WHO confirmed that Tunisia has eliminated trachoma as a public health problem

The World Health Organization (WHO) has confirmed that Tunisia has eliminated trachoma as a public health problem. This is a major milestone in the country’s public health journey, coming after decades of sustained national efforts.

“I congratulate Tunisia on this historic public health achievement,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “The elimination of trachoma shows what long-term political commitment, strong primary health care and teamwork can do. Tunisia has proven that even the world’s leading infectious cause of blindness can be overcome.”

Trachoma is closely associated with limited access to water, sanitation and hygiene, and affects vulnerable populations the hardest. In the early to mid-20th century, trachoma was endemic in Tunisia, affecting at least half of the population, especially in its southern regions.

“I congratulate Tunisia for eliminating trachoma as a public health problem. This is a major achievement that reflects sustained and consistent national commitment over many years and shows what is possible when the country remains focused on addressing the preventable causes of blindness,” said WHO Regional Director for the Eastern Mediterranean Dr Hanan Balkhy.

For decades, Tunisia has led a comprehensive and sustained trachoma response that has turned a once heavy health burden into a success story. The country has adopted and scaled up the WHO-recommended SAFE strategy: WITHurgency in advanced cases, ANDantibiotics to clear the infection, Fair cleanliness to reduce the spread and Eimprovement of the environment, especially better access to water and sanitary conditions. Tunisia has also implemented national screening and treatment campaigns, integrated eye care into primary health care and school health programs, and worked with communities to promote good hygiene.

“The validation marks a historic achievement for Tunisia and reflects our country’s longstanding commitment to public health, prevention and equity,” said Dr. Mustapha Ferjani, Tunisia’s Minister of Health. “This milestone is the result of decades of coordinated national efforts, with the commitment of generations of health professionals, local communities who have worked tirelessly to expand access to care, strengthen prevention and improve eye health across the country. Tunisia remains committed to maintaining these achievements and protecting future generations.”

Tunisia’s success followed a long campaign led by the Ministry of Health, supported by WHO and partners, based on a strong public health policy and social development. Strong health system foundations, including broad access to primary health care and significant progress in water and sanitation coverage, have helped reduce transmission and reduce disease prevalence.

A robust post-validation surveillance system is now in place to detect any disease recurrence at an early stage. This system includes provisions for ongoing case management and training of health professionals.

“The confirmation of the elimination of trachoma as a public health problem in Tunisia reflects the effect of continued collaboration between the Ministry of Health and WHO in achieving improvements in public health throughout the country,” said Dr. Ahmed Zouiten, WHO’s Acting Representative in Tunisia. “This milestone represents a powerful demonstration of how science, evidence-based programming and coordinated technical support can overcome neglected tropical diseases every time, everywhere.”

Tunisia joins a growing number of countries working to eliminate neglected tropical diseases, a key component of the health-related Sustainable Development Goals.

Editor’s Notes

Neglected tropical diseases and efforts to eliminate trachoma

Trachoma is caused by the bacterium Chlamydia trachomatis and is spread by close contact with infected people, contaminated surfaces and flies carrying discharge from the eyes and nose. Repeated infections can lead to scarring of the eyelids, inward turning of the eyelashes, and eventually blindness if left untreated.

Neglected tropical diseases such as trachoma are associated with devastating health, social and economic consequences. Their burden is felt mainly among poor communities in tropical areas.

Public health goals for the control, removal and eradication of these conditions are set in road map for neglected tropical diseases 2021-2030.

In 1996, WHO launched the WHO Alliance for the Global Elimination of Trachoma by 2020 (GET2020), creating a network of governments, non-governmental organizations and academic institutions dedicated to the fight against trachoma. WHO continues to support endemic countries to accelerate progress towards the global goal of eliminating trachoma as a public health problem worldwide; 2030 is the new target date.

Elimination of trachoma as a public health problem is defined as: (i) prevalence of trachomatous trichiasis (TT) “unknown to the health system” of < 0.2% in ≥15-year-olds; and (ii) prevalence of trachomatous inflammation-folliculitis (TF) in children aged 1-9 years of < 5%, in each previously endemic district; plus (iii) the existence of a system for identifying and managing incidents of TT.

Other countries that WHO has confirmed have eliminated trachoma as a public health problem are: Algeria, Australia, Benin, Burundi, Cambodia, China, Egypt, Fiji, Gambia, Ghana, India, Iraq, Islamic Republic of Iran, People’s Democratic Republic of Laos, Libya, Malawi, Mali, Mauritania, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Papua New Guinea, Saudi Arabia, Senegal, Togo, Vanuatu and Vietnam.

Trachoma is the first neglected tropical disease to be eliminated in Tunisia. After the recognition of the national elimination of trachoma there, Tunisia becomes the 14th^th country in the Eastern Mediterranean region of the World Health Organization to have eliminated at least one neglected tropical disease. It’s the 31st^St country in the world that will be certified to have eliminated trachoma as a public health problem.