International Trachoma Initiative (ITI)
The International Trachoma Initiative (ITI) was established in 1998 to support the World Health Organization (WHO)’s goal of eliminating blinding trachoma, the world’s leading cause of preventable blindness, by 2020. Co-founded by Pfizer with the Edna McConnell Clark Foundation, the ITI works to further expand the use of the SAFE strategy, a community-based plan of action that emphasizes the medical, behavioral, and environmental changes essential to the control of trachoma. The four action steps comprising SAFE are: Surgery, Antibiotic treatment (using the single dose preparation Zithromax®), Face washing, and Environmental change, including access to clean water.
Zithromax® has played a key role in the success of trachoma control efforts. As an oral medication, it is easier to administer than tetracycline eye ointment, which was previously the standard treatment for trachoma. Clinical tests confirmed by the ITI’s experience in the field show that a single oral dose of Zithromax® is as effective as tetracycline ointment applied continuously twice daily for six-10 weeks – a difficult course of treatment to maintain in areas where the disease is most often found.
The ITI is the only organization dedicated solely to the elimination of blinding trachoma in the world. In seeking to eliminate blinding trachoma, the ITI is carrying out a mandate established in 1997 by the WHO’s Alliance for the global elimination of Trachoma by 2020.
In 2006, after six years’ work, Morocco became the first country to complete the campaign for trachoma control and is working toward WHO certification that blinding trachoma has been eliminated as a public health problem. The success of the Moroccan trachoma control campaign offers promise that the global elimination of blinding trachoma is indeed within sight. Morocco had a long history of widespread trachoma with prevalence in the southeast reaching as high as 46 percent just 15 years ago. An aggressive trachoma control campaign in recent years has lowered the national prevalence by more than 90 percent.
By the end of 2006, the Initiative had achieved:
• More than 252,000 surgeries performed.
• Over 44 million antibiotic treatments distributed.
• Millions reached with face washing and environment messages.
• Morocco has met elimination criteria, now entering WHO certification process.
• 75 percent reduction in active infection in Vietnam and Tanzania.