The World Health Organization (WHO) has officially validated El Salvador as having eliminated trachoma as a public health problem, marking a significant milestone in global health. El Salvador is the first country in Central America and the second in the Americas to achieve this status, following a multi-year effort to screen populations and strengthen national health surveillance systems.
The Path to Elimination
Trachoma, a neglected tropical disease (NTD) caused by the bacterium Chlamydia trachomatis, is the world’s leading infectious cause of blindness. According to the WHO, the validation process involved rigorous, multi-year assessments conducted between 2023 and 2026.
Health officials prioritized communities based on environmental and social risk factors. Following these targeted screenings, investigators found no evidence of active trachoma transmission. Furthermore, no cases of advanced, blinding-stage trachoma were detected in the adult population, and no signs of the disease were identified in children. These results met the WHO’s specific criteria for elimination:
- A prevalence of trachomatous trichiasis (TT) "unknown to the health system" of less than 0.2% in those aged 15 and older.
- A prevalence of trachomatous inflammation—follicular (TF) in children aged 1–9 years of less than 5% in each formerly endemic district.
- A functional system to identify and manage new cases of trichiasis.
Integrated Public Health Efforts
El Salvador’s success relied on a multisectoral strategy. The Pan American Health Organization (PAHO) supported the country through the Initiative for the Elimination of Trachoma in the Americas, with funding and collaboration from the Government of Canada.
The national response included:
- Strengthened Primary Care: Integrating eye health services into the existing national health framework.
- WASH Improvements: Enhancing water, sanitation, and hygiene infrastructure.
- Surveillance: Training health personnel to maintain long-term monitoring to prevent the re-emergence of the disease.
"El Salvador’s success is a vital step towards our global target of eliminating trachoma worldwide by 2030," said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.
Context of Trachoma in the Americas
While El Salvador has successfully cleared the disease, trachoma remains a public health concern in other parts of the region. It is still considered endemic in specific rural and remote areas of Brazil, Colombia, Guatemala, and Peru. Regional investigations are also ongoing in countries where the disease is suspected, including Bolivia, Ecuador, Guyana, Panama, Paraguay, and Venezuela.
The elimination of trachoma in El Salvador aligns with the broader PAHO Disease Elimination Initiative, which aims to eliminate more than 30 communicable diseases in the Americas by 2030.
Maintaining Long-Term Success
To maintain this achievement, the WHO recommends that El Salvador continue its surveillance systems and ensure ongoing access to high-quality eye care. By doing so, the country protects its population against the potential re-introduction of the bacterium.
El Salvador now joins a group of 64 countries globally that have been recognized by the WHO for eliminating at least one neglected tropical disease, a list that includes Algeria, Australia, China, India, and Mexico.
Keep reading