Sightsavers stories

“Our programme has transformed communities”

A female community drug distributor measures a girl to see how much medication she needs to protect her from trachoma.

It started with an audacious idea: what if we could eliminate blindness caused by trachoma?

Sightsavers’ chief executive Caroline Harper posed the question as part of a TED talk in 2018. This became the driving force behind the Accelerate programme, an ambitious initiative led by Sightsavers that is aiming to stamp out trachoma in 15 countries across sub-Saharan Africa, as well as speeding up progress towards elimination in two others.

As the programme enters its sixth year, we look at its incredible achievements so far – as well as what the future holds.

Fousseni smiles broadly. He's wearing a traditional African hat and grey tunic.
Fousseni had trachoma for 15 years before he received treatment through the Accelerate progamme. © Sightsavers/David Gnaha

We’ve protected people from sight loss

Trachoma is a devastating eye disease that, after repeated infection, can cause a person’s eyelids to turn inwards, so their eyelashes scrape against the eye with every blink. If left untreated, it can cause permanent blindness.

Working with governments and partners, the Accelerate programme has so far delivered 53 million treatments to prevent people from contracting trachoma, and managed 91,000 advanced cases of the disease.

In 2023, we were thrilled when Benin became the first country supported by the programme to successfully eliminate trachoma as a public health problem. Other countries are on track to achieve the same goal in the coming years.

We’ve promoted healthier, happier communities

Caleb Mpyet, Sightsavers’ global technical lead for trachoma, explains that the Accelerate programme has had a ripple effect that goes far beyond its work on avoidable blindness.

The programme has been working to improve access to water, sanitation and hygiene, one of the key steps in beating trachoma. This has involved some ingenious interventions aimed at changing people’s behaviour, such as the ‘Captain Clean’ board game for children.

According to Caleb, the programme’s focus on hygiene practices has led to “transformations in different communities, in terms of having cleaner communities where people are living healthier lives.”

Watch the video to see Caleb talking about the Accelerate programme.

Three girls sit and play a board game laid out on the ground.
Children in Ethiopia are learning about the importance of good hygiene to tackle trachoma via board games. © Amref Health Africa

We’ve adapted to huge challenges

Although it can sound straightforward, the path to eliminating trachoma as a public health problem has involved navigating some thorny challenges.

This includes the need to cope with conflict and political instability. Caleb explains that outbreaks of violence in some regions have at times hindered the programme’s ability to reach those in need.

“We needed to develop some innovative approaches in order to map where trachoma was present in those insecure areas. This includes using helicopters to fly in survey teams, where it was not safe to use the roads.

“We also decided to collect some trachoma patients and drive them to safer locations, where they could meet with surgeons and have sight-saving operations.”

When the COVID-19 pandemic swept across Africa, this caused another stumbling block for teams working out in the field, as it led to drug treatment campaigns being cancelled and surgical camps being postponed.

However, the programme was quick to bounce back. The World Health Organization (WHO) published a tool for assessing the risk of mass gatherings during the pandemic, and our staff were able to adapt this so it was relevant for programmes to treat trachoma and other neglected tropical diseases.

Armed with the resulting tool, known as the risk assessment and mitigation action tool (RAMA), we were able to safely resume programme activities with health ministries in July 2020. The programme went on to deliver antibiotic treatments to around one million people in Nigeria between July and September that year.

Eye care staff perform trachoma surveys on children in Cote D'Ivoire.

What is Accelerate?

The programme aims to support at least 15 countries to eliminate trachoma as a public health risk, and speed up progress in two others by 2027.

About the programme
A nurse wearing PPE takes the temperature of a patient at an eye clinic.
By adapting WHO’s COVID-19 tool, the programme was able to resume its activities in July 2020. © Sightsavers/David Gnaha

We’re not leaving anyone behind

As the Accelerate programme has worked with health ministries to eliminate trachoma, the focus has been on reaching those groups that are most disadvantaged. This often involves visiting remote populations to ensure they have equal access to treatment.

Caleb explains: “We know that people with disabilities, elderly female patients (who are more likely to have advanced trachoma), and people in very remote communities do not usually come out to receive treatment for trachoma.

“If we are to reach elimination, it’s important that these people are carried along, so the programme used the house-to-house case-finding approach. In this process, we ensure that every community is covered, and every household is visited. This ensures that no one is left behind.”

He adds that the programme will continue to support countries on their journey towards eliminating trachoma, even after treatment campaigns have come to an end.

“We make sure that national governments have what’s required in terms of human and financial resources to manage trachoma in the long-term. Then we support ministries of health to write their dossier to prove to the WHO that they have eliminated the disease.”

A community drug distributor hands an elderly man medication to treat trachoma.
George, who is 96 years old, received medication to protect him from trachoma. © Sightsavers/Samuel Otieno

Now, we’re expanding the programme

Thanks to new funding, the programme has recently been able to widen its scope. Accelerate is now aiming to support 17 countries on their journey to eliminate trachoma.

Caleb is clear about what this will mean, both for individuals and for the wider societies they live in. “When a country reaches elimination, it means that individuals and communities have been freed from pain and misery, and are able to lead economically productive lives without worrying about trachoma and its blinding complications. I think it would be very exciting to achieve that in the countries that we’re supporting.”

Learn about our work across Africa and Asia

Sightsavers and eye health