In April 2021, the World Health Organization (WHO) confirmed that trachoma is no longer a public health problem for the country.
This major accomplishment should be recognised and celebrated. Sightsavers has been tackling this painful and potentially blinding disease in the country for 35 years, and a key part of our work has been helping strengthen the health system so that it is prepared for this critical moment.
While The Gambia no longer needs intensive mass drug administration campaigns or widespread surgical outreach camps to manage advanced trachoma (known as trichiasis), the health system must now incorporate disease surveillance and management of incident cases into primary health care. It is these strong foundations and continued efforts that will truly consign trachoma to history.
Sightsavers directors Balla Musa Joof and Phil Downs have 40 years of combined experience working on neglected tropical diseases such as trachoma. Here they reflect on what this achievement means for The Gambia, what measures are needed to make sure trachoma is kept at bay there, and how other countries can learn from the experience and stay resilient during the COVID-19 pandemic.
Behind this incredible achievement lie three decades of hard work and collaboration. Meet the people who have been integral to the programme’s success.Read their stories
Even though WHO has validated that trachoma is no longer a public health problem in The Gambia, and that large-scale interventions such as mass drug administration are no longer needed, the country still needs to remain on guard to make sure the disease doesn’t come back.
The fact that The Gambia had to manage two outbreaks of trachoma in two successive years at critical times in the elimination effort emphasises how important this is. On these occasions, concerted efforts, especially from the ministry of health surveillance team, controlled the outbreaks and ensured that the momentum needed to eliminate the disease wasn’t lost. So these integrated disease surveillance teams need to remain active to reduce the risk of resurgence.
But surveillance is only one example of the work that needs to continue. Other activities include:
Elimination is in sight for many other trachoma-endemic countries. Not long ago, in 2018, Ghana became the first sub-Saharan African country to eliminate trachoma as a public health problem. Using experience and learning from Ghana, and now The Gambia, countries are increasingly better equipped with the knowledge they need to tackle trachoma.
Key to work in The Gambia was the WHO-endorsed SAFE strategy, which combines the four elements that spell out the acronym: surgery, antibiotics, face-washing and environmental improvements. But it took much more than that to get to where they are today, and other countries can learn from this. Here are three reasons we believe The Gambia has succeeded.