Sightsavers’ SAFE programme has generated a wealth of information for future trachoma programmes, as each country takes the final steps needed to eliminate trachoma as a public health problem. Three key lessons stand out.
A systematic, door-to-door approach to finding people who need surgery is the best way to ensure no one misses out.
A door-to-door approach helps to ensure all those with trichiasis, the most severe form of trachoma, are reached. It also enables marginalised people, such as those with a disability, to access services. This strategy helps to generate good data, which governments can then present to the World Health Organization (WHO) when they are ready to embark on the process of validating whether trachoma has been eliminated as a public health problem.
Plan for sustainability from the outset.
Plans to strengthen national health services and systems to support and maintain the gains made in controlling trachoma were part of the SAFE programme from the outset. In particular, careful consideration was given to sustaining facial cleanliness and environmental improvements once a programme has finished.
Integrating with both eye care and the NTD sector.
As countries move closer to eliminating trachoma, it is increasingly important to integrate services within general eye care and other NTD sectors. But as each country manages trachoma control differently, understanding how current systems operate and the relationships between various sectors, then building relations between and within these entities, holds the key to continuing success.
While significant progress has been made, there are still considerable challenges that must be faced to control and eliminate NTDs. More funding, collaboration and support is needed to achieve this important goal. Together we can improve the health, quality of life and future wellbeing of people affected by NTDs.