For the first time since records began, fewer than 100 million people need treatment for trachoma—a bacterial eye disease that's been blinding humans since ancient Egyptian times. The number at risk has cratered 94% since 2002, from 1.5 billion to 97 million. Twenty-seven countries have eliminated it entirely, making trachoma one of the success stories celebrated at World NTD Day 2026 on January 30.
For the first time since records began, fewer than 100 million people need treatment for trachoma—a bacterial eye disease that's been blinding humans since ancient Egyptian times. The number at risk has cratered 94% since 2002, from 1.5 billion to 97 million. Twenty-seven countries have eliminated it entirely, making trachoma one of the success stories celebrated at World NTD Day 2026 on January 30.
This isn't a vaccine miracle or a pharmaceutical breakthrough. It's soap, antibiotics, and eyelid surgery delivered to the world's poorest villages. The question now: Can the final 97 million be reached by 2030, or will funding gaps—global development assistance for neglected tropical diseases fell 41% between 2018 and 2023—and conflict zones turn this into another almost-won war?
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People Involved
Tedros Adhanom Ghebreyesus
WHO Director-General (Leading global health coordination)
Dr. Anthony Solomon
WHO Medical Officer for Trachoma (Leading WHO's global trachoma elimination programme)
Organizations Involved
WO
World Health Organization
UN Specialized Agency
Status: Coordinating global elimination campaign
Global health authority setting trachoma elimination targets and validating country achievements.
IN
International Trachoma Initiative
Global Health Partnership
Status: Coordinating antibiotic donations and technical support
Partnership managing Pfizer's billion-dose antibiotic donation program for trachoma elimination.
PF
Pfizer Inc.
Pharmaceutical Company
Status: Donating antibiotics through 2030
Co-founded trachoma initiative and committed to donate Zithromax antibiotics through 2030.
Timeline
World NTD Day: Trachoma Featured as Success Story
Statement
WHO and partners mark World Neglected Tropical Diseases Day with theme 'Unite. Act. Eliminate.' Trachoma highlighted as one of elimination successes, with 58 countries having eliminated at least one NTD toward 100-country target by 2030. WHO urges addressing stigma affecting people with NTDs.
Global Trachoma Cases Fall Below 100 Million
Milestone
WHO announces 97.1 million people requiring interventions, first time below 100 million. Marks 94% reduction since 2002.
Egypt Validated as Trachoma-Free
Elimination
Egypt becomes seventh Eastern Mediterranean country to eliminate trachoma, 27th globally.
Fiji Becomes 26th Country
Elimination
Fiji validated for eliminating trachoma as public health problem.
Senegal Validated
Elimination
Senegal joins growing list of countries eliminating trachoma.
Burundi Eliminates Trachoma
Elimination
Burundi validated by WHO as having eliminated trachoma as public health problem.
Papua New Guinea and Mauritania Validated
Elimination
WHO validates both countries for eliminating trachoma as public health problem.
WHO Declares 'Golden Age of Elimination'
Statement
Dr. Tedros recognizes 11 countries for eliminating NTDs since January 2024 at World Health Assembly.
One Billion Doses Delivered
Milestone
ITI and Pfizer announce one billionth Zithromax dose donated for trachoma treatment.
Pfizer Extends Commitment
Funding
Pfizer commits to continue donating azithromycin through 2030, supporting final elimination push.
Original Elimination Target Missed
Assessment
WHO extends global elimination deadline from 2020 to 2030 after falling short. Nine countries validated by then.
137 Million Still at Risk
Data
Number requiring interventions falls to 137 million, a 91% reduction from 2002 baseline.
Mapping Project Completed
Research
GTMP finishes examining 2.6 million people, providing unprecedented data for targeting interventions.
Global Trachoma Mapping Project Begins
Research
Largest infectious disease survey launches, using smartphones to map trachoma in 29 countries.
First Eliminations Validated
Milestone
Oman becomes first country validated by WHO for eliminating trachoma as public health problem.
Baseline Established
Data
WHO estimates 1.5 billion people at risk of trachoma, 7.6 million needing trichiasis surgery.
