The Impact of COVID-19 on Trachoma Elimination Programs

Today, the risk of blindness is 5 to 10 times higher in the developing world than in industrialized countries.

One of the reasons behind this alarming figure is that people affected by blinding diseases are often left without treatment due to difficult access to eye care. What’s more, most blinding diseases are still misunderstood by the general public because of a lack of health education.  

Trachoma is one of these conditions, and the world’s leading infectious cause of blindness. Transmitted through contact with eye and nose discharge, this bacterial infection is easily spread by hands, clothing and even flies. Repeated infections over time may lead to the deformation of the eyelid, which curves the eyelashes that then rub against the surface of the eye, causing pain, discomfort, permanent damage to the cornea and, eventually, blindness. 

Through its Neglected Tropical Diseases (NTD) program, the Organization for the Prevention of Blindness (French acronym: OPC) has been working towards eliminating trachoma in Francophone Africa, a region often overlooked by international development stakeholders. In partnership with local NGOs and governments, the OPC raises awareness about the disease, provides treatment and trains ophthalmic nurses in standardized surgical procedures. This program has already seen a lot of success: in 2019, 6,480 cases of trachoma complications were operated, and 3,127,108 people were given treatment against trachoma. 

Unfortunately, the COVID-19 pandemic has had a negative impact on trachoma elimination programs. On April 1, 2020, to reduce the risk of transmission of COVID-19, the World Health Organization (WHO) recommended that mass drug distribution, active trachoma complications case detection activities and population surveys be postponed until further notice. This advice was renewed a guidance document published on May 5, 2020.

The annual French speaking African Countries Trachoma Experts meeting (French acronym: RAFET), exceptionally organized on Zoom this year, allowed OPC to address this issue with a wide array of experts, non-governmental organizations and 13 Ministries of Health.

The RAFET members highlighted the quantitative and qualitative cost on inaction when it comes to eye health service delivery and neglected diseases control. The Ministries of Health in West and Central Africa are eager to see activities resume. 

COVID-19 impacts the ability of nonprofits to provide care, treatments, and surgeries for those infected by trachoma. The lack of funding for trachoma elimination programs will put a halt on all of the progress that has been made from the previous years and will stop people from asserting their human right to sight.

The necessity of restarting trachoma elimination activities will abide by the best practices and recommendations of the World Health Organization (WHO). These precautions and procedures include: 

 

A. Five-pronged risk analysis

  • Expected impact on public health of the planned anti-trachoma activity
  • Expected impact on public health if the planned anti-trachoma activity is not implemented
  • Implications of excluding risk groups from anticipated anti-trachoma Activity
  • Social context
  • Gender, equity, and human rights…

 

B. Precautionary measures applicable on sites affected by the planned anti-trachoma activity for health workers and social health workers (social distancing, mask and hydroalcoholic solution) and patients (i.e., medical masks for people aged 60 and over and those with pre-existing medical conditions, non-medical masks (fabric or canvas) for the general population with social distancing, masks and hydroalcoholic solution made available).

 

Many countries will face a dilemma. First, the risk analysis prerequisites can be difficult to satisfy, thus leading to a frustrating status-quo. Second, the costs related to the implementation of the barriers and social distancing measures in all anti-trachoma activities will have to be covered.

We need your help to ensure we can continue saving and restoring the eyesight of the most vulnerable populations through our trachoma elimination program. Please donate what you can today.

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