Tunisia Eliminates Blinding Trachoma: A Historic Public Health Victory Recognized by WHO

The World Health Organization (WHO) has officially validated Tunisia as having eliminated trachoma as a public health problem. This announcement marks a crowning moment in the North African country’s decades-long battle against one of the oldest and most painful infectious causes of blindness. Tunisia now becomes the 31st nation in the world to reach this milestone and the 14th country in the WHO Eastern Mediterranean Region to knock out at least one neglected tropical disease.

A Disease of Poverty and Close Contact

Trachoma begins quietly. The bacterium Chlamydia trachomatis spreads through fingers, shared towels, bedding, and flies that land on the eyes and noses of infected people. In communities where clean water and soap are scarce, the disease moves quickly from child to child. Repeated infections scar the inside of the upper eyelid, pulling it inward in a painful condition called trachomatous trichiasis. With every blink, eyelashes scrape the cornea. Over time, this damage clouds vision and leads to irreversible blindness.

The link between trachoma and poverty is undeniable. The illness thrives where families lack access to safe water, basic toilets, and good hygiene. Women and young children are infected most often, partly because women are the primary caregivers and spend more time around small children who carry the highest loads of bacteria. Blindness from trachoma can push entire families deeper into poverty, robbing a breadwinner of the ability to work and a child of the chance to go to school.

Tunisia’s Long Road to Success

In the early to mid-20th century, trachoma was everywhere in Tunisia. At least half of the population was affected, and the burden was especially heavy in the country’s southern regions. The government recognized the scale of the problem and began laying the groundwork for a coordinated response that would stretch across generations.

“I congratulate Tunisia on this historic public health achievement,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Eliminating trachoma shows what long-term political commitment, strong primary health care and teamwork can do. Tunisia has proven that even the world’s leading infectious cause of blindness can be overcome.”

For decades, Tunisia ran a comprehensive and sustained response. The country adopted and expanded the WHO-recommended SAFE strategy, a four-part approach that attacks the disease from every angle:

• Surgery for advanced cases where eyelashes have already turned inward
• Antibiotics to clear the infection and stop it from spreading
• Facial cleanliness to reduce transmission between people
• Environmental improvement, especially better access to clean water and safe sanitation

National screening and treatment campaigns reached even the most remote villages. Eye care was integrated directly into primary health centers and school health programs. At the community level, health workers taught families about the importance of washing faces and keeping eyes clean. Each piece of the strategy reinforced the others, slowly starving the disease of the conditions it needed to survive.

“Validation marks a historic achievement for Tunisia and reflects our country’s long-standing commitment to public health, prevention and equity,” said Dr Mustapha Ferjani, Minister of Health of Tunisia. “This milestone is the result of decades of coordinated national efforts, with the dedication of generations of health-care professionals, local communities who worked tirelessly to expand access to care, strengthen prevention and improve eye health across the country. Tunisia remains committed to sustaining these gains and protecting future generations.”

How Elimination Is Defined

For a country to be validated, it must meet strict criteria set by WHO. Elimination as a public health problem means that the disease is no longer a threat to the population, even if a small number of cases may still occur. Specifically, the benchmarks for trachoma are:

• A prevalence of trachomatous trichiasis (inward-turned eyelashes) “unknown to the health system” of less than
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  Source: World Health Organization