Countries, partners, and donors are committed to the global elimination of blinding trachoma by 2020. Achieving this public health milestone requires more than funding; it requires health personnel with the right mix of skills, and well supported and managed health systems. Mass drug administration (MDA) with Zithromax®, the Pfizer, Inc. donated antibiotic, is a key component of the SAFE strategy, endorsed by the World Health Organization. There is growing recognition that improving all aspects of MDA, from planning to training, recording to reporting, and receipt of drug to distribution (the supply chain), will be necessary if MDA programmes are going to reduce the community burden of Chlamydia trachomatis, and eliminate trachoma as a cause of blindness by 2020.