Trachoma at Risk Population Drops 94% Since 2002

The global population requiring interventions against trachoma fell below 100 million in 2025 for the first time since records began, marking a milestone in efforts to eliminate the world’s leading infectious cause of blindness, according to the World Health Organization (WHO).

The number of people estimated to be at risk declined to 97.1 million as of November 2025, down from about 1.5 billion in 2002, a reduction of 94%. The decrease follows decades of coordinated action by national health ministries, local communities, and international partners applying the WHO-endorsed SAFE strategy, which combines surgery, antibiotics, facial cleanliness, and environmental improvements.

“The reduction of the population requiring interventions against trachoma to below 100 million is testament to strong country leadership and consistent implementation of the SAFE strategy,” says Daniel Ngamije, Director of the Department of Malaria and Neglected Tropical Diseases, WHO. He adds that progress across all trachoma-endemic regions shows the approach can be adapted to different settings and that WHO will continue to support countries seeking elimination of trachoma as a public health problem by 2030.

Trachoma is caused by the bacterium Chlamydia trachomatis and spreads through contact with infected eye and nasal secretions, often in areas with limited access to clean water, sanitation, and health services. Repeated infections can lead to scarring of the eyelid and inward-turning eyelashes that damage the cornea, a condition known as trachomatous trichiasis, which can result in blindness. The disease is classified as a neglected tropical disease and primarily affects vulnerable populations.

The decline in the global at-risk population reflects sustained investments in surveillance, treatment, and prevention since the early 2000s. As recently as 2011, an estimated 314 million people required interventions. Since then, expanded antibiotic distribution, improved data collection, and stronger community-based health systems have allowed programs to focus resources where transmission persists.

A central factor in the progress has been the scaling up of partnerships. Nongovernmental organizations, academic institutions, and donors have coordinated efforts through the International Coalition for Trachoma Control, while Pfizer Inc. has donated over 1.1 billion doses of azithromycin through the International Trachoma Initiative. These arrangements have supported large-scale antibiotic distribution and reinforced national delivery systems.

Michaela Kelly, Chair, The International Coalition for Trachoma Control, says the results reflect a long-term emphasis on data and coordination. She notes that while the reduction since 2002 is substantial, nearly 100 million people remain at risk. An estimated US$300 million is still needed to close funding gaps for surgery, antibiotics, surveys, and research required to reach the 2030 elimination target.

Data collection initiatives have played a key role in directing interventions and documenting progress. The Global Trachoma Mapping Project, conducted between 2012 and 2016, established standardized survey methods and supported health ministries with training, analysis, and data validation. Survey teams collected information from 2.6 million people in 29 countries using smartphone-based tools. The work is being continued by Tropical Data, which has supported over 4,000 surveys across 55 countries and examined over 13.1 million people. Since 2012, these programs have averaged one trachoma examination every 25 seconds, providing evidence used to guide elimination decisions.

In parallel with global progress, regional initiatives have reinforced gains. In the Americas, the Pan American Health Organization (PAHO) has reported advances in disease surveillance, vaccination, and emergency response, while warning that access gaps and climate-related risks continue to affect public health systems. Trachoma elimination remains part of PAHO’s broader effort to eliminate over 30 communicable diseases and related conditions by 2030.

Through the Initiative for the Elimination of Trachoma in the Americas, launched with support from the Government of Canada, PAHO has expanded interventions in countries where the disease persists, including Brazil, Colombia, Guatemala, and Peru, where an estimated 5.6 million people remain at risk. The program applies the SAFE strategy and emphasizes surveillance, antibiotic distribution, hygiene promotion, and surgical capacity. Women and children are considered particularly vulnerable in affected communities.

Surveillance activities in Brazil and Venezuela have included prevalence surveys in Indigenous and remote regions, while rapid assessments are under way in Bolivia, Ecuador, Guatemala, and El Salvador to determine the need for expanded surveys. Training of local health workers has been another priority, with PAHO supporting programs in several countries between 2023 and 2024 to strengthen surgical skills and data collection.

Mexico, which was validated by WHO as having eliminated trachoma as a public health problem in 2017, continues surveillance to prevent reemergence. Globally, WHO has validated 27 countries as having eliminated trachoma as a public health problem, including Egypt and Fiji most recently. The list spans all trachoma-endemic regions and includes countries in Africa, Asia, the Middle East, and the Americas.

WHO officials link trachoma elimination efforts to Sustainable Development Goal 3.3, which calls for an end to epidemics of neglected tropical diseases, and to the road map for 2021–2030. As of December 2025, 58 countries have eliminated at least one neglected tropical disease, signaling broader progress toward the target of 100 countries by 2030.

Despite the milestone, health authorities say sustained attention is required. Remaining transmission is concentrated in hard-to-reach areas, and continued investment will be needed to maintain surveillance, complete interventions, and integrate trachoma services into primary healthcare. Officials say the drop below 100 million people at risk demonstrates what coordinated public health action can achieve, while underscoring the work still required to meet global elimination goals.