Burundi Eliminates Trachoma as a Public Health Problem, Marking Major Milestone in Disease Control
The World Health Organization (WHO) has officially validated that Burundi has eliminated trachoma as a public health problem, becoming the eighth country in the WHO African Region to achieve this milestone. The success also marks the first time Burundi has eliminated a neglected tropical disease (NTD), highlighting the country’s growing capacity to combat health inequities.
“Eliminating a disease like trachoma is a major public health achievement that requires sustained effort and dedication,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “I congratulate the government and the people of Burundi for their commitment and hard work. It’s inspiring to see Burundi join a growing number of countries that have successfully eliminated at least one NTD.”
Understanding Trachoma
Trachoma is a contagious bacterial infection caused by Chlamydia trachomatis. It spreads through direct personal contact, contaminated clothing or surfaces, and flies that come into contact with eye or nasal discharge from infected individuals. Repeated infections can lead to scarring of the inner eyelid, causing the eyelashes to turn inward (a condition known as trichiasis), eventually resulting in irreversible blindness if left untreated.
Although preventable and treatable, trachoma remains a public health threat in many parts of the world, especially in communities with poor access to clean water, sanitation, and healthcare. It is the world’s leading infectious cause of blindness and continues to affect millions, primarily in rural and underserved regions.
Burundi’s Journey to Elimination
Prior to 2007, Burundi had limited knowledge of the extent of trachoma within its borders. There were no recorded cases or epidemiological studies to assess the disease’s prevalence. That changed in 2007 when the country launched a national initiative targeting NTDs, including trachoma. Through integrated mapping efforts, the government was able to gather vital data on multiple diseases, including soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis, and trachoma.
Follow-up surveys in 2009–2010 confirmed that trachoma was endemic in parts of Burundi. In response, the Ministry of Public Health and the Fight Against AIDS began implementing the WHO-recommended SAFE strategy, which stands for Surgery for trichiasis, Antibiotics to treat the infection, Facial cleanliness, and Environmental improvement to reduce transmission. This approach was rolled out across 12 health districts, reaching approximately 2.5 million people.
“This validation marks a major milestone in our commitment to health equity,” said Dr. Lydwine Baradahana, Burundi’s Minister of Public Health and the Fight Against AIDS. “It is a collective victory made possible by nearly two decades of national mobilization and international solidarity. I thank all our partners, community workers, and institutions that contributed to this historic success.”
Collaborative Efforts and International Support
Burundi’s elimination of trachoma would not have been possible without strong national leadership and coordinated international assistance. Technical and financial support was provided by several global health organizations, including CBM Christoffel Blindenmission, the END Fund, Geneva Global, and the WHO. The International Trachoma Initiative, a program of the Task Force for Global Health, provided essential antibiotic donations—specifically azithromycin (Zithromax, donated by Pfizer).
Dr. Xavier Crespin, WHO Representative in Burundi, praised the comprehensive collaboration, saying, “This achievement reflects the government’s resolve to protect its most vulnerable populations. Under the leadership of the Ministry of Public Health and the Fight Against AIDS, and with the dedication of community health workers, support from key partners, and WHO’s technical guidance, this success was made possible. This win inspires us to press forward with the same determination to eliminate all remaining neglected tropical diseases.”
WHO will continue supporting Burundi in its post-validation surveillance efforts to ensure trachoma does not re-emerge in previously affected areas.
Trachoma’s Global and Regional Footprint
Despite remarkable progress, trachoma continues to pose a public health challenge in many parts of the world. Currently, 32 countries still require interventions to control or eliminate the disease, with an estimated 103 million people living in areas where they remain at risk.
Africa bears a disproportionate burden. As of April 2024, about 93 million people in the WHO African Region were still at risk, accounting for 90% of the global burden. However, the region has seen significant progress in recent years. Between 2014 and 2024, the number of people requiring antibiotic treatment in Africa declined from 189 million to 93 million—a 51% reduction.
Twenty countries in the African Region still require trachoma elimination interventions. These include Algeria, Angola, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Eritrea, Ethiopia, Guinea, Kenya, Mozambique, Niger, Nigeria, South Sudan, Tanzania, Uganda, Zambia, and Zimbabwe.
Seven African countries have already been validated by WHO as having eliminated trachoma as a public health problem: Benin, Gambia, Ghana, Malawi, Mali, Mauritania, and Togo. Additionally, four more—Botswana, Guinea-Bissau, Namibia, and Senegal—report having achieved the elimination thresholds, though they have yet to be officially validated by WHO.
A Global Milestone in the Fight Against NTDs
With Burundi’s achievement, a total of 57 countries worldwide have now eliminated at least one neglected tropical disease. Of these, 24 countries have successfully eliminated trachoma as a public health problem. In addition to Burundi, the list includes:
- Africa: Benin, Gambia, Ghana, Malawi, Mali, Mauritania, Togo
- Asia and Middle East: Cambodia, China, Islamic Republic of Iran, India, Iraq, Lao People’s Democratic Republic, Myanmar, Nepal, Oman, Pakistan, Saudi Arabia, Viet Nam
- Americas and Pacific: Mexico, Papua New Guinea, Vanuatu, Morocco
This growing list is a testament to what can be achieved through a sustained, collaborative, and equity-focused approach to public health. The global community continues to work toward the ambitious target set out in the WHO’s NTD roadmap for 2021–2030, which aims to eliminate trachoma and other NTDs as public health problems in more countries and eventually eradicate them entirely.
