Trachoma Control Program

The Trachoma Control Program works with ministries of health in four African countries to eliminate blinding trachoma, the world’s leading cause of preventable blindness.

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What is Trachoma?

Trachoma is a bacterial eye infection found in poor, isolated communities lacking basic hygiene, clean water, and adequate sanitation. Trachoma is easily spread from person to person through hands, clothes, and eye-seeking flies. Repeated infection over time leads to scarring and inward turning of the eyelid, causing the eyelashes to scratch the cornea — a very painful condition called trachomatous trichiasis (TT) which eventually causes blindness if left untreated.

Guinea worm is a particularly devastating disease that incapacitates people for extended periods of time, making them unable to care for themselves, work, grow food for their families, or attend school.

How Widespread is the Disease?

Trachoma can be found in 29 countries, mostly in Africa and the Middle East, and a few in the Americas and Asia.

Globally, 92 million people are at risk for trachoma. However, 1.2 million are still at immediate risk for blindness from trachomatous trichiasis, also known as TT, and require intervention.

The Carter Center works to control and prevent blinding trachoma in Ethiopia, Niger, South Sudan, and Sudan. Ethiopia has the highest known burden of active trachoma infection in the world, accounting for 68% of the total global population at risk for trachoma, according to the World Health Organization (WHO). The Carter Center supports Ethiopia’s (and thus the world’s) most affected region, Amhara.

Our Goal

Since 1986, The Carter Center has led the international campaign to eradicate Guinea worm disease, working closely with ministries of health and local communities, the U.S. Centers for Disease Control and Prevention, the World Health Organization, UNICEF, and many others.

Guinea worm disease could become the second human disease in history, after smallpox, to be eradicated. It would be the first parasitic disease to be eradicated and the first disease to be eradicated without the use of a vaccine or medicine.

Our Strategy

The Carter Center’s Trachoma Control Program was established in 1998. As a global leader in the fight against trachoma, the Center and partners implement the WHO-endorsed SAFE strategy for trachoma control. SAFE is a multipronged approach to trachoma prevention that consists of Surgery, Antibiotics, Facial cleanliness, and Environmental improvement.

Results and Impact

The Carter Center trains and equips local health workers to surgically correct eyelids deformed by trachomatous trichiasis (TT), the scarring that results from multiple trachoma infections. In 2025, the Center supported 31,084 corrective eyelid surgeries. This included specialized TT surgeries for nine children under 15 years of age in South Sudan as part of the pediatric TT pilot completed that year. From 1999 through 2025, the Center has assisted national programs in providing 991,767 TT surgeries in Ethiopia, Mali, Niger, Nigeria, South Sudan, and Sudan.

Since 1999, The Carter Center has assisted in the distribution of more than 247 million doses of Pfizer-donated azithromycin, an effective trachoma-fighting antibiotic. In 2025, the Center assisted in the distribution of 13,050,708 doses, including 268,640 doses given to children in six districts in the Amhara region of Ethiopia through a second treatment targeting children ages six months to nine years as part of the child mass drug administration (also known as Child MDA) strategy to assist in reducing persistent trachoma.

The Carter Center has ongoing health education efforts in over 3,800 villages each year across Ethiopia, Niger, South Sudan, and Sudan. For more than 25 years, The Carter Center has assisted in the training and retraining of more than 440,000 persons, including teachers and principals, in conducting health education against trachoma.

The Carter Center continues to support the construction of household latrines. Since 2002, more than 3.6 million household latrines have been built to help reduce breeding sites for flies, a principal source of infection transmission.

On April 27, 2023, the WHO validated Mali as having met all criteria for the elimination of trachoma as a public health problem. Mali is the 17^th country to achieve this status and has done so despite insecurity and significant disease prevalence at baseline. The Carter Center began its partnership with the Mali National Program in 1998.

Ghana in 2018 became the first sub-Saharan African country to be validated by the WHO for eliminating trachoma as a public health problem. Ghana reached its goal by 2010, but the WHO had not yet developed a process or criteria to evaluate the country’s achievement. The WHO created a process in 2016 to allow Ghana and other countries to be validated as having met the targets. The Center’s Trachoma Control Program assisted Ghana’s Ministry of Health from 1999 through 2011.

Two states in Nigeria, Plateau and Nasarawa, eliminated trachoma as a public health problem in 2018. The Carter Center’s Trachoma Control Program worked with both states’ health ministries from 2000 through 2015.