Fears for trachoma resurgence in Uganda amidst aid cuts

Trachoma, a bacterial infection that can cause irreversible blindness, is at risk of resurgence in Uganda following aid cuts, warns Save the Children.

Once prevalent in Karamoja – one of the world’s worst-affected regions – and ruining the lives of nearly 10% of the community, trachoma cases have been halved through interventions supported by foreign aid.

A four-year Save the Children programme to reduce trachoma – which disproportionately affects children and their mothers – reached about 58,000 people and reduced prevalence to 5% of the community.

Susan, 29, a local resident last year, said, “Our village was in a dire state. It was incredibly dirty, with rampant cases of trachoma and diarrhoea. There were no latrines, and the worst sanitation situation.

However, since the arrival of the health office, water office and Save the Children, significant changes have occurred; we now have 50 latrines [in our village], and households without latrines are actively constructing their own, with many nearly finished.”

Aid workers now fear that the loss of access to hygiene education, trachoma drugs, and the termination of latrine construction could lead to a resurgence in the disease, which is spread through flies and is rife in areas with poor sanitation.

Trachoma initially infects the membrane, covers the outside of the eyeball and lines the inner surface of the eyelid. Repeated infections lead to scarring of the upper eyelid, leading to eyelashes curving inwards and rubbing against the cornea, causing intense pain and leading eventually to irreversible blindness.

Famari Barro, Country Director for Save the Children in Uganda, emphasised the urgency of continued support: “Trachoma has been eliminated in most parts of the world, but in Karamoja, it was blighting almost 10% of the population, mostly women and children.

It’s a nasty disease that can cause a lifetime of suffering but is so easily preventable. This was a real aid success story – rates were going down, and communities were able to keep not just trachoma but other infectious diseases at bay. Closing down this programme risks pushing people back into lives of disease and misery.”

Through the Save the Children programme, community health workers were identifying preliminary symptoms of trachoma in remote areas as well as providing access to correct preventative information, medicines and referrals to health facilities in hard-to-reach communities. Trachoma is preventable.

Gabriella Waaijman, Chief Operating Officer at Save the Children, criticised aid cuts: “Cutting aid is not just a failure of moral leadership; it is a strategic miscalculation. Failure to tackle these kinds of health crises will taint children’s lives and will come back to bite us all.

“We have years – decades, even – of evidence, recorded not just on spreadsheets on a screen but in the transformation of real human lives, that these programmes work to safeguard children and their communities in some of the poorest places in the world.

“We owe children a better future. We owe them a world in which every child’s life truly counts.”