As Australia works to shake the unenviable badge as the only developed country with endemic trachoma, its closest neighbour has welcomed official recognition of its elimination efforts.
Vanuatu, Malawi, Iraq, India, Vietnam, and Mauritania. Since 2022, these countries have all been validated by the World Health Organization (WHO) for eliminating trachoma as a public health problem. Now, Papua New Guinea (PNG) has joined those ranks.
This “landmark public health achievement” was announced during the 78th World Health Assembly in Geneva in May 2025, following a rigorous review of PNG’s elimination dossier.
For many Australians working in ophthalmology and public health, it’s bound to bring both celebration and reflection. While the nation’s closest neighbour has succeeded in stamping out the world’s leading infectious cause of blindness, Australia is the only developed country where trachoma remains endemic.
It impacts a relatively small number of Aboriginal and Torres Strait Islander communities. Efforts have seen the national trachoma prevalence rate in screened children aged five to nine fall from 14% in 2009 to 3.3% in 2021, but Australia may now be on the verge of adding its name to the list of successful countries, according to Mr Mitchell Anjou, from Minum Barreng: Indigenous Eye Health Unit at the University of Melbourne.
“[We are] pleased to learn that trachoma prevalence rates in NT, WA and SA are being maintained at under the WHO elimination requirements,” he said.
“We understand that a national dossier will be submitted to WHO later this year, from where we expect certification that Australia has eliminated trachoma as a public health problem. This achievement would not be possible without work such as that undertaken by Ms Lesley Martin, a Central Arrernte woman who has worked as community engagement health promotion officer with Minum Barreng for the past seven years.”
With good community engagement and stakeholders working together Anjou said efforts had been successful in reducing trachoma rates across Central Australia.
“The job is not finished yet – as we still need to focus on healthy homes to sustain the elimination of trachoma and tackle other infectious diseases.”
According to the WHO, trachoma thrives in areas where the water is scarce, and sanitation is poor. The infection is easily spread through personal contact and by flies that have been in contact with people’s eyes or noses. And it disproportionately affects mothers and children.
Unlike many countries that have required widespread surgical interventions, mass drug administration, and water and sanitation upgrades, PNG’s own elimination strategy was distinctly epidemiology-led.
“Papua New Guinea’s achievement is an example of medical science in action,” said Dr Saia Ma’u Piukala, WHO regional director for the Western Pacific. “It reflects a deep understanding of local epidemiology and a commitment to using the right interventions for the right reasons.”
Surveys conducted in 2015 detected signs of active trachoma in children, but very low prevalence of the bacteria Chlamydia trachomatis and minimal rates of trachomatous trichiasis – the advanced stage that leads to blindness. A follow-up ancillary study in 2020 confirmed children were not progressing to more severe disease. This pattern, also observed in other Melanesian countries, underpinned WHO’s validation.
According to the agency, rather than defaulting to blanket treatment campaigns, key to the success was PNG’s National Department of Health, with support from numerous partners, that conducted rapid assessments, prevalence surveys, and in-depth community investigations. These demonstrated that mass interventions were unnecessary, a finding that ultimately shaped PNG’s trachoma strategy.
The Fred Hollows Foundation played a key role in supporting PNG’s elimination efforts, especially since 2018.
Dr Ana Cama, The Fred Hollows Foundation’s trachoma co-ordinator, noted trachoma in PNG has been complex and presented atypically.
“Additional research and ancillary surveys looking at levels of scarring on the inner eyelid and limbal signs pathognomonic for trachoma in 10 to 14-year-old-children was crucial in understanding the picture of trachoma in the country and ultimately moving the country into drafting its dossier,” she said.
WHO director-general Dr Tedros Adhanom Ghebreyesus congratulated PNG, saying: “This success demonstrates what can be achieved when science and sustained partnerships come together to serve the health and dignity of communities.”
The accomplishment is particularly notable as trachoma is the first neglected tropical disease (NTD) eliminated in PNG. The country now joins 22 others that have eliminated trachoma as a public health problem, and is among 56 countries that have eliminated at least one NTD.
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