The Very Beginning

“Two things made ITI possible. One was research that The Edna McConnell Clark Foundation supported, which verified that the four elements of the SAFE strategy were individually effective, and which packaged them all together...The second thing was the availability of azithromycin, and the willingness of Pfizer to take a chance on giving this drug away. What we needed was a single-dose effective antibiotic."

- Dr. Joseph Cook, Tropical Disease Research Program Director,
Edna McConnell Clark Foundation (1978-1999),
former ITI Director (1998-2003)

Antibiotic Distribution Begins

Tanzania and Morocco were the first countries to receive donated antibiotics. In Tanzania, the acronym SAFE has been translated to SAFI, the Kiswahili word for "good," "clean," or "nice." The Kiswahili slogan for the Tanzania trachoma campaign was "Uso SAFI? Poa!!"or "Clean face? Cool!!"

"We integrated trachoma into the work of every government agency. We created a model lesson for the schools. We made films to encourage people to think about the cleanliness of their wells, and we asked the National Office of Potable Water (ONEP) to show our films. We gave posters to our health care workers and offered to provide communications training to workers in any agency. We taught them how to communicate about their projects and educated them about trachoma control and prevention."

- Dr. Youssef Chami-Khazraji,
Director of the Division of Communicable Diseases,
Department of Epidemiology & Disease Control,
Ministry of Health, Morocco.

Quick Facts for 1999

• New countries: Tanzania and Morocco
• Cumulative shipments: 1,107,984
• Number of countries served: 2

Quick Facts for 2002

• New countries: Ethiopia and Niger
• Cumulative shipments: 8,668,086
• Number of countries served: 11

Pfizer Expands Donations

In 2003, Pfizer increased drug donation from 10 million doses in ITI's first five years to 35 million for the next five, greatly facilitating ITI's expanded support for the global programme.

Quick Facts for 2003

• New countries: Mauritania
• Cumulative shipments: 15,544,733
• Number of countries served: 12

International Coalition for Trachoma Control (ICTC) is Established

"We can do so much more when we do it together."

-Catherine Cross, First Chair of ICTC

The beauty of the ICTC lies in the inclusive and collaborative operating model that plays to the strengths of partners, allowing them to focus their efforts on supporting countries instead of competing for funds. The collaborative approach gives us a comparative advantage in every aspect of our work - whether it be data collection, resource mobilization, and sharing best practices. New and expanding country programs could avoid the pitfalls of pilot phases, learn from the experiences of neighboring countries, and go straight to scale-up.

Quick Facts for 2004

• New countries: Senegal
• Cumulative shipments: 36,294,044
• Number of countries served: 13

USAID Support

Through USAID, the U.S. government took their first steps towards becoming the single greatest supporter of MDAs for trachoma elimination. The number of antibiotics donated rose from 81 million total doses between 1999 and 2005 to almost a billion total doses between 2006 and 2021.

Quick Facts for 2006

• New countries: Kenya and The Gambia
• Cumulative shipments: 80,826,887
• Number of countries served: 15

100 Million Doses Milestone Reached

 In 2007, the cumulative number of doses of the Pfizer donated antibiotics shipped by ITI exceeded 100 million doses.

Quick Facts for 2007

• New countries: Burkina Faso and Uganda
• Cumulative shipments: 114,212,057
• Number of countries served: 17

ITI Celebrates 10 Year Anniversary

"Among ITI's major accomplishments from 2003 to 2007 was a strategic shift in ITI's role in trachoma elimination. We moved from ITI-owned programs to government-owned, government-led and government-supported programs. We began to implement SAFE support in 12 countries. This meant scaling up mass drug administration from 1.5 million people in 2002 to more than 25 million four years later. Most importantly, we saw community empowerment. The lives of people in several communities where SAFE was implemented had been transformed. In addition to a drastic reduction in the prevalence of trachoma, we saw less respiratory disease and diarrhea in children, greater use of latrines, cleaner faces, and fewer flies."

