With the WHO Alliance for the Global Elimination of Trachoma by the year 2020 meeting in Sydney this week, Vision 2020 Australia talks to Professor Hugh Taylor AC for an update on progress towards the elimination of trachoma in Australia.
- Professor Taylor, can you provide our readers with an overview of trachoma and its impact and prevalence in Australia?
Trachoma disappeared from mainstream Australia over one hundred years ago, however blinding endemic trachoma still occurs in remote Aboriginal communities. Internationally, the disease is the world’s leading cause of preventable blindness, and is one of the oldest diseases known to man. It is caused by the bacterium chlamydia trachomatis, which spreads by contact with infected eye secretions often on a person’s hand or clothing. Once endemic in Europe and the United States, blinding trachoma still occurs in 47 countries, and Australia is the only developed country on that list. Ten low or middle-income countries have eliminated trachoma in the last few years!
- Why is Australia the only developed country in which trachoma is still endemic?
Sadly, it is an Indigenous health issue. Endemic trachoma persists in areas where living standards are inadequate, with poor personal and community hygiene that permit the frequent spreading of infected eye secretions from one child to another. The key to eliminating trachoma is in the message ‘Clean faces, safe bathrooms’. Every child with a dirty face is a ‘health hazard’ and risks spreading trachoma.To eliminate trachoma in Australia we need to have all the children keeping their faces clean and to do that we need to make sure they have access to functional washing facilities and bathrooms. We need to upgrade the basic services in houses and schools of remote Indigenous communities to the same minimal standard that every other Australian enjoys. We must work with the departments of health, education and housing and direct and empower federal, state and local governments to provide the basic community infrastructure and health hardware. This would be a good example of ‘practical reconciliation’, espoused by the Coalition Government.
- On a practical level, what are we doing on the home front to tackle this issue?
A lot, and we are making progress. Trachoma rates of 14 per cent in 2009 were reduced to 4 per cent by the end of 2015. The key to preventing trachoma is to stop the repeated spread of infection from one child’s eye to another. The ‘clean faces, strong eyes’ health promotion campaign as part of the SAFE strategy for trachoma control that includes surgery for in-turned eye-lashes, antibiotic treatment, facial cleanliness and environmental improvement has been effective at getting this message across.
- Finally, if you had to summarise what we need to do to eliminate trachoma from Australia, what would that message be?
Very simple. We can stop this if we as a community care. Trachoma is entirely preventable. Although it disappeared from white Australia 100 years ago, it could take another century to disappear from Indigenous Australia if we do not do something about it. We can’t wait that long. All Australians have the right to sight. The time to act is now.
Image credit: Indigenous Eye Health, University of Melbourne