Egypt becomes the seventh country in the Eastern Mediterranean Region to eliminate trachoma as a public health problem – World Health Organization (WHO)

Report on the Elimination of Trachoma in Egypt

Executive Summary

The World Health Organization (WHO) has officially validated that the Arab Republic of Egypt has successfully eliminated trachoma as a public health problem. This achievement marks a significant milestone in public health for both the nation and the WHO’s Eastern Mediterranean Region. Egypt is the 27th country globally to receive this validation. The success is a direct result of sustained national efforts aligned with key Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 6 (Clean Water and Sanitation), and SDG 17 (Partnerships for the Goals).

Historical Context and National Burden

Trachoma has been a documented health issue in Egypt for over three millennia. Organized public health interventions began in the early 20th century with the establishment of specialized eye hospitals. Despite these early efforts, by the 1980s, the disease remained a significant cause of blindness in adults and affected a high percentage of children in certain regions. This long-standing challenge necessitated a comprehensive and modern public health strategy to achieve elimination.

Strategic Implementation and Alignment with Sustainable Development Goals (SDGs)

Since 2002, Egypt’s Ministry of Health and Population, in collaboration with national and international partners, has systematically implemented the WHO-endorsed SAFE strategy. This multi-faceted approach directly contributes to several SDGs.

The SAFE Strategy and SDG 3 (Good Health and Well-being)

The medical components of the SAFE strategy were critical to achieving SDG Target 3.3, which calls for an end to the epidemics of neglected tropical diseases (NTDs). The strategy includes:

• Surgery: Providing surgical intervention for trachomatous trichiasis to prevent irreversible blindness.
• Antibiotics: Administering antibiotics to clear the causative bacterial infection, Chlamydia trachomatis, from affected communities.

Environmental Improvements and SDG 6 (Clean Water and Sanitation)

The behavioral and environmental components of the strategy were fundamental to interrupting disease transmission and align directly with SDG 6. These efforts were significantly bolstered by national initiatives such as Haya Karima, which expanded access to essential services in rural areas.

• Facial cleanliness: Promoting hygiene practices to reduce person-to-person transmission.
• Environmental improvement: Increasing access to safe water and sanitation facilities to address the root causes of the disease.

Partnerships and SDG 17 (Partnerships for the Goals)

The elimination of trachoma in Egypt exemplifies the effectiveness of multi-sectoral collaboration as outlined in SDG 17. The success was the result of coordinated action between the government and a wide range of partners, including:

• World Health Organization (WHO)
• Haya Karima Foundation
• Eastern Mediterranean Region Trachoma Alliance
• Nourseen Charity Foundation
• International Trachoma Initiative
• Global Trachoma Mapping Project
• Sightsavers
• CBM
• Kilimanjaro Centre for Community Ophthalmology
• Magrabi Foundation
• Tropical Data global initiative

Validation and Surveillance

Validation of elimination was based on extensive data collected between 2015 and 2025. Surveillance across all 27 of Egypt’s governorates confirmed that prevalence rates for both active trachoma in children and trachomatous trichiasis in adults were below WHO elimination thresholds. To ensure sustainability, Egypt integrated trachoma surveillance into its national electronic disease reporting system in 2024, enabling rapid response to any future cases.

Global Implications

Egypt’s achievement is the second NTD elimination for the country, following the validation of lymphatic filariasis elimination in 2018. It serves as an important precedent for the 30 countries where trachoma remains a public health problem. Globally, an estimated 1.9 million people are visually impaired due to trachoma, and 103 million people reside in at-risk areas. Egypt’s success demonstrates that the global elimination of trachoma is an attainable goal through sustained political commitment, robust public health strategies, and strong partnerships, contributing to the broader goals of reducing poverty (SDG 1) and health inequalities (SDG 10).

Sustainable Development Goals (SDGs) Addressed

• SDG 3: Good Health and Well-being

  • The article’s central theme is the elimination of trachoma, a neglected tropical disease (NTD), in Egypt. This directly contributes to ensuring healthy lives and promoting well-being for all at all ages. The text states, “Egypt has successfully eliminated trachoma as a public health problem,” and notes that the disease is “responsible for the blindness or visual impairment of about 1.9 million people” globally.

• SDG 6: Clean Water and Sanitation

  • The article explicitly links trachoma to environmental conditions. It mentions that the WHO-endorsed “SAFE strategy” includes “Facial cleanliness and Environmental improvement.” It also highlights that the disease “remains endemic in many vulnerable communities where access to clean water and sanitation is limited” and credits the “Haya Karima” initiative for expanding “access to safe water, sanitation, and primary care services in rural communities.”

• SDG 17: Partnerships for the Goals

  • The success of the trachoma elimination program is attributed to extensive collaboration. The article emphasizes “strong national leadership, coordinated action and broad collaboration across sectors.” It lists a wide range of partners, including the “Ministry of Health and Population of Egypt, in partnership with WHO,” and other national and international stakeholders like the “Haya Karima Foundation,” “Sightsavers,” and the “International Trachoma Initiative,” showcasing a multi-stakeholder partnership.

Specific SDG Targets Identified

1. Target 3.3: End the epidemics of communicable diseases

   • This target aims to “end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases.” The article is a case study of achieving this target, focusing on trachoma, which is an NTD. It states, “Trachoma is the second neglected tropical disease (NTD) eliminated in Egypt,” directly aligning with the goal of ending NTD epidemics.

2. Target 6.2: Achieve access to adequate and equitable sanitation and hygiene for all

   • This target focuses on achieving access to sanitation and hygiene. The article connects the elimination of trachoma to improvements in this area, citing the “SAFE strategy” which includes “Facial cleanliness and Environmental improvement.” The success is also linked to initiatives that “have expanded access to safe water, sanitation, and primary care services in rural communities.”

3. Target 17.16: Enhance the Global Partnership for Sustainable Development

   • This target calls for multi-stakeholder partnerships that mobilize and share knowledge and resources. The article exemplifies this by describing how “WHO worked closely with the Ministry of Health and Population to provide technical guidance, monitoring and validation support” and acknowledges the “technical and financial contributions of many partners.”

Indicators for Measuring Progress

1. Indicator for Target 3.3 (Implied): Prevalence thresholds for disease elimination

   • While the official SDG indicator is the “Number of people requiring interventions against neglected tropical diseases,” the article provides more specific, practical indicators used by WHO to validate elimination. These are:
     • The proportion of children aged 1–9 years affected by active (inflammatory) trachoma being below the WHO elimination threshold.
     • The burden of the blinding complications of trachoma in adults being below the WHO elimination threshold.

     The article confirms that in Egypt, “Both indicators are now below WHO elimination prevalence thresholds nationwide.”

2. Indicator for Target 6.2 (Implied): Expanded access to water and sanitation services

   • The article does not provide quantitative data but implies progress by stating that initiatives like “Haya Karima” have “expanded access to safe water, sanitation, and primary care services in rural communities.” The expansion of these services serves as a qualitative indicator of progress towards achieving universal access.

3. Indicator for Target 17.16 (Mentioned): Existence and effectiveness of multi-stakeholder partnerships

   • The article demonstrates the existence of a strong partnership by listing numerous collaborators, including government bodies (Ministry of Health and Population), international organizations (WHO), and non-governmental organizations (Sightsavers, CBM, Magrabi Foundation). The effectiveness of this partnership is indicated by the ultimate outcome: the successful “elimination of trachoma as a public health problem.”

Summary of Findings

Source: who.int