Trachoma: What It Takes to Eliminate a Disease in the Pacific Islands

Dr Anasaini Cama of the Fred Hollows Foundation conducts tropical disease training in the Solomon Islands. Credit: Shea Flynn/RTI International

By Catherine Wilson
SYDNEY, Australia, Feb 25 2026 (IPS)

Two Pacific Island nations have been applauded for their successes in the global health campaign to eliminate the infectious eye disease, Trachoma.

Better disease data, effective treatment campaigns and improved access to water and hygiene contributed to the major progress now being celebrated as 27 nations worldwide are declared Trachoma-free by the World Health Organization (WHO). But, above all, experts say that the key to the permanent riddance of diseases is a genuine buy-in to the eradication programmes by entire communities.

“Trachoma elimination efforts are most effective when communities understand the disease, trust the interventions and are actively involved in prevention activities,” Dr Anasaini Cama, Pacific Trachoma Technical Lead at The Fred Hollows Foundation, a global non-government organisation working to eradicate preventable blindness, told IPS.

Finally eliminating Trachoma in countries such as Papua New Guinea is a major achievement when more than 80 percent of people live in rural and remote communities, where the risk of infection is especially high.

“This milestone reflects the power of public health at its best…It is a reminder that equity, visibility and prevention must be at the heart of our health system,” Elias Kapavore, Minister for Health in PNG, the most populous Pacific Island nation of more than 10 million people, told the media last year.

The infectious eye disease is one of 21 Neglected Tropical Diseases that, under Sustainable Development Goal 3.3, are being targeted for global eradication by 2030. And reports reveal that strides are being made. Between 2002 and 2025, a period of little more than two decades, the global population at risk of Trachoma fell from 1.5 billion to 97.1 million people, WHO reported in January.

“Trachoma, once a leading cause of blindness in Fiji, was widespread in the 1950s, with prevalence exceeding 20 percent among children in some areas. Today, following sustained national action, the prevalence of active Trachoma has fallen to below 1 percent,” Fiji’s Health Minister, Dr Ratu Antonio Lalabalavu, told local media.

Trachoma is the leading cause of blindness around the world and is found primarily in tropical climate zones and rural communities affected by poverty and lack of basic services. It is caused by a micro-organism, Chlamydia trachomatis, known to be carried by flies, with children and those living in overcrowded conditions the most vulnerable. In advanced cases of the disease, there is chronic scarring of the underside of the eyelid, which can then turn inward, resulting in the eyelashes inflicting permanent damage to the eye’s cornea.

Trachoma was first identified in PNG and Fiji when health surveys were conducted in the 1950s. Studies also revealed that it was endemic in the Solomon Islands and Vanuatu. More recently, in 2015, extensive studies were carried out in the provinces of Central, Madang, Morobe, East New Britain, Southern Highlands and Western in PNG as part of the Global Trachoma Mapping Project. The prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years was found to be between 6 percent and 12.2 percent, exceeding the WHO threshold of 5 percent.

The disease can be debilitating and make it increasingly difficult for a child to attend and participate in school classes and, thus, hinder their development and increase their exposure to poverty and malnutrition.

Changing the conditions and habits through which the disease thrives is, therefore, crucial. And this is a vital part of WHO’s recommended approach, called the SAFE strategy. That is, surgery for patients with an advanced stage of the disease, including blindness, prescribing antibiotics to diminish infection, encouraging facial cleanliness, and environmental improvements.

Today, the development charity Mercy Works is working to boost better health in very remote villages in Kiunga in Western Province, close to the far western border of PNG, by ensuring supplies of clean water. Here, “safe water remains a daily challenge,” Andrew Lowry, Head of Mercy Works’ Programs, told IPS. “Frequent flooding contaminates water sources and damages infrastructure. Many communities have no road access, so materials and tradespeople travel by plane or boat, and often on foot. Schools and health centres often operate without a reliable water supply, making basic hygiene practices difficult to sustain.”

Mercy Works installs rainwater collection and storage systems in schools, health centres, and villages in both the Western Province and the Simbu Province in the Highlands region.

Nearly 4,000 kilometres southeast of PNG in Fiji, Cama has witnessed the impacts of eye diseases and interventions that have been effective. In the north of the country, she visited villages that were kept clean and neat and it was difficult to see if there was overcrowding in the households. “Generally, extended families living together is considered normal. What we did notice, and similarly in nearby villages, was the water issues, where water was not always available and water trucks would cart water to the village,” Cama told IPS.

In the community, “children were active and did not appear unwell in any way,” she recounted. “It was only when health care workers flipped the child’s eyelids that the inner surface of the eyelid would have follicles that were typical for Trachoma.” Once a child was diagnosed, Tetracycline eye ointment was prescribed to be applied twice a day for six weeks, together with recommended regular face washing.

This year, WHO announced that, for the first time since world records began, the number of people requiring healthcare intervention for Trachoma has fallen below 100 million. Yet the future cannot be one of complacency. Rising climate extremes across the Pacific Islands could reverse this achievement.

“Climate change can impact Trachoma programmes and cause re-emergence of Trachoma, meaning long-term vigilance is required,” Cama emphasised. “Flooding and warmer temperatures can damage sanitation systems that lead to a reduction in environmental hygiene, causing an increase in the presence of flies in the community, which can increase the spread of Trachoma. Through drought and low rainfall, accessibility to water is decreased, making regular face washing and hygiene more challenging.”

Boosting the number of trained health professionals is also critical in countries where national health services battle against limited resources, medical supplies and manpower. “One of the biggest challenges in the Pacific is the shortage of trained eye care specialists,” Cama said.

This is the case in both Fiji and PNG, where “only 8 of 22 provinces actually have an eye doctor”. To overcome this deficit, the Fred Hollows Foundation established the Pacific Eye Institute, the region’s first ophthalmic training institute, in Suva, Fiji. “Our goal is to have at least one eye doctor and a team of eye nurses in every province [in PNG],” she said.

The dividends of extinguishing diseases, such as Trachoma, are profound for people and communities. And aspirations of national development can be realised when health services contend with a diminished burden of illness, more children can finish their education and more people of working age can contribute to their communities and the economy.

Note: This article is brought to you by IPS Noram in collaboration with INPS Japan and Soka Gakkai International in consultative status with ECOSOC.

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