The World Health Organization announced today that trachoma, a preventable disease that causes blindness, has officially been eliminated in Benin. Thanks to organizations like Sightsavers, local government leadership, and support networks, the West African nation joins six other African countries in successfully eliminating this disease.
To date, Sightsavers, a nonprofit organization that provides health services to 30 countries, has supported the delivery of 1.5 billion treatments and helped to deliver 8.3 million eyesight operations for people from Benin and around the world, helping pave the way for this announcement.
In 2018, Global Citizens took 5 million actions to end extreme poverty in the lead up to Global Citizen Festival: Mandela 100 in Johannesburg, South Africa, including actions calling for increased investment in combating neglected tropical diseases (NTDs) like trachoma.
On the festival stage, on Dec. 2, 2018, world leaders announced the launch of the Accelerate program, led by Sightsavers. Its goal was to eliminate trachoma in 14 countries across the African continent.
As chief executive of Sightsavers since 2005, Dr. Caroline Harper has seen the organization transform communities worldwide, and become a major player in the fight against neglected tropical diseases (NTDs) globally.
Global Citizen spoke with Harper about Sightsavers’ urgent work and the need for global commitment to health care initiatives worldwide.
Global Citizen: What inspires you about your work and the work of Sightsavers?
Harper: It’s incredible knowing that the work we do has an impact on so many people across the world, particularly those living in really difficult circumstances.
I’ve met a lot of patients who have received cataract operations, and I challenge anyone not to be incredibly moved watching someone see again for the first time in many years. Speaking with visually impaired children and their parents, I've heard their stories of optimism and confidence as they face the world independently.
My work has led me to witness mass drug distributions protecting whole villages from the ravages of various NTDs. Who would not be inspired? I also love talking to our supporters, who are critical to our success, many of whom have supported us for years and decades.
How has Sightsavers' core mission changed since the COVID-19 pandemic — and how has this affected global health funding?
We are fighting for a world where no one is blind from avoidable causes, and where people with disabilities can participate equally in society. The pandemic may have interrupted progress for a while but hasn’t changed our fundamental mission.
It has made funding more difficult, as the UK government (a major donor to Sightsavers) cut back spending on development dramatically, and this continues to this day.
We have also seen an increase in insecurity — including strikes, floods, disease outbreaks, conflict, terrorism, and political unrest. But we’re here to bring about long-term change for millions of people, and that was never going to be quick or easy.
Fundraising from the public was not affected by COVID-19 — at Sightsavers, we saw income rise during this period. But the potential impact of cost-of-living increases is something to be mindful of over the next couple of years.
We’re incredibly lucky and grateful for the generous people and organizations, like the Accelerate donors, who keep showing up and staying committed to our mission.
A child receiving Tetracycline in the MANKONO Health district in Cote d'Ivoire.
What is the impact of NTDs on the global health system, and how is it affected by the treatment and elimination of preventable diseases like trachoma?
Until recently, many NTDs weren’t even part of the global health system, that’s why we call them “neglected.” For example, people living in agony and slowly losing their sight to trachoma, with their eyelashes turning inwards and scraping against their eyes, had nowhere to go for help.
One of the things that I’m proud of is how organizations like Sightsavers are supporting governments to bring NTDs into their health systems and take leadership in treating and eliminating them.
When you strengthen a health system to handle one condition, for example by training eye surgeons or building networks of trusted community health workers, the system becomes stronger for other conditions too.
The returns on investing in disease elimination are huge. It costs just $0.20 per person for the drugs to treat an entire community for trachoma, but the global economy loses $8 billion a year from people unable to work after suffering pain and losing sight of the disease.
Fighting NTDs has a ripple effect — improving education, well-being, and economic and health outcomes. More children can learn, adults can earn, and individuals, families, communities, and nations can thrive.
What role did Sightsavers play in Malawi's elimination of trachoma in September 2022? What does this mean for other countries on their road to elimination?
The Malawian Government led and deserves all credit for eliminating trachoma as a public health problem in 2022. As one of the poorest countries in the world, this was an incredible achievement.
