According to the World Health Organization (WHO), one third of the globe’s 45 million blind and half of the 1.5 million blind children live in Southeast Asia. In this region, 4 people become blind every minute. And yet, ninety per cent of blindness is avoidable. Cataracts can be cured with inexpensive surgery and refractive errors are correctable with simple optical devices. Providing free or affordable access to eye surgery, particularly across the poor rural areas of Southeast Asia is still a huge challenge. But in one area, there has been significant progress in tackling blindness. Cases of trachoma, the main cause of preventable blindness from infection have been decreasing, with Vietnam a leading example in tackling the disease.
Trachoma is an eye infection which forces the eyelid to turn inwards. The eyelashes then scratch the cornea so that the sufferer is eventually blinded. Around 40 million people worldwide are affected by trachoma and over 8 million are estimated to have the late blinding stage of the disease, where eyelid surgery is needed to avoid irreversible blindness. Roughly half of global trachoma cases are now concentrated in five countries (Ethiopia, Guinea, India, Nigeria and Sudan). Trachoma is prevalent in poor communities, where overcrowding and lack of sanitation lead to poor hygiene and the use of infected water which spreads the bacteria.
But the disease is preventable using the WHO’s ‘SAFE’ strategy. SAFE stands for Surgery, where a simple operation can pull back the eyelid in the most advanced stage of the disease, known as trichiasis; A is for the antibiotics which can successfully treat trachoma in the early stages; F is for face-washing and E is for environmental hygiene. VISION 2020 was launched in 1999 as a global initiative to eradicate avoidable blindness by 2020. Set up jointly by the WHO and the International Agency for the Prevention of Blindness (IAPB), the initiative brings together a range of organizations from non-governmental bodies, professional associations, eye care institutions and corporations. One part of VISION 2020 is to encourage the use of ‘SAFE’ programmes in developing countries where trachoma is still a major cause of preventable blindness.
In Vietnam, trachoma was endemic through the population in past decades. In 1960, 80 per cent of Vietnamese people suffered from the disease and 30 per cent became blind from it. The country’s Trachoma Control Program was launched in 2000 through 53 districts where the disease was prevalent. Today, following a ‘SAFE’ strategy over the last 10 years, including a mass drug administration (MDA) programme, cases of active trachoma have dropped to less than one per cent of the population. This means an MDA programme is no longer necessary and the country expects to eliminate the disease entirely within the next two years. The experience of Vietnam shows that the terrible blight of trachoma can be beaten and many developing countries are rolling out MDA programmes to work towards the goal of VISION 2020.