Trachoma in Sub-Saharan Africa

Trachoma, the leading infectious cause of preventable blindness, is caused by ocular infection Chlamydia trachomatis. Blindness due to trachoma is preventable through the multipronged approach of Surgery, Antibiotics, Facial cleanliness and Environmental improvement (SAFE) strategy. Trachoma was targeted for global elimination as a public health problem by 2020; however, despite the substantial progress made in the last two decades, only 11 countries had been validated for elimination of trachoma as a public health problem by 2021. Trachoma remains endemic in 44 countries of which 26 (59%) are in sub-Saharan Africa. In addition, 85% of the global burden of active trachoma is found in sub-Saharan Africa. This chapter covers the epidemiology of trachoma in sub-Saharan Africa, underscores the continued need for SAFE strategy implementation, and outlines present-day trachoma elimination endgame challenges that affect trachoma endemic countries, mainly in sub-Saharan Africa. The recently launched NTD roadmap 2021–2030 brings renewed enthusiasm for global elimination of trachoma by 2030. A lot has been learnt in the last two decades of SAFE implementation thus building on these lessons alongside new strategies of tackling endgame challenges makes global trachoma elimination attainable in the next decade.