Learn from trachoma success to reduce nation’s disease burden

The WHO estimated that trachoma caused 4 percent of all blindness in India in 2005, which significantly declined to 0.008 percent by 2018.
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On October 8, the World Health Organization officially acknowledged India’s success in eradicating trachoma as a public health problem. Known as the leading infectious cause of blindness, trachoma is caused by the bacterium Chlamydia trachomatis and affects individuals lacking in hygiene and clean water supply. It spreads via contact with the eye, nose or throat secretions of an infected person, or indirectly via flies.

The WHO estimated that trachoma caused 4 percent of all blindnesses in India in 2005, which significantly declined to 0.008 percent by 2018. A series of surveys involving pre-validation and trichiasis cases (where eyelashes start growing inwards into the eye—a condition common in trachoma), completed in 2024, confirmed that the elimination targets had been met in all evaluation units.

While this is a success story, a lesson needs to be drawn to replicate such efforts in eliminating more challenging communicable and non-communicable diseases. Tuberculosis, diabetes and cardiovascular diseases are the more prevalent ones affecting Indians, and need focused attention to eliminate or reduce them. India accounts for 27 percent of the global TB burden despite a high treatment success rate of 86.30 percent in 2023 and a decline of 17.7 percent in cases between 2015 and 2023, as compared to the global average decline of 8.3 percent during the same period. In 2023, India reported 25,37,235 cases, a record high up from 24,22,121 in 2022.

Prime Minister Narendra Modi has set an unrealistically ambitious target to eliminate TB in India by 2025, five years ahead of the UN's sustainable development goals deadline of 2030 to reduce deaths by 90 percent and incidence by 80 percent from the 2015 figures. But reports from the WHO and Indian authorities this year indicate we will not be able to eliminate TB by 2025. Major challenges prevail—more cases of drug-resistant TB and increasing air pollution among them—pointing to the need for a multi-front approach to put this disease down.

At the same time, more than a quarter of adults living with diabetes around the world are Indians. Metabolic syndrome and hypertension remain major risk factors for cardiac diseases that are now striking at younger ages than ever before. If health is not given top priority now, nothing will be a bigger liability for India than its population afflicted with disease.

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