$10 million grant aims to improve trachoma treatment

Key Points

Research to find better treatment answers has gotten a big boost in the form of a $10 million grant from the Bill & Melinda Gates Foundation to Johns Hopkins University (JHU) to head up a consortium of investigators. The award is one of the largest single grants ever given to support trachoma research.

"Neglected tropical diseases are a special interest to the Gates Foundation, and trachoma is one of those diseases," said Sheila West, PhD, of the Dana Center for Preventive Ophthalmology at JHU's Wilmer Eye Institute, Baltimore.

WHO has established a goal of fully controlling trachoma worldwide by 2020. The research conducted by PRET will help determine the most effective strategies to help reach that goal.

"No other research partnership has the breadth and ability to undertake such a comprehensive and critical proposal for trachoma control," said Dr. West, who also is a professor at the JHU School of Medicine and holds a joint appointment at the university's public health school.

Two parts

One part of the study will focus on mass use of antibiotics, seeking to answer crucial questions such as how long a patient should be treated, the ideal coverage for a community, and which lab tests can help medical professionals identify the appropriate time to cease treating a population. The other part of the study will be a surgical trial designed to review new devices to treat the in-turned lashes of trachoma that cause corneal scarring and can lead to blindness.

"We know surgery can fix this problem, but there are very high recurrence rates," Dr. West told Ophthalmology Times. "We are working to develop tools to improve the outcomes of this surgery, particularly because it often is performed by eye nurses and other allied workers. We want to help them achieve the maximum outcomes possible."

The surgical trial will include only adults with end-stage trachoma, she said. The antibiotic trial will include entire communities in a randomized manner.

The antibiotics trial will be performed in Ethiopia, a country in which trachoma treatment programs have not yet started; Tanzania, a country in which treatment programs are in place and the disease is on the decline; and The Gambia, where the disease is on the verge of elimination. The surgical component will occur only in Tanzania.

Pfizer, the private-sector partner in the consortium, has pledged sufficient antibiotics to country programs to control trachoma as part of the SAFE (surgery, antibiotics, facial cleanliness, and environmental improvement) intervention. Antibiotics also will be provided for research needs.

"Public-private partnerships have been successful in developing the evidence necessary for addressing trachoma elimination and improving the safety and efficacy of the SAFE strategy intervention," said Charles Knirsch, MD, MPH, vice president, Pfizer Global Medical Research and Development, in a news release.

Trachoma disproportionately affects women and children in poor and rural communities, and they often do not have a voice in health-care spending decisions, Dr. West said.

"With this grant, we can target research to our trachoma control armamentarium and make better use of scarce resources and control strategies to alleviate blindness. None of us can do it on our own. We need to share the data among us to conquer the disease," she said.

"The Johns Hopkins Center for Global Health is pleased to be able to facilitate and coordinate this extraordinary grant from the Bill & Melinda Gates Foundation," said Tom Quinn, MD, director of the Center for Global Health.