Pakistan eliminates trachoma as a public health concern

The two-decade journey to elimination

Pakistan’s fight against trachoma began in the 1950s with a control program under the Ministry of Health. However, the program was discontinued in the 1970s without achieving its goals due to resource constraints.

In the early 2000s, under the leadership of Prof. Mohammad Daud Khan, the fight against trachoma was revived. The WHO identified Pakistan as a priority country for its Global Elimination of Trachoma 2020 (GET 2020) initiative. In 2002, a National Trachoma Rapid Assessment (TRA) identified high-prevalence areas, leading to the establishment of the National Trachoma Task Force (NTTF).

The NTTF implemented the WHO SAFE strategy:

• Surgery to treat trichiasis (advanced trachoma).
• Antibiotics (azithromycin) to eliminate infection.
• Face washing for improved hygiene.
• Environmental improvements to reduce disease transmission.

Over two decades, the program trained trichiasis surgeons, mobilised resources, and launched community education campaigns. These efforts significantly reduced the prevalence of trachoma, improving eye health outcomes for millions in Pakistan.

The program’s success is credited to sustained leadership and collaboration:

• Prof. Mohammad Daud Khan laid the foundation for elimination efforts.
• Prof. Asad Aslam Khan, who succeeded Prof. Daud Khan, led the program to its conclusion as Chair of the NTTF.
• Dr Zahid Hussain Awan, CBM IEH Project Manager CBM, who has been part of the trachoma elimination journey in Pakistan since 2000, has been instrumental in mobilising resources, implementing interventions, and driving community engagement, ensuring that critical health services reached even the most underserved communities, leading us to this proud milestone of elimination.
• Dr. Mohammed Babar Qureshi, CBM Director of the Inclusive Health Initiative, was the first National Field Coordinator and Secretary of the National Trachoma Task Force. He led Pakistan's first National Trachoma Rapid Assessment and designed the SAFE strategy for the National Trachoma Control Programme, which lasted two decades. In his roles with the Trachoma Expert Committee, EMR Alliance for Trachoma Control, and IAPB, he provided technical guidance that led to the certification of Trachoma elimination as a public health issue in Pakistan, supported by the contributions of CBM teams in the Regional and Country Offices.

International partners, including CBM, Fred Hollows Foundation, Sightsavers, and corporate donors, played a crucial role. The active participation of Pakistani communities in awareness campaigns, treatment, and prevention efforts was essential for eventual elimination.

A collaborative success

The success demonstrates the strength of partnerships among the public, private, non-government, and community. When these groups work together, they can effectively promote awareness campaigns, treatment initiatives, and healthier practices, ultimately achieving elimination goals.