Viet Nam makes trachoma history

Last-mile efforts by dedicated health-care workers and cross-sectoral collaboration have been key to Viet Nam eliminating trachoma, a neglected tropical disease and the leading infectious cause of blindness in the world.

The ultimate efforts of a team of dedicated medical staff, along with inter-sectoral coordination, have played a key role in helping Vietnam successfully eliminate trachoma as a public health problem. This neglected tropical disease is the leading infectious cause of blindness in the world.

The achievement follows more than 70 years of intense efforts to treat hundreds of thousands of people and implement rigorous control measures.

Trachoma is a preventable disease that is spread by flies or through direct contact with discharge from the eyes or nose of an infected person. With repeated infections, the eyelashes rub on the eye, causing pain and damaging the cornea.

Nine years ago, Viet Nam seemed on the verge of eliminating trachoma, said Dr Tran Minh Dat, the Vice-Head of the Community Eye Care Department of the Viet Nam National Eye Hospital, known as the Central Eye Hospital.

Then, a survey in 2015 identified an undetected cluster of active trachoma infections among people living in a remote community in Ha Giang Province. Dr Dat and his team went to investigate.

"Lung Ho commune is in a very difficult, rocky, mountain area. We had to walk about 10km from the commune centre to the villages and hamlets where people lived, and in conditions that could be rainy, slippery and muddy. The rocks were as big as a person's head. I had to walk and climb over two to three mountains to get to the village. People living so far from the centre of the commune didn't have access to clean water and good sanitation," Dr Dat said.

His determination was rewarded.

"We knew the roads would be very difficult. We had to overcome the obstacles. However, when we arrived, the village welcomed us enthusiastically. It was very touching," Dr Dat said.

Families in Lung Ho were poor, often lived close to farm animals under stilt houses, and lacked access to clean water and sanitation.

"I felt moved by the difficult life of people in these mountainous areas. Most of all, I felt sorry for the children living in such difficult circumstances.

"In the middle of the winter, it was 10 degrees cold. The children were lightly dressed, some only in shorts.

"When we examined the children, we found they had a discharge coming from their eyes. They were suffering from trachoma."

In the commune, Dr Dat started to implement the SAFE strategy, developed by the World Health Organization (WHO), focusing on surgery, antibiotics, facial cleanliness and environmental improvements.

Health-care teams worked across Ha Giang province, searching for any other remaining pockets of trachoma, especially where people lived in crowded households, with poor hygiene and lacking adequate access to clean water and sanitation. In each team were two to three health care workers, including ophthalmologists and postgraduates from the Central Eye Hospital, provincial doctors, and local village health workers.

Local knowledge and language use were crucial to better understanding local situations, treating cases and improving access to clean water in Ha Giang, which has 16 ethnic groups including the H'mong, Tay, Kinh (Vietnamese), Nung and Dao.

Also crucial was collaboration among several government agencies. This included the Ministry of Health, the Ministry of Education and Training, and the Ministry of Agriculture and Rural Development, with the support of WHO and international health partners; the Australian Department of Foreign Affairs and Trade (DFAT), the Fred Hollows Foundation, the International Trachoma Initiative (ITI), RTI International, UNICEF and the United States Agency for International Development (USAID). Viet Nam was also one of the first group of countries to receive Pfizer-donated azithromycin for trachoma treatment through ITI, a donation critical to global progress against trachoma.

What followed were several years of rigorous checks to find any missed cases anywhere in the country.

In October 2024, WHO validated Viet Nam's successful elimination of trachoma.

WHO Representative to Viet Nam Dr Angela Pratt commended the Government of Viet Nam for this historic success, and paid tribute to the determination of health care workers.

"WHO congratulates Viet Nam warmly on making trachoma history. Eliminating a disease - especially without a vaccine - is a monumental achievement for any country.

"On this very proud occasion for Viet Nam, we salute the decades of work by dedicated health care workers at all levels, the incredible cross-sectoral collaboration to reduce the environmental and social risk factors for trachoma, and the unwavering support of many partners. Viet Nam's elimination of trachoma is a great example of what it means to reach the unreached, and leave no one left behind."

To ensure trachoma never returns, health care workers will continue to conduct surveillance for cases.

WHO's announcement is a proud moment for Dr Dat and other health workers.

"We are very happy that from now on, this eye disease is not a problem. We feel very proud. I am happy that I have contributed to this work," he said.

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