The Lancet Global Health Commission
Our guest blogger this week is Professor Matthew Burton, co-chair of Lancet Global Health Commission on Global Eye Health. He is the Director of the International Centre for Eye Health (ICEH) at the London School of Hygiene & Tropical Medicine (LSHTM). He holds a Wellcome Trust Senior Research Fellowship and leads a large international research group of clinicians and scientists, working to improve eye health in low and middle-income countries.
He has also recently agreed to chair the Vision Catalyst Funds Programme Expert Committee, which launches next month.
2021 is a pivotal year for eye health.
It marks the culmination of the global initiative, “VISION 2020: The Right to Sight”, which, alongside several World Health Assembly resolutions and World Health Organization (WHO) Action Plans, provided the framework over the last two decades for national programmes to address eye health.
Following this, in 2019, WHO published the World Report on Vision, and its key strategies were endorsed by the World Health Assembly in 2020. The report called for the advancing of eye health as an integral part of Universal Health Coverage, through the implementation of “Integrated People-Centred Eye Care”.
This February sees the publication of The Lancet Global Health Commission on Global Eye Health. The Commission is the work of an interdisciplinary group of 73 academics and national programme leaders and practitioners from 25 countries. Building on the World Report on Vision, the Commission analysed all aspects of eye health in 2020 and beyond.
By looking at global development, economics, healthcare systems, equity and the workforce, the Commission argues that improving eye health is essential to achieving the United Nations Sustainable Development Goals and provides recommendations to improve lives and livelihoods for all.
In 2020, 1.1 billion people were living with untreated impaired vision, and hundreds of millions more are receiving ongoing care for diagnosed conditions. Furthermore, 90% live in low- and middle-income countries (LMICs), with the greatest proportion occurring in Asia and sub-Saharan Africa.
Analyses indicate that a large economic cost due to this magnitude of impaired vision. The report estimates that blindness and moderate-to-severe vision loss cost the world US$411 billion in 2020, with east Asia (US$90 billion) and South Asia (US$70 billion) experiencing the greatest magnitude.
This is despite the fact that there are existing, highly cost-effective treatments for the vast majority of eye health conditions. In fact, over 90% of people living with vision loss have could be treated either with cataract surgery or simply receiving spectacles. Both interventions are shown in the report to be highly cost-effective in many settings, particularly LMICs.
Sarah Day, Clearly, Tea Pickers Co-Op in Assam
New thinking is needed to increase investment in eye health and ensure that it reaches appropriate initiatives, delivering services that include promotion, prevention, treatment, and rehabilitation. As financial barriers to accessing eye care leave many people behind, eye health needs to be included in national health financing to pool the risk.
Public-private partnerships can provide promising tools to improve eye health, especially for specific areas such as increasing spectacle coverage. These partnerships can ensure a safety net for those who are unable to afford private sector services.
Funding for technological developments such as telemedicine, mHealth, and artificial intelligence also offers the potential to revolutionise eye health care in the next decade by delivering affordable, high-quality services to remote areas.
Urgent investment is needed to build on the strong foundation laid by VISION 2020. The world has a unique opportunity to start rapidly improve lives and livelihoods by putting eye care in its rightful place on the global public health agenda.
For more information on the report and resources please visit www.globaleyehealthcommission.org