An Open Letter from Dr. Paul Emerson
2016 was a pivotal year in the history of the International Trachoma Initiative. We started the year with a near complete summary of the global distribution and intensity of trachoma because of the global trachoma mapping project. For the first time we no longer had to estimate the scale of the problem or shoot in the dark. We knew what we had to do, and where to do it.
Since moving to the Task Force for Global Health, ITI’s annual rolling average of donation has been 45.6 million doses of Pfizer-donated Zithromax® a year to around 15 countries. This has been estimated as reaching 10 to 30% of those at risk of blinding trachoma. In 2016, thanks to a doubling of their annual commitment, we were able to ship 120.7 million doses of Zithromax® to 24 countries. Knowing that the number of people living in known endemic areas is 200 million, 2016 could have been the year when the global program reached more than half of those at risk. Indeed, with the rapid implementation of tropical data (which is not well known yet and is effectively a stealth weapon in the battle to defeat trachoma) we know that during the year the number of endemic districts went down, and that the population now living in known endemic districts is nearer 175 million. We eagerly await the distribution records from the endemic countries, and expect that the proportion of those at risk who were reached maybe even greater than 50%.
With progress this fast the prospects of achieving the elimination targets seem more realistic than they ever have.
With the number of people reached increasing, and the number of people at risk of decreasing, implementation of the global program can be considered to be “at-scale”. We are anxious to see those at risk of trachoma in Yemen, Egypt, Pakistan and Fiji get access to trachoma interventions. The people of those countries deserve better than they are getting. We are planning on shipping 110 million doses of Zithromax® this year because we anticipate that the number of endemic districts will decline and no more than that will be needed.
We are committed to increasing transparency at the International Trachoma Initiative. We will launch an online Zithromax® tracking tool which will enable national programs and their partners to see in real time the status of their antibiotic allocation and shipment.
We will continue to work closely with our partners at the NTD department of WHO, both in the joint database and also in the expansion of tropical data which will allow results of impact surveys to be shared in virtually real-time.
Our program team look forward to working with our partners in Ghana, the Gambia, Mexico, and Nepal in the preparation and submission of their paperwork to demonstrate that trachoma has been eliminated in those countries as a public health problem. We also look forward to working with our partners in the ICTC on regional work groups for east and west Africa, and launching a new initiative for trachoma endemic countries in southern Africa. These regional groupings have been very successful in allowing countries to share their context specific solutions to common issues across borders.
Trachoma is a miserable disease that has plagued humankind since antiquity. It is our privilege to be in the vanguard of a huge coalition dedicated to eliminating it. In 2017 more than 100 million people will be active participants in this program. Their success will be the gift of vision to future generations.