is that this is unnecessary. Unlike cataracts, for example, trachoma can be prevented with simple changes in household and environmental hygiene."

Dr. Zingeser expects early success will come from integrating the Guinea worm and trachoma programs. In Yemen, for example, the Center is working with the same partners who successfully eradicated Guinea worm there. "On the other hand, in countries like Ghana and Nigeria, the trachoma program works hand-in-hand with the Guinea worm program, reinforcing each other."
Dr. Zingeser, a veterinarian who specialized in public health epidemiology, served with the Centers for Disease Control and Prevention before coming to The Center and spent three years as technical advisor for the Guinea worm program in the Republic of Niger.
Health education is important to all of the Center's health programs, including trachoma. Dr. Zingeser said, "We observe the personal hygiene habits of parents and children, then help them make facial cleanliness part of their household routine. A concurrent effort is made to improve the environment - helping communities build and improve access to safe water."
In areas where support for the antibiotic aspect of the SAFE strategy is lacking, the Center draws on its experience with river blindness control to help international and local organizations develop a distribution system for antibiotics. In some countries, Pfizer Inc, donates Zithromax® for annual treatment of trachoma patients.
The Trachoma Control Program is possible thanks to generous grants from the Conrad N. Hilton Foundation and Lions Clubs International. In addition, Pfizer Inc, the World Health Organization, Helen Keller Worldwide, the International Trachoma Initiative, and World Vision International are indispensable partners.
"We can't be satisfied with success in one program," Dr. Zingeser said, "when the people we work with in underdeveloped countries continue to face other crippling but preventable diseases. Our goal is to fight disease, but we never lose sight of The Carter Center's mission to build hope. Building hope is key in our struggle to break the cycle of disease and poverty that grips so many countries in the world today."

Salissou Kane, Global 2000 resident technical advisor, and Dr. Jim Zingeser team up to control trachoma in Niger. The Carter Center helps implement the SAFE strategy by focusing on health education and environmental change