Trachoma Elimination Campaign Launches
Initiative
Pfizer and Edna McConnell Clark Foundation establish International Trachoma Initiative. WHO endorses SAFE strategy globally.
Scenarios
1
Global Elimination Achieved by 2030
Discussed by: WHO, International Trachoma Initiative, public health analysts
The remaining 32 endemic countries receive adequate funding ($300M identified gap), maintain political commitment, and successfully implement SAFE strategy in final hard-to-reach communities. Surgery backlog cleared through trained non-physician providers. Mass antibiotic distribution reaches remote villages. Facial cleanliness and water access programs sustained. All countries validated by 2030 deadline, making trachoma the second disease ever eradicated as a public health problem globally after smallpox.
2
Partial Success: Most Countries Eliminate, Pockets Remain
Discussed by: Lancet Global Health analysis, LSHTM researchers
Majority of endemic countries achieve elimination, but conflict zones (parts of Ethiopia, Sudan, Chad, South Sudan) and extremely remote areas prove unreachable. Funding gaps slow surgery programs. By 2030-2035, trachoma eliminated in 40+ countries but persists in isolated pockets with perhaps 10-20 million still at risk. Becomes similar to Guinea worm: nearly eradicated but lingering in fragile states. Recrudescence in some Ethiopian districts shows disease can return after apparent control.
3
Stalled Progress and Resurgence
Discussed by: Public health contingency planning, funding agencies
Funding gap remains unfilled as donor fatigue sets in. COVID-19 and future pandemics repeatedly disrupt mass drug administration campaigns. Climate change worsens water scarcity in endemic regions, undermining environmental improvement efforts. Political instability in African endemic countries halts programs. Surgery backlog grows faster than capacity. By 2035, progress reverses in some areas with cases climbing back above 100 million. Elimination postponed to 2040s or abandoned as countries deprioritize.
Historical Context
Smallpox Eradication (1967-1980)
1967-1980
What Happened
WHO launched intensive global campaign using ring vaccination strategy, tracking every outbreak, and vaccinating contacts. Disease declared eradicated in 1980—the only human infectious disease ever completely eliminated. Last natural case occurred in Somalia in 1977.
Outcome
Short Term
WHO declared world free of smallpox on May 8, 1980.
Long Term
Saves over $1 billion annually since 1980; proved disease eradication feasible with sustained commitment.
Why It's Relevant Today
Trachoma could become second disease eliminated globally as public health problem, but unlike smallpox requires behavior change (facial cleanliness, water access) not just medical intervention, making complete eradication more complex.
Guinea Worm Eradication Campaign (1986-present)
1986-present
What Happened
Carter Center led campaign reduced Guinea worm cases from 3.5 million annually in 20 countries to fewer than 15 cases by 2021. Used community-based surveillance and behavior change—no vaccine or cure exists. Achieved 99.99% reduction through education and clean water access.
Outcome
Short Term
Seventeen countries certified Guinea worm-free by 2022, including Ghana and DRC.
Long Term
Final eradication delayed repeatedly by conflict in South Sudan, Chad; demonstrates how political instability can stall final elimination stages.
Why It's Relevant Today
Shows behavior-change-based elimination can succeed but takes decades. Also warns that final mile—reaching last pockets in conflict zones—can drag on indefinitely despite 99%+ reduction.
Polio Eradication Effort (1988-present)
1988-present
What Happened
Global campaign reduced wild polio by 99.9% from 350,000 annual cases in 125 countries to fewer than 50 cases in two endemic countries (Pakistan and Afghanistan) by 2020s. Uses mass vaccination campaigns, but faces vaccine hesitancy and access issues in conflict zones.
Outcome
Short Term
Certified eradication in multiple regions; Africa declared wild polio-free in 2020.
Long Term
Final elimination repeatedly delayed; vaccine-derived polio emerged as new challenge requiring continued vigilance.
Why It's Relevant Today
Demonstrates that even with 99%+ reduction, final eradication can remain elusive for decades when disease persists in fragile states. Trachoma faces similar challenges in Ethiopia, Chad, South Sudan.
