PRESS BRIEFING ON GLOBAL EFFORT AGAINST EYE DISEASE, TRACHOMA

PRESS BRIEFING ON GLOBAL EFFORT AGAINST EYE DISEASE, TRACHOMA

     The key to eliminating the preventable eye disease trachoma that has blinded six million people worldwide was to form alliances and address the behavioural dimensions of the contagious infection, the representative of the World Health Organization (WHO), Serge Reznikoff, told correspondents this afternoon at a Headquarters press conference celebrating the fifth anniversary of the International Trachoma Initiative (ITI).

Mr. Reznikoff is WHO’s Coordinator of Blindness and Deafness Prevention.  The briefing was sponsored by the Permanent Mission of Morocco to the United Nations, since that country has been implementing a flagship trachoma initiative programme for five years.  Since success rates were, as high as 70 per cent in some areas of Morocco, today’s celebratory event included an announcement that the programme was being expanded.

     Moderating was Lou Clemente, the ITI Board Chairman who said “living partnerships” were the only way to make progress with endemic diseases.  He said ITI’s goal was to eliminate trachoma by 2020.  In many areas, results were promising enough to indicate earlier victory, perhaps eradication by 2010.  Morocco’s goal now was 2005.

     Also taking part in the briefing were Dr. Jacob Kumaresan, President of the New York-based International Trachoma Initiative (ITI); Dr. Fouad Hammadi, General Secretary of Morocco’s Ministry of Health; and Dr. Hank McKinnell, the Chief Executive Officer of Pfizer Inc., the world’s largest research-based pharmaceutical company and co-founder of the Initiative along with a United States-based foundation; and Gourisankar Ghosh, Executive Director of the Geneva-based Water Supply and Sanitation Collaborative Council, an international organization operating with a General Assembly mandate to enhance water and sanitation services among the world’s poor. 

     Describing the disease, ITI’s Dr. Kumaresan explained that trachoma was a contagious eye infection caused by the bacterium chlamydia trachomatis.  It usually began in childhood and was spread by contact with discharge from an infected person.  Repeat infections caused scarring of the eyelids and scratched corneas that eventually led to blindness in adulthood if untreated.  Women were three times more likely to develop the blindness than men, because of greater exposure to the disease in children.  The illness was prevalent in 85 countries primarily across Africa, Asia, Central and South America.

He said the ITI programme begun five years ago was now operating in nine countries with up to a 50 per cent drop in acute childhood infections.  The key to success was the public/private kind of partnership, that was the only way to eradicate such global diseases.

     Trachoma was a disease that did not have to exist, he continued.  The ITI approach was basically a social development strategy with a cornerstone in a “SAFE” formula.  It focused on “surgery” (S) to correct advanced stages of the disease; “antibiotics” (A) to treat active infection  through a revolutionized single-dose medicine developed and donated by Pfizer Inc., the world’s largest research-based pharmaceutical company; “face washing” (F) to reduce disease transmission; and “environmental change” (E) to increase access to clean water and sanitation facilities to eliminate the disease altogether. 

     Describing the Initiative, Pfizer’s Dr. McKinnell said not all problems in the world could be solved, but this one could.  The disease had been around throughout history.  It was time to put an end to it through public/private partnerships that “can and do work”, if they were based on realistic and yet aggressive goals, appropriate investment and genuine commitment.  He had been greatly influenced during travels by the sight of village children leading their blind parents through the streets.  He had been struck by the fact that they did not have to be blind.  The ITI had proved that commitment worked.

First, he said his company had developed a one-dose pill called Zithromax to fight the disease rather than the antibiotic ointment, previously used.  The simplified modality for delivering the medicines to the poor had been a major step forward.  “Ease of use makes the difference between success and failure in poor countries”, he added, saying that ITI had worked with governments, agencies and local institutions at all levels to deliver drugs.  Pfizer had donated 8 million doses in the past five years.  In the next five, it would donate 135 million doses, or a 15-fold increase, while ITI expanded the programme into two more countries.

Dr. Hammadi of Morocco’s Health Ministry described the intensive programme his Government had implemented in the five provinces where the disease was present.  The King’s commitment had been responsible for the concerted effort that had enabled the country to reach 70 per cent of those affected.  All had worked in synergy, backed by political will and support, as demonstrated concretely.  The ITI strategy had been worked into both the country’s development and anti-poverty campaigns.  Emphasis had been on ensuring that all were reached.  Mobile and stationary medical units had been used.  The country’s neighbours were consulted.  International agencies were brought in, as were social workers and members of the media to publicize the aims.

The simple act of washing the face and hands could cut the occurrence of the disease in half, the Water Council’s Mr. Ghosh said.  Disease, malnutrition and environmental contamination were the factors that cycled together and kept people trapped in poverty.  To break the cycle, people needed information about the simple basics of prosperity and health.  A global conference, or “Wash Forum”, would be held in December 2004 in Senegal.  Media Awards would be granted for writing on health, sanitation and water-related issues.

Asked about the cost of the ITI programme, Pfizer’s Dr. McKinnell said it was “priceless, literally”.  Not only could one not put a price tag on people’s life and welfare, but in this case there was no market for the drug.  Those in need could not afford to buy them.  In terms of material cost, however, donating the 8 million doses so far had cost Pfizer $300 million.

Asked what had motivated Pfizer to initiate the ITI, he said three factors had entered into it.  First, was to provide access to medicine for those suffering from disease.  Another was to fulfil corporate citizenship responsibilities.  And finally, those two aims could not be achieved without the corporation’s financial success.

A correspondent asked what benefit Pfizer hoped to gain from ITI, with regard to positive publicity, when the pharmaceutical industry was under attack.  Dr. McKinnell said Pfizer expected nothing in that regard, since good works done by pharmaceutical companies did not get covered in the media.

In response to a question, he went on to elaborate on other partnerships Pfizer had entered into, on diseases other than trachoma.  One concerned the development and distribution of an antifungal medication used in relation to AIDS.  Some involved collaborations with infectious disease researchers in the United States.  One was a partnered programme in which 100 Ugandan doctors per year would be trained at a special clinic being built as a training centre.  They would return to towns and districts to pass on what they had learned.  Their students, in turn, would train others, and so on.

Local commitment was the basis for sustainable treatment of diseases and the conditions that caused them, Morocco’s Dr. Hammadi said.  In his country, 95 per cent of people had been reached because the Government had worked with civic groups.

Mr. Ghosh of the Water Council said his group worked in the same way.  Eighty-five percent of the burden with regard to trachoma was contained in a few countries.  Those countries would be studied to determine the disease burden they carried.  Ten of those countries would be targeted over the next five years, until the goal of eradicating the disease was achieved, hopefully well before 2020.

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