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Skip to 0 minutes and 10 seconds The world report on vision is really important for a number of reasons. Firstly it’s the first ever world report on vision that the World Health Organisation have published and and I think that recognises, firstly how serious is the WHO is now taking vision and the significance of the issue but it’s also important because of what it says. So it’s the first time that we’ve got together the full scope and magnitude of the issue and it draws out very clearly that vision is a universal issue. Everybody at some time in their life will experience an eye condition or a vision issue and that comes through very clearly in the report and the scale and magnitude comes through.

Skip to 0 minutes and 52 seconds And from that the urgency of tackling the issue. But the world report on vision also sets out the strategic framework for tackling the problem and it sets out the framework for action at country, at global and at regional level and what it shows is that the scale and magnitude of the issue is enormous. It sets out that at least 2.2 billion people worldwide have a vision impairment and of those 2.2 billion, 1 billion of those 2.2 billion people that vision impairment could have been prevented or is yet to be addressed. That’s an enormous scale that it shows.

Skip to 1 minute and 30 seconds But within that of course it shows that the burden of vision impairment isn’t shared equally; the people in, in rural areas, people on lower income, women, people from ethnic minorities and from indigenous populations, older people, people with disabilities are all much more likely to have a vision impairment and the World Report on vision sets out that the burden of vision impairment is at least four times higher in low and middle income countries than in higher income countries. And it’s not just, it’s not just a healthcare issue it cuts across many of the sustainable development goals. It cuts across improved productivity and the economy, improved education, gender equality and the ability to participate in daily life.

Skip to 2 minutes and 19 seconds We haven’t got enough research that underpins that but, but the research we have shows that…. that for example study last, that was published last year showed that productivity in tea workers in India increased by between 20 and 30 percent, when they had access to proper eye care services and access to glasses. In children it’s thought that eye care is probably the single most cost effective health care intervention for education and that giving, giving children again access to proper eye care and access to properly prescribed glasses can have the equivalent of the impact of an extra half years education for them.

Skip to 3 minutes and 0 seconds In road traffic accidents it’s estimated that people with a vision impairment are 30 percent more likely to be involved in in road traffic accidents. So what that shows is that eye care really cuts across many of the sustainable development goals. Having access to proper eye care can reduce poverty, can give access to good quality work, good quality education, can improve gender equality. In many respects it’s a kind of golden thread that runs through all the sustainable development goals. So the problem isn’t simply…

Skip to 3 minutes and 28 seconds isn’t that we don’t know what to do The problem is we haven’t yet got the will and we haven’t yet managed to integrate eye care into mainstream services So the World Report on Vision sets out five high-level recommendations for how to do this. recommendations for how to do this. Firstly eye care needs to be integrated and be a core part of universal health coverage. Secondly it recommends that it needs to be implemented as integrated people-centered eye care as part of health systems.

Skip to 4 minutes and 1 second Thirdly, they recommend promoting high quality research into eye, into eye care Fourthly, obviously this needs to be monitored and evaluated and, finally, communities need to be empowered so that they are actually involved in the delivery of eye care services. Of course critically, universal health coverage is not universal if it does not include eye care, and we will only get lasting and sustainable change when eye care is properly integrated as part of a universal health coverage. And that needs to start at a national level with the plans and strategies.

Skip to 4 minutes and 40 seconds At the UN launch of the world’s report on vision, the World Health Organisation representative told us that of the 194 national health plans and strategies that are lodged with the World Health Organisation, precisely three mentioned eye health and eye care. So that means that there are a 191 countries who do not mention eye care or eye health as part of their national health plan or national health strategy. And at the core of what the world report on vision is is saying about how eye care can be implemented as part of a country’s health system is integrated people-centred eye care.

Skip to 5 minutes and 19 seconds And that means that eye care needs to be part of the full continuum of health services, a promotion prevention, treatment and rehabilitation level. And so that means that eye care needs to be integrated as part of primary care services, at secondary care and at specialist level and that there need to be referral pathways between between all those levels, and the eye care needs to be implemented in people’s homes and in communities as well. So I think this is a critical moment for eye health On its own the World Report on Vision won’t be enough we need to use it to persuade governments of the critical importance of eye care and of the scale and the magnitude of the problem.

Skip to 6 minutes and 3 seconds It obviously marks the end of Vision 2020 and it’s important that we recognise the successes and achievements that we’ve had. But it’s also an opportunity to really set a new agenda for the new decade, and the world report on vision really gives us that opportunity. And the World Health Organisation has already identified two eye care indicators as part of its package of 30 indicators for universal health coverage, those two indicators are effective coverage of cataracts, surgery and effective coverage of uncorrected refractive error services. So what it’s proposing is that those are two of the 30 core indicators that the World Health Organisation has to measure the implementation of universal health coverage across the board.

The World Report on Vision and IAPB

In this video, Peter Holland, chief executive of the International Agency for the Prevention of Blindness (IAPB), explains why the World Report on Vision provides a direction for the next decade through a framework for action. The approach aims to strengthen health systems by integrating eye care and building a strong foundation for service delivery that addresses population needs.

The World Report states clearly:

  • That globally, at least 2.2 billion people have a vision impairment or blindness. Of these, at least 1 billion have a vision impairment that could have been prevented or has yet to be addressed.
  • The need tends to be greatest in low- and middle-income countries and underserved populations, such as women, migrants, indigenous peoples, people with certain kinds of disability, and in rural communities.
  • Population growth and ageing, along with behavioural and lifestyle changes and urbanisation, will dramatically increase the number of people with eye conditions, vision impairment and blindness in the coming decades.

IAPB and its many partners around the world have made major strides to address avoidable blindness. Successes have included global advocacy, resolutions and actions plans at a national level.
This progress must now accelerate to keep pace with the increasing need and, to help achieve this, the ‘World Report’ sets out five key recommendations:

  1. Make eye care an integral part of universal health coverage.
  2. Implement integrated people-centred eye care in health systems.
  3. Promote high-quality implementation and health systems research, which complements the existing evidence for effective eye care interventions.
  4. Monitor trends and evaluate progress towards implementing integrated people-centred eye care.
  5. Raise awareness, engage and empower people and communities about eye care needs.

To achieve better integration of eye care into health systems, and reduce inequalities by delivering quality eye services that meet a population’s needs, requires political will, directed scientific evidence and planning. It also needs the building of an appropriate eye care workforce that can provide the necessary coordination and continuity of care.

Key activities following on from the World Report include:

  1. 40 different launches of the report at country and regional level.
  2. Advocacy activities from the UN Friends of Vision Group
  3. Commonwealth leaders will convene under the overarching theme ‘Delivering a Common Future: Connecting, Innovating, Transforming’ at the Commonwealth Heads of Government Meeting in Rwanda.
  4. The IAPB 2020 General Assembly in Singapore

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Global Blindness: Planning and Managing Eye Care Services

London School of Hygiene & Tropical Medicine