Egypt Joins 27 Nations Free of Trachoma as Public Health Threat
Cairo/Geneva: The World Health Organization (WHO) today announced that Egypt has eliminated trachoma as a public health problem, marking a significant milestone for both the country and the WHO Eastern Mediterranean Region. Egypt becomes the seventh nation in the region to reach this status, bringing to 27 the total number of countries worldwide validated by the WHO for eliminating trachoma as a public health problem.
According to the WHO, trachoma remains endemic in 30 countries and continues to cause blindness or visual impairment in about 1.9 million people. Data from April 2025 indicate that roughly 103 million people still live in trachoma-endemic areas and are at risk of losing sight to the infection.
Trachoma, caused by the bacterium Chlamydia trachomatis, has been documented in Egypt for more than 3,000 years. Early attempts to control it date back to the 1900s when ophthalmologist Sir Arthur Ferguson MacCallan established Egypt’s first mobile and permanent eye hospitals, forming the foundation of organised trachoma control. Despite these efforts, by the 1980s the disease continued to blind thousands of adults and affected more than half of all children in parts of the Nile Delta.
Since 2002, Egypt’s Ministry of Health and Population (MoHP), in partnership with the WHO and several international stakeholders, has implemented the WHO-endorsed SAFE strategy — Surgery for trichiasis, Antibiotics to clear infection, Facial cleanliness, and Environmental improvement. Between 2015 and 2025, national mapping and surveillance across all 27 governorates confirmed a steady decline in infection rates among children and no significant burden of blinding complications in adults. Both indicators now fall below WHO’s elimination thresholds. In 2024, trachoma surveillance was integrated into Egypt’s national electronic disease-reporting system, allowing rapid investigation and response to any suspected cases.
In practice, the SAFE strategy operates through a combination of medical intervention, community mobilisation, and environmental management. The “S” component – Surgery for trichiasis – is carried out by trained ophthalmic teams in local health facilities and through mobile units that reach remote desert and Delta settlements. The “A” component – Antibiotics to clear infection – uses azithromycin, supplied through global access programmes, to suppress bacterial transmission across entire at-risk communities. The “F” component – Facial cleanliness – focuses on community-based health education promoting daily face-washing among children, often supported by local schools and women’s groups. Finally, the “E” component – Environmental improvement – addresses sanitation and water access, encouraging the construction of latrines, management of waste, and reduction of fly breeding sites. Together, these pillars aim to interrupt transmission cycles maintained by poor hygiene and overcrowding.
Operationally, however, several hurdles continue to impede full implementation in other endemic regions. Many communities in sub-Saharan Africa and parts of South Asia lack reliable access to clean water and basic sanitation. Periodic conflict and insecurity disrupt antibiotic distribution and outreach surgeries. Some national health systems struggle to retain trained trichiasis surgeons, and community participation wanes when infection rates decline, threatening relapse. Funding shortages particularly affect the environmental component, which requires sustained infrastructure investment beyond the health sector. Post-elimination surveillance systems remain fragile in several countries, raising concern that undetected transmission pockets could reverse progress.
“Congratulations to Egypt on this historic achievement in eliminating trachoma as a public health problem,” said Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean. “Together, we have proven that with collaboration and persistence, elimination is achievable. This success reflects years of dedication and the tireless efforts of communities, health workers, and partners who stood firm in the conviction that everyone deserves to live free from preventable disease. Today, Egypt exemplifies what determination can accomplish.”
Deputy Prime Minister and Minister of Health and Population Khaled Abdel Ghaffar said the achievement reflects Egypt’s sustained commitment to equitable healthcare and cited initiatives such as the Haya Karima programme, which expanded access to safe water, sanitation, and primary care in rural communities. He described the success as a collective result of cooperation among health workers, local communities, and development partners.
Trachoma is the second neglected tropical disease (NTD) that Egypt has eliminated as a public health problem. In 2018, the WHO validated the country for eliminating lymphatic filariasis. Globally, 58 countries have now eliminated at least one NTD, nine of them in the WHO Eastern Mediterranean Region.
The WHO commended Egypt for its sustained political commitment, effective partnerships, and national leadership in implementing a model that could be replicated elsewhere. The organisation noted that Egypt’s experience demonstrates how science-based strategies, continuous monitoring, and community participation can remove long-entrenched diseases from national burden lists. With trachoma still endemic in parts of Africa, the Middle East, and Asia, WHO officials emphasised that elimination requires not only medical treatment but also permanent improvements in water, sanitation, and hygiene infrastructure.
Egypt’s validation stands as both a national public health milestone and a case study in operational persistence — showing that a disease rooted in antiquity can be overcome through coordinated planning, sustained investment, and accountability mechanisms linking surveillance to rapid response.
– global bihari bureau
