Gift of Anti-Blindness Drug

Times Staff Writer

Pharmaceutical giant Pfizer Inc. said Tuesday that it will donate nearly half a billion dollars' worth of the antibiotic Zithromax to treat 135 million people for trachoma, an infectious disease that has blinded 6 million people worldwide.

The gift will make the drug available over the next five years, providing a major impetus toward the World Health Organization's goal of eliminating the disease by 2020.

The donation follows an initial gift of 8 million doses over the last five years that has proven that the program can be effective even in poor countries. In Niger, for example, the prevalence of trachoma has dropped from 63% to 26%. Morocco, the first country to receive the drug, has achieved a 90% reduction in prevalence and is expected to achieve eradication by 2005.

The donation of the pills and accompanying programs "will have a profound effect on the lives of millions of people in the developing world," said Dr. Jacob Kumaresan, president of the International Trachoma Initiative, which is sponsored by Pfizer, the Edna McConnell Clark Foundation, national governments and other charities.

Trachoma is the world's leading cause of preventable blindness. It is endemic in 48 countries -- most of them in arid, water-poor regions of the world -- with an estimated 146 million people infected. Women are three times as likely as men to be infected with the disease. Because trachoma causes blindness in the most productive years of life, it can lead to economic ruin for entire families and communities.

During its first five years , the trachoma initiative targeted nine countries identified by the World Health Organization as having the highest rates of infection: Morocco, Tanzania, Ghana, Mali, Sudan, Vietnam, Ethiopia, Nepal and Niger.

With the new donation, "we are broadening the scope of the trachoma programs already in place and will launch at least 10 new country programs," Kumaresan said.

The disease is caused by Chlamydia trachomatis, a close relative of the bacteria that cause genital chlamydial infections. Infected individuals develop a sticky discharge from the eyes and nose. When water for washing is not readily available, bacteria are readily passed from person to person, particularly from children to mothers. It can also be spread by flies.

Untreated, the repetitive infections scar the inner eyelid. Excessive scarring forces the eyelid to turn inward, causing the eyelashes to rub against the cornea, eventually producing blindness.

Before the development of Zithromax -- whose generic name is azithromycin -- the standard treatment was an ointment of the antibiotic tetracycline, which was rubbed on the eyelids twice daily for six weeks. But the ointment stings and many children did not complete the treatment.

In contrast, azithromycin, developed by Pfizer to treat genital chlamydia, cures the infection in one dose and provides protection for as long as a year.

In addition to antibiotics, the trachoma initiative also provides assistance in training teams to perform corrective surgery on eyelids, improving sanitation and providing water for face washing.

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