“We need to look at what has happened over time and use that science to change this program. We need to dose people more.”
Callahan said that if successful, the trial could be replicated in countries beyond Ethiopia that have not started mass drug administration at scale, such as South Sudan.
Several areas of Ethiopia have seen the disease decrease or even disappear as a result of the SAFE strategy, Callahan said. The Carter Center has been focused on trachoma elimination in Ethiopia since 2000. It works in concert with federal and regional ministries and partners to support local authorities in building their capacity to tackle the disease, while relying on community-based volunteers for many SAFE-related activities.
But trachoma persists in other parts of Ethiopia, namely in the Amhara region, where access to adequate sanitation is rendered difficult by geography — its population is spread over vast expanses of mountainous terrain — and by widespread poverty. Despite tremendous advances in the promotion of hygiene, 62 million people in Ethiopia still remain without access to safe water, and 97 million live without access to improved sanitation.
“We need to use our data to drive programming towards improved access to water and sanitation, thus improving people's lives overall and thus strengthening health systems overall,” Callahan said.
62 million people
in Ethiopia still remain without access to safe water
Source: Water.org
The trachoma community will increasingly focus its efforts on the remaining pockets of at-risk populations, like those in Amhara, while exiting countries that reduce the burden of disease so that it is no longer a public health problem. Partners are reflecting on how to translate 20 years of lessons learned on cost-effectiveness, cross-sector collaboration, and innovative partnerships to other areas of global health so that the gains from trachoma will not be lost.
“We have been able to deliver against promises and have built a tremendous amount of trust between the donors, the partners, and all the other stakeholders,” Emerson said. “I'd love to see [ITI and the International Coalition for Trachoma Control] be a first-case use and to see the lessons, the infrastructure, and the processes that we've managed to build together be applied to other diseases and other conditions.”
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