This study addresses a current research gap in Medicine concerning Comparative efficacy of single-dose oral azithromycin versus topical tetracycline for the treatment of active trachoma in a mass drug administration campaign in Amhara, Ethiopia in Ethiopia. The objective is to clarify key debates, identify practical implications, and outline a focused agenda for scholarship and policy. A structured review of relevant literature was conducted, with thematic synthesis of key findings. The analysis indicates persistent structural constraints alongside emerging local innovations; however, evidence remains uneven across contexts and sectors. The paper argues for context‑specific approaches and stronger empirical foundations in future research. Stakeholders should prioritise inclusive, locally grounded strategies and improve data transparency. Comparative efficacy of single-dose oral azithromycin versus topical tetracycline for the treatment of active trachoma in a mass drug administration campaign in Amhara, Ethiopia, Ethiopia, Africa, Medicine, systematic review This structured abstract provides a standardised summary to support rapid screening, indexing, and assessment of scholarly contribution.