The antibiotic Azithromycin, sold on the U.S. as Zithromax or Z-Pak, is one of the most widely used antibiotics in the world. Despite some legal troubles in the U.S. over serious Zithromax side effects like heart attacks and skin reactions, the drug is still a popular choice for many health organizations due it its efficacy.

One of those Zithromax uses is for the treatment of Trachoma.

Established in 1948, the World Health Organization (WHO) is a specialized agency of the United Nations (UN) that is concerned with international public health. They are responsible for providing leadership on global health matters. One such matter is Trachoma, a painful and infectious eye disease that causes blindness, and is prevalent in Africa.

The WHO hopes to eliminate the disease by 2020. The goal is to find the disease, then eliminate trachoma using WHO’s SAFE strategy as a guide. SAFE stands for Surgery, Antibiotics, Facial cleansing, and Environmental Change. Pfizer has donated Zithromax to be the “A” for the program.

Funded by the UK government, a consortium of NGOs and academics led by Sightsavers, the International Trachoma Initiative (ITI), and the London School of Hygiene & Tropical Medicine are working to globally map Trachoma by March 2015. The project, known as the Global Trachoma Mapping Project (GTMP), was started in 2012. It is reaching its second anniversary with most of the initial scope of work completed.

With trachoma, an individual’s eyelashes turn in and rub on the cornea, eventually leading to scarring and blindness. According to Africa Science News, “prior to the GTMP, it was known that over 110 million people lived in confirmed trachoma-endemic areas in some of the world’s poorest countries, and another 210 million people lived in areas where insufficient data had been gathered, but where there were strong indications that trachoma was present hence the urgent need to complete the mapping.”

The project uses trained eye health workers with a smartphone. Survey teams “visit and examine people living in a sample of communities within pre-identified districts and capture data on the presence of the disease.” The data is then used to update the Trachoma Atlas – an ITI tracking tool. Collected data is helping ministries of health plan their trachoma intervention programs, including guiding their requests for Zithromax.

Zithromax Use Around the World

In the states, Azithromycin, sold as Zithromax or “Z-Pak,” is prescribed to treat bacterial infections such as bronchitis, pneumonia, or ear infections. It’s used globally, but its largest market is in the U.S.; often the supply abroad is insufficient.

Internationally, the need of antibiotics is huge and growing, like in the case of trachoma. However, with demand overshadowing supply, the counterfeit drug market is growing, and their product is spurring a world of new issues. It is one that keeps the World Health Organization busy.

The WHO is running an investigative program examining 80 countries and the counterfeit drug market. The findings show that fake antibiotics are a growing international problem. With a rapidly growing industry filled with subpar phony medications, superbugs are becoming a more prevalent issue. This threat is drawing a strong response from pharmaceutical companies. Pfizer Inc., for example, is working with Microsoft to stop the online fake drug trade. Zithromax, their best-selling drug, earns the company close to $400 million annually; maintaining its purity and reputation is of utmost importance for its market share.

But in the U.S., Zithromax’s reputation is already tarnished. Pfizer’s Z-Pak has been connected to heart attacks and it’s alleged the antibiotic is especially risky for those with existing heart issues. Z-Pak side effects have also been linked to Stevens Johnson Syndrome, a rare but serious drug reaction that causes skin blister and lesions to form on the patient’s skin, eyes, mouth, and/or genitals.

The company has already been hit with dozens of Zithromax lawsuits filed by with Z-Pak side effect victims who say that there were insufficient warnings about the Z-Pak complications to the public and on the label.