Burundi eliminates trachoma as a public health problem

Burundi has been validated by the World Health Organization (WHO) as having eliminated trachoma as a public health problem. It is the 8th country in the WHO African Region and the 24th country globally to achieve this milestone.

Trachoma was determined to be a public health problem in Burundi following rapid trachoma assessments and baseline prevalence surveys from 2007–2010. Survey results showed that 12 districts had a TF prevalence above 5% in children ages 1–9, which led to the implementation of the WHO-endorsed SAFE strategy. It was determined that trachomatous trichiasis, the blinding stage of trachoma, was not a public health problem in any district in the country; therefore, a surgical campaign was not required.

In 2011, Burundi began implementation of antibiotic mass drug administration (MDA) using azithromycin donated by Pfizer Inc. through the International Trachoma Initiative. Burundi consistently achieved high therapeutic coverage, including 95% of the estimated resident population treated in the last MDA campaign in Gashoho health district in 2019.

Fixed and mobile distribution sites were used to implement MDA. At fixed sites, trained nurses administered azithromycin to individuals who visited local health centers. Mobile sites were set up in schools, where teachers or school principals oversaw the treatment of students. Additionally, community health workers conducted door-to-door visits to encourage participation. Community mobilization efforts employed a variety of communication channels, including radio broadcasts, posters, announcements in churches and mosques, town criers, and face-to-face health education sessions.

To reduce transmission and sustain trachoma elimination, messages on face and hand washing with soap and water were developed and disseminated nationwide through a variety of stakeholders, including the Directorate of Health Promotion, Healthcare Demand and Community and Environmental Health, as well as religious leaders, teachers, and community health workers. Since 2009, the Government of Burundi has also implemented a community-led total sanitation approach to put an end to open defecation and increase community access to sanitation.

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. In November 2020, WHO Member States endorsed the global road map for neglected tropical diseases 2021–2030, which targets trachoma for global elimination as a public health problem by 2030. Following a trachoma funding gap analysis completed in 2025, ICTC estimates that between $268–334 million is needed to fill existing funding gaps in support of the 2030 target.

Other countries validated by WHO as having eliminated trachoma as a public health problem are: 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.