How can Malawi overcome the final hurdle to eliminate trachoma?

This month sees the progress review of the Sustainable Development Goals (SDGs) at the High-Level Political Forum. With ten years to go until the deadline for achieving the goals, and amid a global pandemic, how are countries faring? Sightsavers programme manager Effie Kaminyoghe updates us from Malawi.

At Sightsavers, one of the key SDGs for us is goal 3: ensure healthy lives and promote wellbeing for all at all ages. In Malawi, we are working towards achieving this goal; in particular, through eliminating neglected tropical diseases (NTDs). Importantly, we are also focused on the ‘all’ part of the goal – ensuring healthcare is accessible to everyone and that no one is left behind.

Over the course of the past nine months, my team has worked with the government of Malawi’s planning commission to include NTDs in its report to the High-Level Political Forum (HLPF).The result of our efforts means that the report includes a section called ‘Ministry of Health in Malawi on track to eliminating trachoma as a public health problem’.

Trachoma is an NTD that, if left untreated, can slowly cause the eyelashes to turn inwards and scratch at the eye, resulting in blindness. This year is the first that the government has reported at the HLPF and trachoma has made it into its report, so we are really pleased with this achievement.

But why is it significant that NTDs were selected for inclusion in Malawi’s report? For me, it was important to include trachoma because we are  on the home straight to eliminating the disease as a public health problem. We could even be the second country (after Ghana) in sub-Saharan Africa to eliminate trachoma.

By including this progress in the report, we are putting trachoma in particular and NTDs in general in the limelight. This will help us to get support from the ministry of health and other partners to put what we need to in place. There is still some work to do before we reach this status, and we need the government and other partners to see that with a final push, the end is very much in sight.

We need to move quickly now to finalise the surveys that check that trachoma rates remain low before we apply for elimination status. To achieve the status of elimination as a public health problem, Malawi needs to demonstrate that it can stand on its own two feet, and cope with any remaining trachoma cases as part of routine healthcare work. The whole health care system needs to be stronger so that we can get to this point. This means training health workers and getting the right supplies so that inclusive universal health coverage is possible.

For about 12 years, the team here has been working as an integral partner in the trachoma elimination process alongside the ministry of health – the government even mentioned us in their report.

Supported by The Queen Elizabeth Diamond Jubilee Trust, through collaborative efforts, we have managed more than 6,000 cases of advanced trachoma; administered 12.9 million antibiotics; and supported water, sanitation and hygiene initiatives to reduce transmission of the disease. We have also provided training to advanced trachoma surgeon trainers and surgeons themselves, so that the health system is equipped with the skills to manage trachoma now and in the future.

There is a long way to go before we achieve the SDGs in Malawi. We have a lot of work ahead of us to ensure that no one is left behind. But if we can start our progress by eliminating one NTD, we can then focus our efforts on eliminating the other NTDs. And if we can eliminate those too, and begin to build a stronger health system, then the knock-on impact to the other goals will be tangible. After all, how can we achieve zero poverty (SGD1), quality education (SDG4) and decent work and economic growth (SDG8) – without good health care for all?

Effie Kaminyoghe
Effie is Sightsavers’ programme manager in Malawi.