Chronic diseases and health promotion

Part Three. What works: the evidence for action

Chapter One. A strategy to achieve rapid results

Eliminating trachoma in Morocco

Morocco is on track to achieve the elimination of blinding trachoma by 2006. This success has resulted from a combination of high-level political commitment, partnerships and community participation in prevention and control efforts.

Trachoma is a chronic disease with an infectious origin that results in irreversible blindness if untreated. It was common in Morocco in the 1970s and 1980s. A national assessment in the early 1990s found that despite existing activities, the disease was still blinding the poor citizens of five provinces who were not yet benefiting from the development of services and infrastructure seen elsewhere. An integrated programme backed by the King of Morocco and Ministry of Health officials was implemented with external partners. The programme included provision of surgical services to stop the progression of blindness, health promotion and environmental measures to prevent infection, and treatment with antibiotics in trachoma-endemic areas.

As a result, in the last 10 years more than 80 000 people have had progression of blindness prevented through surgery; more than 700 000 people were treated with antibiotics; over 40 000 sessions per year were organized to educate communities about primary prevention; some 8000 women per year received literacy education; and more than 80% of rural villages gained access to water points (from 14% in 1990).

In rural disease-endemic areas, trachoma elimination has also been the entry point for introducing a surveillance system, which is now used for chronic diseases generally, developing the primary health care system, and enhancing eye and other health care interventions. Trachoma surgery is integrated with cataract services and dental care. Villages have also received support for the development of income-generating activities, with some of the revenue supporting health promotion and health service provision for children and the elderly.