The World Health Organization has confirmed that El Salvador has eliminated trachoma as a public health problem

The World Health Organization (WHO) has confirmed that El Salvador has eliminated trachoma as a public health problem. Trachoma is the world’s leading infectious cause of blindness.

“I congratulate El Salvador on this remarkable achievement. It is a testament to the strength of political commitment, strategic investment and community engagement,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, “El Salvador’s success is a vital step towards our global goal of eliminating trachoma worldwide by 2030 and a clear signal that a healthier and fairer future is within reach.”

The validation follows a rigorous, multi-year process to determine whether trachoma was present as a public health problem in the country and to document the capacity of the health system to detect, investigate and respond to any potential future cases.

Between 2023 and 2026, El Salvador conducted targeted assessments in communities prioritized based on environmental and social risk factors. These assessments found no evidence of active transmission of trachoma. No signs of the disease were detected in children, and no advanced cases that could cause blindness were found in adults.

These findings confirmed that trachoma is not a public health problem in the country.

“This confirmation reflects El Salvador’s commitment to reaching the population in the most vulnerable conditions and creating solid evidence showing that trachoma is not endemic in the country,” said Dr. Jarbas Barbosa, director of the Pan American Health Organization (PAHO). “This is the result of ongoing efforts to reach out to communities, identify potential cases and ensure that no one is left behind.”

El Salvador’s progress has been supported by a multisectoral approach, including strengthened primary health care services, improved water, sanitation and hygiene (WASH), eye health services, including adult vision screening, and collaboration between government sectors, communities and international partners.

The country has also established systems to sustain this achievement, including trained health personnel, integrated surveillance mechanisms and the capacity to detect and treat cases of trichiasis (an advanced stage of trachoma in which the eyelashes turn inward and can lead to blindness) within the national health system.

“El Salvador has reached a major health milestone by achieving certification as a trachoma-free country, which is the result of ongoing national efforts, with the support of the Pan American Health Organization and the Embassy of Canada,” said El Salvador’s Minister of Health, Francisco Alabi. “We are proud to have achieved this achievement in just three years, positioning the country in the region and improving the visual health of our population.”

PAHO supported the country’s efforts through the Trachoma Elimination Initiative in the Americas, in collaboration with the Government of Canada. The process of elimination also created opportunities to provide integrated health services to the communities covered during the assessments.

Trachoma, caused by bacteria Chlamydia trachomatis, transmitted by contact with discharge from the eyes and nose of an infected person. Repeated infections can lead to scarring of the inner eyelid, causing the eyelashes to curl inward (trichiasis), which can ultimately result in blindness.

The disease is strongly associated with poverty and inequalities in access to basic services, including WASH and health care, and remains endemic in some of the world’s most vulnerable communities.

In the Americas, trachoma remains a public health problem in rural and remote areas of Brazil, Colombia, Guatemala, and Peru. Regional efforts to investigate and better define the epidemiologic status of trachoma have also been expanded in countries where the disease is suspected, including the Plurinational State of Bolivia, Ecuador, Guyana, Panama, Paraguay, and the Bolivarian Republic of Venezuela. El Salvador was among those countries pending the completion of assessments that provided the evidence needed for WHO validation.

WHO recommends that countries that have achieved elimination maintain surveillance systems and ensure continued access to quality eye care services to prevent disease recurrence.

Trachoma is one of more than 30 infectious diseases and related conditions targeted by PAHO’s Disease Elimination Initiative, which aims to eliminate them in America by 2030.

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

Public health goals for the control, elimination, and eradication of these conditions are defined 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 by 2030.

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 - follicular (TF) in children aged 1-9 years of < 5%, in each previously endemic area; 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, Tunisia, Vanuatu and Vietnam.

El Salvador is the first country in Central America and the second in the Americas to achieve this milestone. With this confirmation, El Salvador joins the group of 64 countries worldwide recognized by the WHO for eliminating at least one neglected tropical disease. Seven of these countries are located in the Americas.