WHO recommends MDA, as well as “F” and “E”, at the district level (which for trachoma elimination purposes WHO defines as “the normal administrative unit for health care management consisting of a population unit between 100,000–250,000 persons”) for five years where TF prevalence is ≥ 30% in 1–9 year-olds, three years where TF is 10.0–29.9%, and one year where TF is 5.0–9.9%, before reassessment of TF prevalence [3]. The gene discussed is TF; the disease is inclusion conjunctivitis.