- Dr. Jacob Kumaresan, former ITI President  (2003-2007)

Quick Facts for 2008

• New countries: Guinea Bissau
• Cumulative shipments: 149,847,285
• Number of countries served: 18

Looking Forward

"We only have ten years left to reach the goal of eliminating blinding trachoma. In order to achieve this, all endemic countries must have the full scale SAFE strategy in place by 2015 to allow enough time for implementation to have an impact. Enormous challenges lie ahead of us. Some of the remaining endemic countries are in conflict or have just come out of conflict, and lack infrastructure and resources to fully address the disease. Even countries free of conflict lack financial resources for the epidemiological surveys to determine which districts need intervention, or to support intervention in endemic districts...However, we believe that, together, we can overcome these challenges and reach our goal."

- Dr. Danny Haddad, former ITI Director (2009-2013)

Quick Facts for 2010

• New countries: Burundi, Nigeria, Zambia
• Cumulative shipments: 244,058,917
• Number of countries served: 22

ITI Publishes The End in Sight: 2020 INSight

This collaborative road map between national programs and implementing partners infused new energy into trachoma elimination efforts.

 “After INSight 2020, we realized we needed quality assurance, standardization, and huge scale up. That was when we decided to use some strategic reserve funds to kick-start the global mapping and standardization process.”

- Dr. Danny Haddad, former ITI Director (2009-2013)

“To eliminate any disease, the critical step is knowing where the disease is - otherwise you’re just shooting in the dark.”

- Dr. Anthony Solomon, Lecturer, London School of Hygiene & Tropical Medicine (1999-2014)Medical Officer, Neglected Tropical Diseases, WHO

Quick Facts for 2011

• New countries: Cameroon and Malawi
• Cumulative shipments: 293,200,933
• Number of countries served: 24

Global Trachoma Mapping Project is Launched

ITI and a consortium of partners supported the development of the Global Trachoma Mapping Project (GTMP), a standardized methodology conforming to WHO guidelines for data collection based on a mobile platform to gather disease prevalence data and allowing analysis on a real-time basis.

These data have been made available on the ITI-managed Trachoma Atlas at www.trachomaatlas.org.

Consistent with the large scale-up, the azithromycin supply chain was streamlined by shipping 500 count bottles. The large bottles replaced the previous 30-tablet ones reducing transport costs and the required storage space. Each full pallet of bottles of tablets increased from 33,600 doses to 215,000.

Quick Facts for 2012

• New countries: Central African Republic, Chad, Guinea, Mozambique, and Solomon Islands
• Cumulative shipments: 346,522,629
• Number of countries served: 29

Outreach Expansion

2016 was the first year in which over 100 million doses of antibiotics were shipped to endemic countries. The number of doses shipped in 2016 alone exceeded the cumulative total shipped in the first ten years of ITI.

Over 85 million people received treatment in 2016.

ITI with partners RTI International and Sightsavers supported the launch of Tropical Data, a consortium of scientific, technological and implementation partners to work alongside Ministries of Health to support rigorous epidemiological surveys to conform to WHO guidelines for data collection.

Quick Facts for 2016

• New countries: Benin, Cote d'Ivoire, Democratic Republic of the Congo, Kiribati, Vanuatu, and Zimbabwe
• Cumulative shipments: 627,860,465
• Number of countries served: 36

20th Anniversary Celebration

ITI celebrated 20 years of working for a world free from trachoma and the exciting news that there has been a 50% reduction in the global burden of trachoma. More good news, Pfizer extends azithromycin donation to 2025 to reach most marginalized communities.

Watch the 20th Anniversary documentary

Quick Facts for 2018

• New countries: Yemen
• Cumulative shipments: 810,777,123
• Number of countries served: 40

Management Guidelines Published

ITI Published the Management Guide with the goal of enhancing safety, ease, and acceptability of azithromycin administration. The Guide is designed for all stakeholders at all levels who use donated azithromycin for trachoma elimination. Access the Management Guide.

Quick Facts for 2019

• Cumulative shipments: 897,718,347
• Number of countries served: 40