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Report of the Second Meeting of the Who Alliance For WORLD HEALTH ORGANIZATION WHO/PBL/GET/98.2 Distr.: General Original: English REPORT OF THE SECOND MEETING OF THE WHO ALLIANCE FOR THE GLOBAL ELIMINATION OF TRACHOMA Geneva, Switzerland 12 - 14 January 1998 PROGRAMME FOR THE PREVENTION OF BLINDNESS AND DEAFNESS Geneva, Switzerland © World Health Organization, 1998 This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. The document may, however, be freely reviewed, abstracted, reproduced and translated, in part or in whole, but not for sale nor for use in conjunction with commercial purposes. The views expressed in documents by named authors are solely the responsibility of those authors. WHO/PBL/GET/98.2 1 TABLE OF CONTENTS INTRODUCTION ............................................................. 4 I. ACTIVITIES UNDERTAKEN FOR THE GLOBAL ELIMINATION OF TRACHOMA (GET) (1 July-31 December 1997) .............................. 4 1.1 Secretariat of the World Health Organization’s Alliance (1 July- 31 December 97) 4 1.1.1 Country visits for national programme development ............... 4 1.1.2 Preparation/production of documentation ........................ 5 1.1.3 Operations research and field studies ........................... 6 1.1.4 Progress on the Geographic Information System (GIS) for trachoma mapping ...................................... 7 1.1.5 Strengthening of Information Communication Systems ............. 7 1.2 Activities reported by endemic countries present at the meeting .................. 9 1.2.2 Burkina Faso ............................................. 10 1.2.3 The Gambia .............................................. 11 1.2.4 Mali ..................................................... 11 1.2.5 Morocco ................................................. 12 1.3 Participating Organizations of the Alliance .................................. 13 1.3.1 African Medical and Research Foundation (AMREF) ........ 13 1.3.2 Al-Noor Foundation .................................. 13 1.3.3 Christoffel Blindenmission e.V. (CBM) ......................... 13 1.3.4 Conrad N. Hilton Foundation ........................... 14 1.3.5 The Edna McConnell Clark Foundation (EMCF) ............ 14 1.3.6 French Ministry of Cooperation ......................... 14 1.3.7 Helen Keller International (HKI) ......................... 15 1.3.8 International Agency for the Prevention of Blindness ........ 15 1.3.9 International Organization Against Trachoma (IOAT) ........ 16 1.3.10 International Eye Foundation (IEF) ............................. 16 1.3.11 Organisation pour la Prévention de la Cécité (OPC) .............. 16 1.3.11 Sight Savers International (SSI) ............................... 17 1.3.12 Swiss Red Cross .......................................... 17 2. DEVELOPMENT OF A TRACHOMA RAPID ASSESSMENT METHODOLOGY ..... 17 2.1 Report on field use ..................................................... 17 2.1.1 Recruitment of trichiasis cases in adults ....................... 18 2.1.2 Diagnosis of active trachoma ................................ 18 2.2 Discussion ........................................................... 18 3. TRICHIASIS SURGERY ................................................. 19 3.1 Field testing of low-cost surgical kits ....................................... 19 3.2 Monitoring of training and quality of surgery .................................. 19 3.3 Availability of a trichiasis surgery video ..................................... 19 2 WHO/PBL/GET/98.2 4. UPDATE ON AZITHROMYCIN ............................................ 20 4.1 Resistance ........................................................... 20 4.2 Field results from Morocco .............................................. 20 4.3 Development of topical preparation ........................................ 20 4.4 Other developments ................................................... 20 4.4.1 A family disease ........................................... 20 4.4.2 A mathematical model of mass treatment ...................... 21 5. ELABORATION OF COMMON APPROACHES FOR THE ALLIANCE ............ 21 5.1 Rational use of systemic antibiotic treatment ................................ 21 5.2 District programme model development .................................... 22 5.2.1 At national level ........................................... 22 5.2.2 At the district level ......................................... 22 5.2.3 Surgical training ........................................... 23 5.2.4 Community-based personnel ................................ 23 5.2.5 District coordinator ......................................... 23 5.3 Development of national health policies for trachoma elimination ................ 23 5.4 Mobilization of resources ................................................ 