What if we eliminated one of the world’s oldest diseases?

Caroline Harper, April 2018
Caroline Harper speaks at TED 2018.
Sightsavers CEO Caroline Harper during her TED Talk.

Last week I stood in front of hundreds of entrepreneurs, tech visionaries and creative thinkers at TED2018 with a pair of tweezers hanging from a chain around my neck.

I was in Vancouver to talk about trachoma, the world’s biggest infectious cause of blindness, and how we could be just years away from eliminating it. I was wearing tweezers because after years of repeated trachoma infections with no treatment, scar tissue forms under the person’s eyelid. This inverts the eyelashes so they painfully rub against the cornea until they become blind in the most painful way imaginable. Girls in Africa wear tweezers to pull out their eyelashes for temporary relief, but they grow back more vicious than before.

Trachoma has been recorded as far back as ancient Egypt. Right now, more than 182 million people are at risk of going blind from the eye disease, which blights the world’s poorest communities. Despite being entirely preventable and treatable, trachoma still damages children’s ability to learn and people’s employment prospects. It traps whole communities in a cycle of poverty.

An ancient painting from a tomb showing hieroglyphics, including eyes and tweezers.
An ancient mural showing eyes and tweezers, indicating trachoma.

But thanks to one of the most successful collaborative alliances in the history of global health, momentum to eliminate trachoma is gathering pace. In 2012, Oman became the first country validated by WHO as having eliminated trachoma as a public health problem. In 2016, Morocco announced the end of the disease, and in 2017 Mexico, Cambodia and Laos became trachoma-free.

Six other countries are believed to be close to elimination. One of these six, Ghana is on the cusp of making history as the first sub-Saharan African country, and indeed the first Commonwealth country, to receive WHO validation that it has eliminated the disease.

The progress that has been made in recent years shows that trachoma elimination is possible. How has this all been achieved? Collaboration is the key. Ministries of health, communities themselves, donors, pharmaceutical companies, INGOs such as Sightsavers and other members of the International Coalition for Trachoma Control are united by a shared vision and working together under a common strategy, namely the World Health Organization-endorsed SAFE strategy.

The SAFE acronym stands for surgery, antibiotics (donated by Pfizer), facial cleanliness and environmental improvement, and we know that it works. To eliminate trachoma globally, we need every country where trachoma is a public health problem to have the resources to deliver the strategy right until the end.

The progress that has been made in recent years shows that trachoma elimination is possible

A schoolboy splashes water on his face to learn about facewashing, as part of a SAFE initiative in Senegal.
A boy learns to wash his face to prevent trachoma infection.

High-quality data also has an essential role to play in bringing about the end of trachoma. The Tropical Data service supports national health ministries to collect accurate and high-quality data on where programmes have been a success and where further activities are required.

Through the Tropical Data initiative, teams in the field use smartphone technology to enable them to collect and transmit data more quickly, meaning results can be analysed and applied faster by health ministries. This means field teams in even the most remote and difficult environments can conduct good quality surveys.

At TED2018 we revealed one of the most exciting recent developments in the quest to eliminate trachoma: the Audacious Project. It’s hosted by TED, and supported by leading non-profit organisations and philanthropists. The Audacious Project has chosen trachoma elimination as one of the Audacious ideas because it recognises that those working to end trachoma are now in a position to bring about this momentous global change. The only thing holding many countries back is having the resources to end the disease.

The only thing holding many countries back is having resources to end the disease

A five-year-old girl in Ethiopia has her eyes checked for trachoma.
A young girl in Ethiopia is screened to check for trachoma.

Straight after TED, a second, massive step along the path to trachoma elimination came to the fore as UK aid announced a new £20 million funding commitment to boost elimination efforts in 10 Commonwealth countries by 2020. The new Commonwealth 2018-2020 Fund will be coordinated by Sightsavers in Africa and the Fred Hollows Foundation in Asia and the Pacific, in close collaboration with ministries of health, local communities and other members of the International Coalition for Trachoma Control.

With the help of both projects, as well as the continued work of partners across the world, countries that are on the verge of eliminating trachoma will have the resources to finally consign it to history. We will then be very close to eliminating the disease for good.

To be able to finally rid the world of this disease will be one of the greatest achievements in human health: a future in which no one suffers or goes needlessly blind because of trachoma is now on the horizon. In this world, all necklaces will be worn for pleasure, not to ease pain.

This article was originally published on

To finally rid the world of this disease will be one of the greatest achievements in human health



Caroline Harper.Caroline Harper
Caroline is Chief Executive at Sightsavers, a role she has held since 2005. In 2015 she received a CBE for services to people with visual impairments.

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