Conclusions & Recommendations

TEC appreciates ESPEN’s continued commitment to filling the gaps in the African and Eastern Mediterranean region.

The Trachoma Expert Committee and invited guests met in May 2021 to consider the criteria under which Zithromax® for more-frequent-than-annual MDA would be allocated
Three scenarios were discussed:
1. Catch-up treatments in areas that have experienced programmatic delays or other constraints (e.g., funding, insecurity)
2. Accelerated treatments in areas where the national program would like to expedite elimination (discussions still underway)
3. Intensified treatments in areas with trachoma ‘persistence’ (discussions still underway)

Regarding catch-up treatments, the TEC concluded that:
- In certain situations where national programs have experienced delays in mass drug administration (MDA) and would like to catch up to their implementation timeline, TEC will consider Zithromax® donation requests with an interval between MDA rounds of at least 6 months.
- 6 months is the 'minimum acceptable' interval between MDA rounds and is not typically expected to replace the standard annual cycle.
- This is subject to change as more data become available.
- Trachoma impact surveys should be conducted after the usual number of rounds (e.g., ≥6 months following the 3rd MDA in implementation units with TF1-9 10-29.9%).

Following the TEC 24 meeting, ITI will share this ‘catch-up’ conclusion with national trachoma programs, implementing partners, and donors.

TEC recognizes the urgency to achieving elimination of trachoma as a public health problem and will continue to meet in consultation with WHO and informed experts to develop actionable guidance for decision-making.

TEC recommends that ITI collaborate with The Task Force for Global Health to convene a meeting including partners and experts (e.g., a pharmacologist) to discuss more-frequent-than-annual MDA and other topics of urgency to the global trachoma program.

TEC notes with concern the challenges with funding and technical support for Afghanistan and Yemen and program delays in Pakistan.

TEC recognizes the current gap in leadership at the MOH and urges WHO-EMR and the International Agency for the Prevention of Blindness (IAPB)-EMR to undertake high-level advocacy for filling the gap in leadership and for taking the trachoma program forward. TEC is prepared to offer assistance to this process, and in particular looks forward to receiving a Zithromax® Application for consideration to address the scale of the trachoma needs in Egypt.

TEC notes with sadness the passing of Dr. Nabil, long-time Country Director for The Carter Center and former head of the Ministry of Health Guinea Worm Eradication Program in Sudan, whose support to the trachoma program was so vital to its progress over the years.

TEC also notes the trichiasis surgery needs in Sudan.