We’ve promoted healthier, happier communities

Caleb Mpyet, Sightsavers’ global technical lead for trachoma, explains that the Accelerate programme has had a ripple effect that goes far beyond its work on avoidable blindness.

The programme has been working to improve access to water, sanitation and hygiene, one of the key steps in beating trachoma. This has involved some ingenious interventions aimed at changing people’s behaviour, such as the ‘Captain Clean’ board game for children.

According to Caleb, the programme’s focus on hygiene practices has led to “transformations in different communities, in terms of having cleaner communities where people are living healthier lives.”

We’ve adapted to huge challenges

Although it can sound straightforward, the path to eliminating trachoma as a public health problem has involved navigating some thorny challenges.

This includes the need to cope with conflict and political instability. Caleb explains that outbreaks of violence in some regions have at times hindered the programme’s ability to reach those in need.

“We needed to develop some innovative approaches in order to map where trachoma was present in those insecure areas. This includes using helicopters to fly in survey teams, where it was not safe to use the roads.

“We also decided to collect some trachoma patients and drive them to safer locations, where they could meet with surgeons and have sight-saving operations.”

When the COVID-19 pandemic swept across Africa, this caused another stumbling block for teams working out in the field, as it led to drug treatment campaigns being cancelled and surgical camps being postponed.

However, the programme was quick to bounce back. The World Health Organization (WHO) published a tool for assessing the risk of mass gatherings during the pandemic, and our staff were able to adapt this so it was relevant for programmes to treat trachoma and other neglected tropical diseases.

Armed with the resulting tool, known as the risk assessment and mitigation action tool (RAMA), we were able to safely resume programme activities with health ministries in July 2020. The programme went on to deliver antibiotic treatments to around one million people in Nigeria between July and September that year.

We’re not leaving anyone behind

As the Accelerate programme has worked with health ministries to eliminate trachoma, the focus has been on reaching those groups that are most disadvantaged. This often involves visiting remote populations to ensure they have equal access to treatment.

Caleb explains: “We know that people with disabilities, elderly female patients (who are more likely to have advanced trachoma), and people in very remote communities do not usually come out to receive treatment for trachoma.

“If we are to reach elimination, it’s important that these people are carried along, so the programme used the house-to-house case-finding approach. In this process, we ensure that every community is covered, and every household is visited. This ensures that no one is left behind.”

He adds that the programme will continue to support countries on their journey towards eliminating trachoma, even after treatment campaigns have come to an end.

“We make sure that national governments have what’s required in terms of human and financial resources to manage trachoma in the long-term. Then we support ministries of health to write their dossier to prove to the WHO that they have eliminated the disease.”