24 5.4.1 Development of funding proposals ............................ 24 5.4.2 Human resources for national trachoma elimination schemes ...... 25 5.4.3 Monitoring and evaluation .................................... 25 5.4.4 Potential funding sources ................................... 25 6. UPDATE ON OPERATIONAL RESEARCH PROJECTS ....................... 25 6.1 Rapid Assessment .................................................... 25 6.2 Surveillance .......................................................... 26 6.3 Antibiotic distribution ................................................... 26 6.4 Barriers to surgery ..................................................... 26 6.5 Other research areas .................................................. 26 6.6 An alternative method for treating trichiasis .................................. 27 7. TRAINING AND PROMOTION ............................................ 27 7.1 Teaching and information package about Trachoma Rapid Assessment .......... 27 7.2 Update on the trachoma newsletter ........................................ 27 8. ANY OTHER MATTERS ................................................ 27 WHO/PBL/GET/98.2 3 8.1 Geographic Information Systems ......................................... 27 8.2 Views on the progress of the Alliance ...................................... 27 8.3 Date and place of next meeting ........................................... 28 CONCLUSIONS AND RECOMMENDATIONS ..................................... 29 Annex 1: Agenda ........................................................ 32 Annex 2: Final List of Participants ........................................... 33 Annex 3: Trachoma Assessment and Programme Development in Guinea-Bissau, Malawi, Mozambique and Nigeria (excerpted from a report prepared by IEF) ................................. 38 4 WHO/PBL/GET/98.2 INTRODUCTION The Second Meeting of the WHO Alliance for the Global Elimination of Trachoma was opened by Dr R. H. Henderson, Assistant Director-General who, in view of the expanding growth of the Alliance meetings, expressed his pleasure for seeing such momentum and commitment toward global elimination of trachoma. He pointed out that this Alliance which is based on pluri- disciplinary and multi-sectorial collaboration (including research institutes, governmental and nongovernmental organizations, foundations, UN agencies and the pharmaceutical industry) was perceived as a new opportunity likely to serve as model for other WHO programme areas. He then reviewed the progress made so far by the Alliance and listed the ongoing and planned developments. Finally, he mentioned that a WHO resolution on trachoma would be submitted to the Executive Board for consideration and possible adoption on the occasion of its 101st session in January 1998. Mr R. Porter, Executive Director of Sight Savers International (SSI) and Dr L. Pizzarello, Medical Director of Helen Keller International (HKI) served as Chairman and Vice-Chairman respectively, and Professor G. Johnson, Director of the International Centre for Eye Health as Rapporteur. The draft agenda (Annex 1) was adopted without modification and the list of participants is included in Annex 2. I. ACTIVITIES UNDERTAKEN FOR THE GLOBAL ELIMINATION OF TRACHOMA (GET) (1 JULY-31 DECEMBER 1997) 1.1 SECRETARIAT OF THE WORLD HEALTH ORGANIZATION’S ALLIANCE (1 JULY- 31 DECEMBER 97) 1.1.1 Country visits for national programme development (a) Within the framework of GET, as follows: Burkina Faso: Dr S. P. Mariotti (October 97). Presentation of the WHO Alliance’s objectives and framework to the National PBL Programme ophthalmologist, and to Ministry of Health authorities. Identification of collaboration opportunities for the National PBL Programme with a review of available data. Drafting of a plan of action for the coming months with the National PBL Programme Coordinator. Chad: Dr S. P. Mariotti (October 97). Meeting with the Minister of Health and other responsible staff of the Ministry to present the WHO Alliance, to discuss the status of trachoma in the country. Establishment of future collaboration with national and international resources. Mali: Dr S. P. Mariotti (October 97). Discussion with Ministry of Health authorities on the WHO Alliance. Working sessions with the National PBL Programme Coordinator to (i) review the status of endemic trachoma in the country, (ii) identify priorities, (iii) draft a tentative plan of action for trachoma elimination related activities. Morocco: Dr A.-D. Négrel & Dr B. Thylefors (Oct. & Dec. 97) to review information concerning trachoma control, particularly the setting up of the specific programme for the elimination of trachoma by the year 2000. Review of the randomized clinical trial on the
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