Lessons from the elimination of trachoma in Senegal: implications for high-burden countries in sub-Saharan Africa

Senegal's achievement in eliminating trachoma as a public health problem offers a powerful model for countries still burdened by the disease. This success was driven by a holistic and context-sensitive implementation of the SAFE strategy. The country invested in training health workers to deliver trichiasis surgeries in hard-to-reach areas, ensured high coverage of azithromycin through consistent mass drug administration (MDA), and embedded hygiene promotion in schools and community structures. Importantly, Senegal tailored interventions to regional cultural and epidemiological contexts, enhancing local acceptance and effectiveness. Community ownership, intersectoral collaboration involving education, water, and sanitation ministries, and strong partnerships with international organizations further strengthened outcomes. The use of high-quality data through standardized tools like the Tropical Data platform enabled real-time surveillance, evidence-based programming, and course correction. Even post-elimination, Senegal has maintained vigilance through integrated surveillance and hygiene programs in primary healthcare, ensuring sustained gains and preventing re-emergence. These insights present actionable lessons for other high-burden countries like Nigeria, Ethiopia, and Chad.