The 19th meeting of the Trachoma Expert Committee (TEC) was held on November 12–14, 2018 at The Grand Hyatt in Muscat, Oman. Former senior vice president and chief medical officer of Pfizer Inc. Joseph Feczko chaired the meeting for the last time before rotating off the chair. Meeting observers included colleagues from WHO, Pfizer, USAID, and implementing partners.

Members of the Eastern Mediterranean Region (EMR) Alliance joined the TEC meeting for the first day. The Omani Ministry of Health organized a visit to observe routine post-endemic trachoma surveillance activities at an elementary school and primary health center in Muscat. EMR Alliance Chair, Babar Qureshi, presented an overview of the EMR trachoma plan and progress towards resource mobilization, and celebrated regional successes. National Program representatives from Oman, Morocco, and Iran presented on achieving trachoma elimination and representatives from Afghanistan, Egypt, Pakistan, Sudan, and Yemen presented on opportunities and challenges to current implementation. The WHO African Regional Office representative of the Expanded Special Project for Elimination of NTDs (ESPEN) representative Amir Bedri highlighted the support given by the African Regional Office to the Eastern Mediterranean Region, in particular, to Egypt, Yemen, and Sudan.

The TEC congratulated the countries in the EMR Alliance that have achieved trachoma elimination targets, recognized significant progress towards trachoma program implementation, and highlighted the need for urgent action in Egypt and Afghanistan. The TEC acknowledged the request from the EMR Alliance for support to countries with drug clearance through in-country advocacy, internal and external advocacy to mobilize funds, and the need for operational research support relevant to the region.

The ITI director Paul Emerson again presented the revised guidance on Zithromax® dosing announced earlier in 2018 and reiterated the goal of zero serious adverse events (SAEs) due to choking.  The guidelines provide more detail on better managing treatments to children and revise the Zithromax® dosing by increasing the minimum age and height of dosing with powder for oral suspension (POS) to ≥7 years and ≥120 cm.

In calendar year 2017, ITI shipped over 81.4 million treatments of Zithromax^®, and provided Zithromax® to 140 new districts with a population of 19.3 million. Two hundred nine districts with a population of 26.7 million reached the TF elimination target and no longer warrant MDA.

During the meeting, TEC members reviewed mid-year Zithromax® donation requests for the Central African Republic and Kenya. The TEC approved a total of 119,625,551 treatments in 895 districts from 28 countries for 2019. The TEC noted that the demand for Zithromax® for 2019 was lower from 2018. Global need will decline reflecting success in the country programs.

TEC 20 is scheduled for June 18–20, 2019 in Decatur, Georgia, USA.