Tunisia Validated By WHO As Having Eliminated Trachoma As a Public Health Problem

The World Health Organization (WHO) has validated Tunisia as having eliminated trachoma as a public health problem. This is a major milestone in the country’s public health journey, coming after decades of sustained national effort.

“I congratulate Tunisia on this historic public health achievement,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Eliminating trachoma shows what long-term political commitment, strong primary health care and teamwork can do. Tunisia has proven that even the world’s leading infectious cause of blindness can be overcome.”

Trachoma is closely linked to limited access to water, sanitation and hygiene, and hits vulnerable populations hardest. In the early to mid-20th century, trachoma was endemic in Tunisia, affecting at least half of the population, especially in its southern regions.

“I congratulate Tunisia on the elimination of trachoma as a public health problem. This is a major achievement that reflects sustained and consistent national commitment over many years and shows what is possible when a country remains focused on addressing preventable causes of blindness,” said WHO Regional Director for the Eastern Mediterranean Dr Hanan Balkhy.

For decades, Tunisia ran a comprehensive and sustained response to trachoma that turned a once-heavy health burden into a success story. The country adopted and scaled up the WHO-recommended SAFE strategy: Surgery for advanced cases, Antibiotics to clear infection, Facial cleanliness to reduce spread, and Environmental improvement, particularly better access to water and sanitation. Tunisia also ran nationwide screening and treatment campaigns, integrated eye care into primary care and school health programmes, and worked with communities to promote good hygiene.

“Validation marks a historic achievement for Tunisia and reflects our country’s long-standing commitment to public health, prevention and equity,” said Dr Mustapha Ferjani, Minister of Health of Tunisia. “This milestone is the result of decades of coordinated national efforts, with the dedication of generations of health-care professionals, local communities who worked tirelessly to expand access to care, strengthen prevention and improve eye health across the country. Tunisia remains committed to sustaining these gains and protecting future generations.”

Tunisia’s achievement followed a long campaign led by the Ministry of Health, supported by WHO and partners, anchored in strong public health policies and social development. Strong health system foundations, including wide access to primary health care and significant progress in water and sanitation coverage, helped reduce transmission and push disease prevalence down.

A robust post-validation surveillance system is now in place to detect any return of disease at an early stage. This system includes provision for ongoing case management and training of health professionals.

“The validation of elimination of trachoma as a public health problem in Tunisia reflects the impact of sustained collaboration between the Ministry of Health and WHO in achieving public health gains across the country,” said Dr Ahmed Zouiten, Acting WHO Representative in Tunisia. “This milestone stands as a strong demonstration of how science, evidence-based programming and coordinated technical support can overcome neglected tropical diseases every time and everywhere.”

Tunisia joins a growing number of countries working toward the elimination of neglected tropical diseases, a key component of the health-related Sustainable Development Goals.

Editor’s notes

Neglected tropical diseases and trachoma elimination efforts

Trachoma is caused by the bacterium Chlamydia trachomatis and spreads through close contact with infected individuals, contaminated surfaces, and flies that carry eye and nose discharge. Repeated infections can lead to scarring of the eyelids, turning eyelashes inward, and ultimately causing blindness if untreated.

Neglected tropical diseases like trachoma are associated with devastating health, social and economic consequences. Their burden is mainly felt among impoverished communities in tropical areas.

Public health targets for the control, elimination and eradication of these conditions were set in the road map for neglected tropical diseases 2021-2030.

In 1996, WHO launched the WHO Alliance for the Global Elimination of Trachoma by 2020 (GET2020), creating a network of governments, nongovernmental organizations and academic institutions dedicated to the fight against trachoma. WHO continues to support endemic countries to accelerate progress towards the global target of eliminating trachoma as a public health problem worldwide; 2030 is the new target date.

Elimination of trachoma as a public health problem is defined as: (i) a prevalence of trachomatous trichiasis (TT) “unknown to the health system” of < 0.2% in ≥15-year-olds; and (ii) a prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years of < 5%, in each formerly endemic district; plus (iii) the existence of a system to identify and manage incident cases of TT.

Other countries validated by WHO as having eliminated trachoma as a public health problem are: Algeria, Australia, Benin, Burundi, Cambodia, China, Egypt, Fiji, Gambia, Ghana, India, Iraq, Islamic Republic of Iran, Lao People’s Democratic Republic, Libya, Malawi, Mali, Mauritania, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Papua New Guinea, Saudi Arabia, Senegal, Togo, Vanuatu and Viet Nam.

Trachoma is the first neglected tropical disease to be eliminated in Tunisia. Following recognition of national trachoma elimination there, Tunisia becomes the 14th country in the WHO Eastern Mediterranean Region to have eliminated at least one neglected tropical disease. It is the 31st country in the world to be validated as having eliminated trachoma as a public health problem.

By WHO.