Bujumbura/Brazzaville/Geneva: The people of Burundi are celebrating a historic health triumph as the World Health Organization has validated the country as having eliminated trachoma as a public health problem, making it the eighth nation in WHO’s African Region to achieve this milestone. Announced on July 11, 2025, this victory, also marking Burundi’s first elimination of a neglected tropical disease, reflects nearly two decades of relentless community effort and international collaboration to protect vulnerable populations from blindness.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, said, “Eliminating a disease like trachoma is a major public health achievement that requires sustained effort and dedication. I congratulate the government and the people of Burundi and commend them for their hard work and commitment. It is great to see Burundi join the growing group of countries that have eliminated at least one NTD.” Trachoma, caused by the bacterium Chlamydia trachomatis, spreads through personal contact, contaminated surfaces, and flies that have been in contact with eye or nose discharge. Repeated infections can lead to scarring, inversion of the eyelids, and ultimately blindness, particularly in communities with limited access to clean water and sanitation.
Before 2007, the extent of trachoma endemicity in Burundi was largely unknown, with no reported cases or epidemiological studies. That year, the country launched an initiative to tackle neglected tropical diseases, including integrated mapping of soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis, and trachoma. Baseline surveys conducted in 2009–2010 confirmed trachoma was endemic in parts of the country, prompting interventions based on the WHO-recommended SAFE strategy for 2.5 million people across 12 health districts. Lydwine Baradahana, Minister of Public Health and the Fight Against AIDS, Burundi, said, “This validation marks a major milestone in our commitment to health equity. It is a collective victory made possible by nearly 20 years of national mobilisation and international solidarity. I thank all the partners, community actors and institutions in Burundi and beyond who made this historic achievement possible.”
Burundi’s trachoma elimination programme was supported technically and financially by CBM Christoffel Blindenmission, the END Fund, Geneva Global, and WHO. The International Trachoma Initiative at the Task Force for Global Health donated azithromycin, known as Zithromax, manufactured by Pfizer in New York, USA. WHO continues to support Burundi’s health authorities in monitoring communities where trachoma was previously endemic to ensure no resurgence of the disease. Xavier Crespin, WHO Representative in Burundi, said, “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.”
Trachoma remains a public health problem in 32 countries, with an estimated 103 million people living in areas requiring interventions. The African Region bears 90% of the global trachoma burden, with 93 million people in at-risk areas as of April 2024. Significant progress has reduced the number of people needing antibiotic treatment in the region by 51%, from 189 million in 2014 to 93 million in 2024. Twenty African countries, including 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, United Republic of Tanzania, Uganda, Zambia, and Zimbabwe, still require intervention. Seven African countries—Benin, Gambia, Ghana, Malawi, Mali, Mauritania, and Togo—have previously been validated for trachoma elimination, with four others—Botswana, Guinea-Bissau, Namibia, and Senegal—claiming to have met prevalence targets.
Globally, 57 countries, including 24 like Burundi, have eliminated at least one neglected tropical disease, with trachoma eliminated in countries such as Benin, Cambodia, China, Gambia, Islamic Republic of Iran, Lao People’s Democratic Republic, Ghana, India, Iraq, Malawi, Mali, Mauritania, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Papua New Guinea, Saudi Arabia, Togo, Vanuatu, and Viet Nam.
The WHO defines trachoma elimination as a prevalence of trachomatous trichiasis “unknown to the health system” of less than 0.2% in adults aged 15 years and older, approximately one case per 1000 total population, and a prevalence of trachomatous inflammation—follicular in children aged 1–9 years of less than 5%, sustained for at least two years without ongoing antibiotic mass treatment in each formerly endemic district, plus a system to identify and manage incident trachomatous trichiasis cases with defined strategies and appropriate financial resources. The WHO SAFE strategy includes surgery to treat the blinding stage, trachomatous trichiasis; antibiotics to clear infection, particularly mass administration of azithromycin donated by Pfizer through the International Trachoma Initiative; facial cleanliness; and environmental improvements, particularly access to water and sanitation. Burundi’s journey, driven by community health workers and global partnerships, offers hope to millions still battling this preventable disease.
– global bihari bureau
