What does ITI do?
ITI helps implement and promote the SAFE strategy, a public health model developed by the World Health Organization which has been proven to eliminate blinding trachoma, a neglected tropical disease that is the world's leading cause of preventable blindness.  ITI currently works in 15 priority countries in Africa and Asia.

How does ITI do its work? ITI accomplishes its work by:

• Collaborating with partner organizations, governmental and nongovernmental agencies, and national ministries to support implementation of  the “S” and “A” components of SAFE:  “Surgery” (ITI supports surgery for trichiasis, the advanced stage of trachoma which causes blindness) and “Antibiotics” (ITI provides Pfizer-donated Zithromax®  and supports its administration); 
• Promoting the “Facial cleanliness” and “Environmental improvement” components of SAFE in national trachoma control programs;
• Providing technical assistance to countries and partner organizations, including logistical assistance, trachoma control research, monitoring and evaluation of trachoma control programs;
• Fundraising and mobilizing local and international resources for trachoma control programs;
• Integrating trachoma control into approaches to eliminate other Neglected Tropical Diseases (NTDs); and
• Advocating for trachoma to be included in wider health and development agendas, including those which target the improvement of a community’s water supply, sanitation, access to education, and which seek to improve the lives of women and children.

What is trachoma?
Trachoma is an infectious disease of the eye caused by the bacterium Chlamydia trachomatis that can eventually lead to irreversible blindness. Those who are infected by trachoma do not instantly go blind—the disease manifests gradually.

While children are highly susceptible to infection, the most severe effects of trachoma emerge in adulthood, when scarring from repeated infections causes eyelashes to turn inward and scratch the cornea—a condition known as trachiasis, which leads slowly and painfully to complete blindness.
 
How does a person become infected with trachoma?
The bacterium that causes trachoma can be spread easily by contact with an infected person’s hands or clothing, or may be carried by flies that have come into contact with discharge from the eyes or nose of an infected person. Because trachoma is transmitted through close personal contact, it tends to occur in clusters, often infecting entire families and communities.
 
Who is most at risk of contracting trachoma?

• Trachoma affects rural populations with limited access to health care and clean water, and disproportionately impacts the most vulnerable members of these underserved populations:  women and children.
• Children under five are most likely to be infected with the trachoma bacteria. Due to the infectious nature of the disease, those who have the most contact with infected children are most likely to become infected themselves.
• Since women are traditionally the primary caregivers of children, they are frequently exposed to trachoma, making them more vulnerable to infection and eventual blindness.

How prevalent is trachoma?
Trachoma affects people in 56 countries worldwide.

Currently, nearly ten million people are visually impaired or irreversibly blind as a result of trachoma, and over 63 million people have active disease. The disease is particularly widespread in Africa, where 36 countries are trachoma-endemic.
 
Can trachoma be eliminated?
Yes.  Trachoma can be effectively eliminated through the WHO-approved SAFE strategy, a comprehensive public health approach that combines treatment (Surgery and Antibiotics) with prevention (Facial cleanliness and Environmental improvement).  Communities in which the SAFE Strategy is applied have shown measurable progress in the elimination of trachoma.

Morocco is likely to be the first country to eliminate blinding trachoma using the SAFE Strategy.  With the support of ITI, Morocco became the first country to complete the campaign for trachoma control in 2006 and is now working toward WHO-certification to signify that blinding trachoma has been eliminated as a public health problem there.  The success of the trachoma-control campaign in Morocco stands as an encouraging challenge to other trachoma-endemic countries and offers hope for the global elimination of blinding trachoma by 2020.

If trachoma is so prevalent, why have I never heard of it?
Although the disease is widespread, trachoma mostly affects poor and isolated communities, meaning it receives little international attention as a public health issue.

As a result, few people have heard of trachoma—even though trachoma is the leading cause of preventable blindness, with 63 million people currently suffering from active infection.  In fact, it is one of the oldest infectious diseases known to mankind; references to trachoma appear on papyrus scrolls dating back to ancient Egypt. 

In the late-19th and early-20th centuries, immigrants seeking to settle in the United States were inspected for trachoma at Ellis Island.  Unbeknownst to most Americans, trachoma once plagued certain areas of the United States:  the U.S. government operated trachoma hospitals in Kentucky, Virginia, West Virginia, Tennessee, North Dakota, Arkansas, Georgia and Missouri.  

Eventually, trachoma was eliminated as a public health concern in most developed nations, mainly due to improvements in living conditions.  But trachoma persists in the developing world where it poses a serious threat to public health and human development. In addition to the tremendous personal suffering caused by trachoma, the disease limits or eliminates its victims’ ability to work, resulting in productivity losses estimated at US$2.9 billion per year.