The World Health Organization (WHO) has validated Malawi as having eliminated trachoma as a public health problem,1 making it the fourth country in WHO’s African Region after Ghana (June 2018), Gambia (April 2021) and Togo (May 2022) to achieve this significant milestone.
Malawi has been known to be endemic for trachoma since the 1980s. However, it was not until 2008, when surveys were conducted with support from Sightsavers and WHO in the districts of Chikwawa and Mchinji, that trachoma received due attention. Further baseline surveys confirmed endemicity in 17 of a total of 28 districts in the country.
Following the launch of the national trachoma control programme by the Ministry of Health in 2011, the National Trachoma Task Force team stipulated the need for integration of the programme within the Ministry of Health structure. Malawi received its first azithromycin (Zithromax®, Pfizer, New York) donation from the International Trachoma Initiative in 2011 to conduct antibiotic mass drug administration. Following the development of its Trachoma Action Plan in 2012–2013 and its rollout in 2014, funding to implement the SAFE strategy in all endemic districts was made possible through financial support from the Queen Elizabeth Diamond Jubilee Trust in 2014. Medium cadre ophthalmic clinicians were trained and certified as trachomatous trichiasis (TT) surgeons. A quality assurance team was formed, and regular national trachoma coordination meetings were conducted. The Ministry of Health also undertook awareness raising campaigns about the importance of facial cleanliness and personal hygiene in the fight against trachoma. Furthermore, stakeholders already present in the districts intensified their work and implementing water, sanitation and hygiene activities resulted in significant improvements in the availability of safe water and access to improved sanitation.
Malawi and WHO will continue to closely monitor previously endemic populations to ensure there is a rapid, proportionate response to any resurgence of disease.
Globally, Malawi joins 14 other countries that have been validated by WHO for having eliminated trachoma as a public health problem. These are Cambodia, China, the Islamic Republic of Iran, the Lao People’s Democratic Republic, the Gambia, Ghana, Mexico, Morocco, Myanmar, Nepal, Oman, Saudi Arabia, Togo and Vanuatu.
Image on top: Hand of Hope Malawi Project for Refugees in Dzaleka Refugee Camp by Lucky Aziken