Join a powerful, unprecedented alliance for better eye health for all.
Join IAPB-
Choose an alternate language here
Mauritania and Papua New Guinea have been validated by the World Health Organization (WHO) as having eliminated trachoma as a public health problem. The announcement was made during the opening day of the 78th World Health Assembly, held in Geneva Switzerland.
In Mauritania, trachoma surveys conducted in 2000 indicated prevalence estimates of active trachoma in under-10-year-olds ranging from 8.4% in south-east regions to 24.9% in northern regions. This prompted the establishment of Mauritania’s national trachoma program. As part of this program, district-by-district surveys were conducted between 2004 and 2010, which identified 19 districts across seven regions as trachoma-endemic. In response, the Ministère de la Santé began implementation of the WHO-endorsed SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvement).
Antibiotic mass drug administration (MDA) was carried out in all 19 trachoma-endemic districts, distributing nearly three million doses of azithromycin, donated by Pfizer Inc., through the International Trachoma Initiative. By 2019, surveillance studies confirmed that trachoma prevalence had fallen below 5% among children aged 1 to 9 years in all districts. However, trachomatous trichiasis (TT) prevalence remained above the elimination threshold in the districts of Adrar and Tagant. As a result, the health ministry conducted a door-to-door TT screening campaign in these two districts between 2020 and 2021, followed by a TT-only survey, which confirmed both districts had met the TT elimination criterion.
In 2020, the health ministry conducted a pre-validation survey in the M’Beré refugee camp, managed by the United Nations High Commissioner for Refugees, on the border with Mali. The survey found no evidence of trachoma in the camp.
Mauritania also prioritized facial cleanliness and environmental improvement by integrating behavior change activities into the country’s broader development agenda, which focuses on poverty reduction, water and sanitation, education, communication, and environmental protection. A community-based approach was adopted, including training school teachers and religious leaders, and promoting trachoma prevention through local media outlets. Intersectoral collaboration was also strengthened to expand access to water and sanitation. Notably, during annual health meetings, the national program advocated with water, sanitation and hygiene (WASH) sector stakeholders and partners to promote water supply initiatives, community-led total sanitation, and the construction of slab latrines.
In Papua New Guinea, cases of trachoma have been documented since 1975; however, vision impairment from trachoma was found to be rare based on a community-based survey conducted from 1979 to 1980.
In 2014, rapid assessments suggested that six districts might have active trachoma among children aged 1–9 years. This prompted the health ministry to conduct formal baseline prevalence surveys in those districts. In addition to standard survey methodologies, Papua New Guinea also collected conjunctival swabs to test for Chlamydia trachomatis infection via PCR, and dried blood spots to detect antibodies to C. trachomatis. These additional components were important given data from other Melanesian countries, where the active trachoma sign trachomatous inflammation–follicular (TF) was common but TT was rare.
Survey findings indicated that the overwhelming majority of children with TF did not have conjunctival C. trachomatis infection. In addition, the seroconversion rate in 1–9-year-olds was very low, suggesting little or no exposure to C. trachomatis infection during childhood. To provide further evidence, Papua New Guinea conducted ancillary surveys in 23 villages where ≥20% of children aged 1–9 had TF. The data showed that the predefined criteria for undertaking antibiotic MDA for trachoma elimination purposes were not met. Based on these findings, Papua New Guinea claimed the elimination of trachoma as a public health problem; their claim has now been validated by WHO.
In a statement about the elimination of trachoma in Mauritania, PJ Hooper, Chair of the International Coalition for Trachoma Control said:
“The elimination of trachoma as a public health problem in Mauritania highlights what can be achieved with strong political will and comprehensive implementation of the SAFE strategy. After identifying trachoma as a public health problem in 2000, Mauritania made rapid progress in conducting surveys and targeting interventions efficiently and effectively, while ensuring that no populations were left behind—including those living in refugee settlements. We congratulate Ministère de la Santé and all partners involved in achieving this great success.”
Commenting on the elimination of trachoma in Papua New Guinea, ICTC Vice Chair Michaela Kelly said:
“Despite historically low levels of trachoma, Papua New Guinea was thorough in surveying potentially endemic areas and conducting the necessary research, including through the use of infection and serology, to ensure that trachoma was not a public health problem in the country. This provides important lessons to other countries which may detect signs of active trachoma in children. ICTC congratulates the Government of Papua New Guinea.”
Trachoma is targeted for global elimination as a public health problem by 2030, as outlined in the global road map for neglected tropical diseases 2021–2030, endorsed by WHO Member States at the 73rd World Health Assembly in November 2020. Significant progress is being made toward the global elimination of trachoma, including a 93% reduction in the number of people at risk, from 1.5 billion in 2002 to 103 million as of April 2024.
With these two announcements, as of May 2025, 23 countries have been validated as having eliminated trachoma as a public health problem, including: Benin, Cambodia, China, Gambia, Ghana, India, the Islamic Republic of Iran, Iraq, Lao People’s Democratic Republic, Malawi, Mali, Mauritania, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Papua New Guinea, Saudi Arabia, Togo, Vanuatu, and Viet Nam.
Several ICTC members supported trachoma elimination efforts in Mauritania, including the Organization for the Prevention of Blindness and the International Trachoma Initiative. ICTC observers that contributed to these efforts included The END Fund, Lions Clubs International Foundation, Pfizer Inc., Tropical Data, UNICEF, and WHO.
In Papua New Guinea, supporting ICTC members include The Fred Hollows Foundation, Kirby Institute, London School of Hygiene & Tropical Medicine, Sightsavers, and the International Agency for the Prevention of Blindness. ICTC observers that worked in Papua New Guinea included Tropical Data, the United Kingdom’s Department for International Development and WHO.
Image Credit: Vision Testing to an old woman during a Village Screening – Theresa Gende, with Fred Hollows Foundation
Vanuatu has been validated by the World Health Organization (WHO) for eliminating trachoma as a public health problem.
