Burundi becomes Africa’s 8th country to eradicate trachoma
Trachoma primarily affects the poorest and most underserved populations, particularly in rural areas with limited access to clean water, sanitation, and basic health services.
Burundi has eliminated its first-ever neglected tropical disease (NTD) to be eliminated in the country with the successful elimination of trachoma as a public health problem. This achievement makes Burundi the eighth country in Africa and the 24th globally
Trachoma, a bacterial eye infection caused by Chlamydia trachomatis, is the world’s leading infectious cause of blindness. It spreads through close personal contact, contaminated surfaces, and flies that have been in contact with eye or nasal discharge. Repeated infections can lead to scarring of the inner eyelid, a condition called trachomatous trichiasis, in which the eyelashes turn inward and scratch the cornea, eventually causing irreversible blindness if left untreated.
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Trachoma primarily affects the poorest and most underserved populations, particularly in rural areas with limited access to clean water, sanitation, and basic health services.
Burundi’s path to elimination began in 2007, when the extent of the disease in the country was largely unknown. That year, the government launched a national programme to address neglected tropical diseases, including trachoma.
Baseline surveys conducted between 2009 and 2010 confirmed that the disease was endemic in 12 health districts, prompting the launch of a comprehensive national elimination plan based on the World Health Organisation’s SAFE strategy—Surgery, Antibiotics, Facial cleanliness, and Environmental improvement.
Approximately 2.5 million people across affected regions were reached through mass drug administration with azithromycin (donated by Pfizer through the International Trachoma Initiative), surgical interventions, hygiene education, and improved access to water and sanitation. The programme was supported by partners including CBM Christoffel Blindenmission, the END Fund, Geneva Global, and the WHO.
“This validation marks a major milestone in our commitment to health equity,” said Dr Lydwine Baradahana, Burundi’s Minister of Public Health and the Fight Against AIDS. “It is a collective victory achieved through nearly 20 years of national mobilisation and global solidarity.”
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, echoed that sentiment: “Eliminating a disease like trachoma is a major public health accomplishment that requires persistence and dedication. I congratulate the government and people of Burundi for their tireless efforts and leadership.”
Despite Burundi’s achievement, trachoma remains a public health concern in 32 countries, affecting an estimated 103 million people. The WHO African Region continues to bear the brunt of the global burden, with 93 million people living in areas at risk as of April 2024, representing 90% of all cases. Nevertheless, the region has seen significant progress, with the number of people requiring antibiotic treatment dropping from 189 million in 2014 to 93 million in 2024.
Twenty countries in Africa, including Ethiopia, Nigeria, Uganda, and the Democratic Republic of the Congo (DRC), still require active interventions. Kenya, a neighbouring country to Burundi, remains among them. While Kenya has made considerable progress in reducing trachoma prevalence through the widespread implementation of the SAFE strategy, it has not yet been validated by the WHO as having eliminated trachoma as a public health problem. However, parts of Kenya have reached elimination thresholds, and the country continues to work closely with WHO and its partners toward national elimination.
Burundi now joins a growing list of African nations that have eliminated trachoma, alongside Benin, Gambia, Ghana, Malawi, Mali, Mauritania, and Togo. An additional four countries—Botswana, Guinea-Bissau, Namibia, and Senegal—report having achieved elimination thresholds and are awaiting validation.
WHO’s criteria for validation include a prevalence of trachomatous trichiasis “unknown to the health system” of less than 0.2% in adults aged 15 years and older; a prevalence of active trachoma (trachomatous inflammation—follicular) of less than 5 per cent in children aged 1–9 years, sustained over at least two years without ongoing mass treatment; and the presence of a surveillance and case management system with sustainable resources.
With Burundi’s accomplishment, 57 countries worldwide have now eliminated at least one neglected tropical disease, and 24 have eliminated trachoma, including India, China, Mexico, Nepal, Morocco, Saudi Arabia, and now Burundi.
Dr Xavier Crespin, WHO Representative in Burundi, emphasised the broader implications of this milestone: “This achievement is a testament to Burundi’s determination to protect its most vulnerable communities. Through strong leadership, dedicated community health workers, and support from international partners, Burundi has achieved what once seemed out of reach. This success inspires us to continue working toward the elimination of all remaining neglected tropical diseases.”
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