Egypt clears trachoma, a disease documented there for more than 3,000 years

The World Health Organization announced on 12 November that Egypt has eliminated trachoma as a public health problem [s1]. It is the seventh country in WHO's Eastern Mediterranean Region to reach that milestone, and the 27th worldwide [s1].

Trachoma has been documented in Egypt for more than 3,000 years [s1]. That is the detail that gives the announcement its weight: this is not a recent import being cleared but an infection that has been part of the country's medical record since antiquity.

What the disease does

Trachoma is caused by the bacterium Chlamydia trachomatis and spreads through contact with infected eye discharges, via hands, clothes, hard surfaces and flies [s1]. Repeated infections scar the inner eyelid, turning the eyelashes inward so they scratch the cornea — a painful condition called trachomatous trichiasis that can end in blindness [s1]. Blindness from trachoma is difficult to reverse [s1].

Globally the disease remains endemic in communities where access to clean water and sanitation is limited [s1]. Following Egypt's validation, trachoma is still a public health problem in 30 countries and is responsible for the blindness or visual impairment of about 1.9 million people [s1]. Based on April 2025 data, 103 million people live in trachoma-endemic areas and are at risk of trachoma blindness [s1].

How Egypt got here

Organised control in Egypt dates to the early 20th century, when the ophthalmologist Arthur Ferguson MacCallan established the country's first mobile and permanent eye hospitals and laid groundwork for organised trachoma control globally [s1]. Even so, by the 1980s the disease still blinded many adults and affected over half of all children in some Nile Delta communities [s1].

The modern programme began in 2002, when the Ministry of Health and Population, working with WHO and other national and international partners, adopted the WHO-endorsed SAFE strategy: Surgery for trichiasis, Antibiotics to clear the causative organism, Facial cleanliness, and Environmental improvement [s1].

Between 2015 and 2025, mapping and surveillance across all 27 of Egypt's governorates showed steady reductions in the proportion of children aged 1 to 9 affected by active, inflammatory trachoma, and no significant burden of the blinding complications in adults [s1]. Both indicators are now below WHO's elimination prevalence thresholds nationwide [s1]. In 2024 Egypt integrated trachoma surveillance into its national electronic disease reporting system [s1].

Why two decades is the normal number

A review published in September of 50 countries that had eliminated at least one neglected tropical disease found that elimination typically required at least two decades of sustained effort and partnership between the endemic country and international stakeholders [s2]. Egypt's programme, running from 2002 to validation in 2025, fits that pattern rather than beating it.

The same review identified the features that recur in successful programmes: country ownership, dedicated elimination efforts, and a combination of strategies rather than a single intervention [s2]. It also catalogued why efforts fail — sociopolitical instability, insufficient resources, deprioritisation, absence of effective interventions, or lax implementation [s2].

Egypt's own account emphasises infrastructure alongside medicine. The Deputy Prime Minister and Minister of Health and Population, Professor Dr Khaled Abdel Ghaffar, credited initiatives that expanded access to safe water, sanitation and primary care in rural communities [s1]. The E in SAFE — environmental improvement — is the part that is not a health intervention at all.

Scale, and the pace of it

Trachoma is Egypt's second neglected tropical disease elimination; the country was validated for eliminating lymphatic filariasis as a public health problem in 2018 [s1]. WHO counts 58 countries that have eliminated at least one NTD globally, nine of them in the Eastern Mediterranean Region [s1].

That figure is worth setting beside the review's count, which stood at 50 countries as of March 2024 [s2]. The two come from different sources with different cutoffs, so the gap between them is not a clean measure of progress — but it is the direction of travel.

The review also notes that elimination has so far been achieved against eight of the NTDs in at least one country: Guinea worm disease, human African trypanosomiasis, lymphatic filariasis, onchocerciasis, rabies, trachoma, visceral leishmaniasis and yaws [s2]. The tools used against trachoma in Egypt — surgery, antibiotics, facial cleanliness and environmental improvement — are not new [s1]. Having the tools has not made the work fast.

What to watch

WHO's stated goal remains global elimination of trachoma as a public health problem [s1]. The 30 countries where it is still endemic are, by definition, the ones that have not managed it yet [s1], and the review's catalogue of what has historically derailed elimination programmes — instability, insufficient resources, deprioritisation, lax implementation — is the checklist against which their prospects will be judged [s2].

Validation is also not eradication. Egypt's integration of trachoma into routine electronic surveillance in 2024 is the mechanism intended to catch a resurgence [s1]; whether post-validation surveillance holds up over years is the quieter question behind every elimination announcement.

Sources

• [s1] Egypt becomes the seventh country in the Eastern Mediterranean Region to eliminate trachoma as a public health problem, World Health Organization, 12 November 2025. https://www.who.int/news/item/12-11-2025-egypt-becomes-the-seventh-country-in-the-eastern-mediterranean-region-to-eliminate-trachoma-as-a-public-health-problem
• [s2] Unlocking the blueprint to eliminating neglected tropical diseases: A review of efforts in 50 countries that have eliminated at least 1 NTD, PLOS Neglected Tropical Diseases, 4 September 2025. https://doi.org/10.1371/journal.pntd.0013424