I’m proud that Sightsavers was able to support them and hope that Malawi’s triumph has encouraged their neighbors still working to eliminate the disease. When the Malawi Ministry of Health, with Sightsavers’ support, launched the Malawi Trachoma Elimination Program in 2014, approximately 9.5 million of the 14 million people in Malawi were at risk of trachoma — that’s 2 out of every 3 citizens. Its elimination shows that the strategy we are using works.
The Ministry of Health and its partners followed the WHO-endorsed SAFE strategy, which combines surgery to stop eyelashes scraping the eye, antibiotics to prevent and treat infection, and facial cleanliness and environmental improvements to stop infection spreading.
In total, the partnership delivered 22.25 million drug treatments of Zithromax, donated free of charge by Pfizer Inc., trained 16 surgeons to manage more than 6,000 advanced cases — where the eyelashes turn inwards and scrape against the eye with every excruciating blink — and supported 253 schools to adopt better hygiene and sanitation and encourage the children to spread the word in their wider communities.
What role has the Accelerate program played in helping eliminate NTDs like trachoma?
Put simply, thanks to Accelerate, more than 14 million people (so far) across 14 countries, are no longer at risk of losing their sight in agony to trachoma. Through the program, over 88,000 advanced trachoma cases have been managed, mostly with surgery, and over 48 million drug treatments have been delivered to communities at risk.
We have also been able to train more than 151,000 health workers to identify the various stages of trachoma infection and deliver treatment.
Benin is the first country supported by Accelerate to announce that they have successfully eliminated trachoma, validated by WHO. While Sightsavers and other donors, such as USAID, have been supporting the government with their elimination strategy since 2013, the Accelerate support has been vital to getting the country across the finish line — a huge achievement!
And while Benin was the first Accelerate-supported country to reach elimination, more will follow in the next few years, so watch this space.
A woman suffering from trachoma awaits surgery that will bring her sight back in the Centre de Sante Biro, Benin.
In what ways can the Accelerate program and its success in Benin be used as a model for eliminating NTDs globally?
Every time a country announces an elimination, it proves that the global strategy is working, inspiring more countries to take leadership on ending NTDs, and galvanizing further international efforts. Working with partners, from national ministries of health and international NGOs to local organizations, has always been a key part of Sightsavers’ approach, and has been vital in the Accelerate program to coordinate activities in collaboration with key stakeholders (including those in the water, sanitation, and hygiene sector).
Our innovative TT Tracker app and mass drug administration reporting and coverage monitoring tool are now being used in countries outside the Accelerate program and even for diseases other than trachoma.
Diseases don’t respect borders so neighboring countries must coordinate efforts if we’re to leave no one behind. Accelerate supported Kenya and Uganda to join forces and deliver their first cross-border community-wide drug campaign in 2021.
We were then able to replicate this in Kenya and Tanzania to reach nomads moving along the Maasai border with their livestock. Now these countries have shown the way we hope that more neighbors will be persuaded to synchronize their efforts.
We expect that the global momentum towards elimination will increase as more and more countries follow in Benin’s footsteps — reaching a goal that Audacious funding has made, and can continue to make a reality.
Read about how #Sightsavers and partners are delivering on our promise to tackle neglected tropical diseases one year on from @GlblCtzn@GlblCtznAfrica#Mandela100! @gatesfoundation@CIFF @Elma @DFID_UK@VirginUnitehttps://t.co/Z0QjRakgKA— Sightsavers (@Sightsavers) December 2, 2019
Sightsavers helps millions of people around the world treat NTDs while advocating for policy reforms worldwide. How will Sightsavers address global health challenges in the future, and what successes will the organization celebrate?
We will celebrate each time a country eliminates an NTD or ratifies a key protocol or piece of legislation to support people with disabilities, and whenever we see governments building on our work in eye health. We conduct assessments of avoidable blindness levels and will celebrate when countries see major falls in this — for example, over the past decade in Pakistan, avoidable blindness has more than halved for the over 50s.
The challenges are large, but it is important not to see them as overwhelming. Each milestone celebrated along the way shows that our mission is achievable.
*This interview has been edited and condensed for clarity.
You can learn more here about Sightsavers and their lifesaving work providing sight-saving operations to vulnerable populations.