1	Community-Based Interventions to Tackle Poverty-Associated Diseases: Case Study of Trachoma Jacob Kumaresan President, International Trachoma Initiative
2	Communicable Diseases: Burden 60% Deaths Communicable diseases 64% DALYs Deaths Cases TB 2 - 3 million 8 million HIV/AIDS 3 million 40 million (prevalence) Malaria 1 million 300 – 500 million 25% of DALYs Infectious/ Parasitic diseases (neglected)
3	Selected Parasitic and Infectious Diseases in Africa Disease Target Population Lymphatic filariasis 300 million Schistosomiasis 200 million Intestinal Helminths 400 million Onchocerciasis 80 million Trachoma 168 million
4	Health Partnerships Supported by Pharma HIV/AIDS: 18 Accelerating Access Initiative (AAI) Diflucan® Partnership Program International AIDS Vaccine Initiative (IAVI) Malaria: 12 GSK African Malaria Partnership Medicines for Malaria Venture (MMV) Novartis Coartem® Tuberculosis: 8 Global Alliance for TB Drug Development (TB Alliance) Lilly MDR-TB Partnership Novartis TB DOTS Donation Tropical Diseases: 8 Global Alliance to Eliminate Leprosy (GAEL) International Trachoma Initiative (ITI) Merck MECTIZAN® Donation Program (MDP) Vaccine Preventable Diseases: 6 Global Alliance for Vaccines and Immunization (GAVI) Global Polio Eradication Initiative
5	Major Accomplishments by Disease Tropical Diseases Global Alliance to Eliminate Leprosy Currently over 13 million people have been cured of Leprosy, 2.5 million treated with Novartis donation and since 1985, the prevalence rate has dropped by over 90% Global Alliance to Eliminate Lymphatic Filariasis Since 2003, 100 million treatments donated in 34 countries and over 80 million people protected against Lymphatic Filariasis Guinea Worm Eradication Program Since 1986, the disease burden of Guinea Worm has been reduced by 99% Merck MDP Since 1987 over 300 million treatments have been administered for Onchocerciasis
6	Trachoma is the world’s leading cause of preventable blindness Trachoma - a disease associated with poverty 7.6 million visually impaired 84 million with active infection $2.9 billion in productivity losses/year Trachoma – disproportionately affects mothers and children Prevalence of infection highest in 1 to 5 year olds Women blinded up to 3 times more than men
7	Knowledge of Burden: Active Trachoma Total number of active cases: 84 million China: 26 million India: 20 million Ethiopia: 9 million Sudan, Egypt: 3 million Tanzania, Kenya, Yemen, Niger: 2 million Cambodia, Mali, Burkina, Brazil, Chad, Uganda: 1 million
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9	Repeated infections lead to blindness
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14	History of Trachoma Known to the Egyptians as well as Hippocrates Copper Sulfate First noted in Europe as a result of French occupation in Egypt Last UK trachoma unit closed in 1947; US trachoma hospitals in 1950s
15	Preventing the Spread of Trachoma in the US
16	Free traveling trachoma clinic
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19	Milestones
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27	SAFE in Action - Morocco Evaluation Results: Morocco Active disease in children reduced by over 90%
28	"International Trachoma Initiative" International Trachoma Initiative “Dedicated to the elimination of blinding trachoma, the world’s leading cause of preventable blindness.”
29	ITI-Supported National Programs
30	ITI-Supported National Programs 1998 - 2004
31	Zithromax Distribution: NIGER
32	Rapid program expansion in Niger
33	From Pilot Projects to 5 Year National Plans In 2004, ITI supported the development of national plans by the Ministries of Health and partners in: Ethiopia Ghana Mali Nepal Niger Tanzania Vietnam
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37	Zithromax Distribution: MALI
38	Ethiopia: Pit Latrine Promotion Project Current Wat-San Situation Sanitation coverage in rural communities of the Amhara region is <4% Safe water coverage in the same rural communities is <25% Very low awareness on hygiene and sanitation
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40	Latrines: A Gender Issue Local traditions do not allow women to defecate during the day (in the Amhara region) Women had to relieve themselves early in the morning or late in the evening (hiding themselves) Women activists (promoters) used this obsolete tradition to mobilize women Women, being more affected than men with trachoma, fueled the need to dig and use latrine as urgently as possible
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42	The Outcome Annual 2004 target: 5,000 pit latrines Following training, motivation and community mobilization: Total # of pit latrines constructed: 89,000
43	Reasons for Success CONVICTION: In order to change others, we may have to change ourselves first VISION: Leaders COMMITMENT: At all levels THINK BIG, START SMALL, ACT NOW!
44	What will it take to eliminate blinding trachoma? Government commitment and ownership in trachoma endemic countries Strengthening of partnerships Community engagement and empowerment
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