Central America's First Trachoma Elimination
How El Salvador Earned WHO Validation

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On 13 July 2026, the World Health Organization (WHO) and the Pan American Health Organization (PAHO) formally validated El Salvador as having eliminated trachoma as a public health problem. It is the first country in Central America to reach this milestone and the second in the Americas as a whole. That same week, officials from countries across the region met in San Salvador and reaffirmed regional cooperation to accelerate trachoma elimination.

What Happened

Trachoma is an eye infection caused by the bacterium Chlamydia trachomatis. Repeated infections scar the inner eyelid, turning the eyelashes inward so that they damage the cornea, and ultimately lead to blindness. It spreads through contact with discharge from the eyes and nose of infected people, and through flies that carry it, so it clusters in areas without adequate water and sanitation. Trachoma is one of the neglected tropical diseases (NTDs) that WHO is working to eliminate, and roughly 1.9 million people worldwide are still estimated to live with visual impairment or blindness caused by it.

El Salvador had long been suspected of trachoma transmission in parts of its rural areas. Between 2023 and 2026, intensive assessment surveys were carried out in districts identified through environmental and social risk factors. The results found neither active infection in children nor the severe cases that lead to blindness in adults above the WHO threshold values.

A Multisectoral Approach That Worked

What the WHO and PAHO announcements emphasize is that this was not the work of the health sector alone but an effort that tied several sectors together. Strengthening primary health care, improving water and sanitation (WASH) conditions, building up eye care services, and expanding vision screening were combined. Through the Trachoma Elimination Initiative in the Americas, PAHO has supported countries with cooperation from the Government of Canada, and El Salvador's validation is also a result of that framework.

The international standard for trachoma control is the well-known SAFE strategy, an acronym for Surgery, Antibiotics, Facial cleanliness and Environmental improvement. What distinguishes El Salvador's experience is that it embedded this thinking into broader development agendas such as water and sewerage infrastructure.

Elimination Is Not Eradication

It is worth being careful here: what was validated is elimination as a public health problem, not eradication. It means the country has fallen below the WHO threshold values, not that infection has been reduced to zero. The history of infectious disease control is full of cases where complacency after elimination allowed a disease to return. With population movement and gaps in sanitation infrastructure on the urban fringe still in place, continuous surveillance is indispensable.

PAHO has set a goal of eliminating or eradicating more than 30 infectious diseases and related conditions in the Americas by 2030, and this validation is one milestone along that road. At the regional meeting in July, participants also discussed sharing surveillance experience and methods so that countries where transmission persists can learn from El Salvador's experience.

The Author's View

I research the assistive-device subsidy system and social security, and I have followed health care in Latin America with a focus on Costa Rica. From that vantage point, what I want to highlight in this news is how easily "preventing disability" and "supporting people with disabilities" end up in separate parts of a system. In Japan, if visual impairment remains, it leads to the issuance of a physical disability certificate and to the assistive-device subsidy system (white canes for people with visual impairment, low-vision glasses and so on), but the infectious disease control that comes before that sits in the domain of public health administration, and the connection between the two is not self-evident. El Salvador's effort is a good example of how investment on the upstream side, in WASH and school health, reduces the future demand for disability services itself.

When I was travelling around clinical sites in Costa Rica, I saw how specialist care, ophthalmology included, was concentrated in the capital region, and how long rural patients had to wait before being seen. Trachoma aside, the capacity to respond to preventable blindness is determined less by the number of specialists than by whether primary care and screening reach the far end of the system. In that sense, it makes good sense that El Salvador made expanded vision screening one of the pillars of elimination.

If you want to follow what comes next, there are two indicators to watch. One is how validation progresses in other countries of the region toward PAHO's 2030 goal; the other is El Salvador's own post-elimination surveillance, meaning whether periodic surveys are carried out and their results published. The announcement of elimination is not an ending but the beginning of the stage in which zero infection becomes the norm.

Glossary

Tracoma / trachoma is a bacterial eye infection in which repeated infections lead to blindness. Eliminación como problema de salud pública (elimination as a public health problem) refers to suppressing a disease below the WHO threshold values, and is distinguished from erradicación / eradication, which means zero infection. NTD (enfermedades tropicales desatendidas) is the abbreviation for neglected tropical diseases.

Elimination is not the end. Real eradication begins on the day zero infection becomes ordinary.

※ This article is the author’s commentary based on public information. Please confirm the latest figures, dates and procedures with governments and primary sources. Quotations are kept minimal and sources are cited.