Uncorrected Refractive Error (URE) is clearly linked to poverty, yet while the solutions are available to correct vision impairment, the required funding is not forthcoming. Delegates at the World Congress on Refractive Error 2010 in Durban, South Africa called for universal commitment to find a solution to this devastating problem that affects more than 670 million people.
Ever since it was founded in Australia in 1988, the International Centre for Eyecare Education (ICEE) has developed and implemented sustainable solutions for improved eye care access.
ICEE collaborates with governments, communities and international non-government organisations to develop long term solutions by investing in local eye care education, professional education, appropriate service delivery systems and research in underserved communities.
It is estimated that in 2005, 1.04 billion people could not see well enough to read this story without the aid of a pair of glasses. The sad reality is that over half of the 1.04 billion do not have access to an eye examination or spectacles.
It impacts on employment opportunities, families and societies and begs the question; just how much is lost in economic productivity due to vision impairment?
Such unnecessary vision impairment is creating disability and a poverty-inducing health crisis worldwide. It impacts on employment opportunities, families and societies and begs the question; just how much is lost in economic productivity due to vision impairment?
A Staggering Economic Impact
ICEE investigated this question and under the leadership of Johns Hopkins University researchers, Tassie Smith and Kevin Frick, published in the Bulletin of the World Health Organization (Bulletin of WHO) in June 2009, an estimate that the global economy loses AUD$269 billion in productivity annually due to vision impairment. Perhaps even more sobering is that the staggering economic impact does not include the cost, in lost productivity, of 517 million people who need vision correction because of uncorrected presbyopia.
The good news, however, reported in the Bulletin of WHO, is that the estimated cost of vision correction for the158 million people with simple distance vision impairment tallies at less than the loss in productivity. Based on US costs, spectacles for those would be AUD$26 billion over three years – around one tenth of the annual cost of lost productivity. Professor Brien Holden, CEO of ICEE explained, “We have understood for some time that vision impairment has a direct link to poverty. This study, led by Smith and Frick’s rigorous financial modelling, and based on ICEE researchers’ field knowledge, adds further weight to the need to act urgently; to commit to providing the financial support to address the issue.”
Professor Holden added, “The Western Pacific region, which includes China and Vietnam, has the highest estimated number of cases of URE at 62 million, and is responsible for almost half the potential loss of productivity.”
“The South East Asia region, encompassing Bangladesh, India and Nepal, has 48.7 million cases. Apart from the moral obligation, this research indicates that there is a tremendous loss of human potential with avoidable blindness and impaired vision due to URE. Failing to act to eliminate the issue not only severely impacts on the lives of individuals, families and communities, but also creates a significant economic burden on the global economy,” he concluded.
Findings from the collaborative study offered a range of possible productivity gains using different assumptions. The global productivity gain is greatest – AUD$428 billion – when it is assumed that people in unpaid roles, such as home duties and subsistence farming, also make a measurable contribution to the world economy.
Improving the quality of life for those significantly affected by URE has become a preoccupation for ICEE. According to Professor Holden, people living with uncorrected vision impairment are more likely to be excluded from education, suffer from depression and have fewer employment opportunities.
Papua New Guinea
ICEE research, in partnership with the Brien Holden Vision Institute and Papua New Guinea (PNG) Eyecare, is currently investigating PNG community perceptions about the need for vision services, barriers to accessing care and the impact of vision impairment on a person’s ability to provide for themselves and their families.
Professor Holden told the story of a woman ICEE staff encountered in a remote area of the Eastern Highlands of PNG who was experiencing unnecessary vision impairment. “For someone like Rebecca, recognising faces in the distance wasn’t possible because of her vision impairment,” he said.
“Because of local customs the people of her community would often be angry with her for not acknowledging them, which isolated her and created difficulties in her daily life. It’s stories like this that are a reminder that the work we do is simple – eye examinations and glasses can change lives and communities.”
Global Programmes Director for ICEE, Professor Kovin Naidoo, has been internationally recognised for his commitment to eye care in underserved communities and, more recently, his social entrepreneurship. To Professor Naidoo, the challenge for all of us is staying focused on finding sustainable, long term solutions that bring access to areas like the Eastern Highlands of PNG.
A Long Road
“We acknowledge that the road to providing the necessary eye care to significantly reduce the number affected by URE, and in turn the productivity loss, is a long one,” he said.
“Planning and true collaborations, like the Avoidable Blindness Initiative of the Australian Government, which is currently rolling out in Asia Pacific through partners of the Vision 2020 Australia Global Consortium, is critical. To be successful in any region you need the involvement of governments and their health care systems, the eye care industry, local communities and authorities, as well as individuals. It’s a multi-level approach that creates sustainability.”
The Durban Commitment
ICEE recently hosted the World Congress on Refractive Error 2010, in Durban, South Africa. At the congress ICEE continued its promotion of the need for a global commitment to the reduction of URE. This time, through the congress theme, ICEE formally linked URE to poverty, addressing its impact on global development. The congress attracted eye care professionals, researchers, government representatives and industry from all over the world.
Addressing delegates at the opening panel discussion, Dr. Kumi Naidoo, Executive Director of Greenpeace International, lost no time passionately highlighting the need for universal commitment to the eradication of URE. “If governments could find, virtually overnight, not millions, not billions, but trillions of dollars to bail out the banks, the bankers and the bonuses, why can’t they find the fraction of money to, for example, ensure that we can prevent blindness when we have the knowledge to do it?” he asked the congress.
He added: “History teaches us that change takes place and we move forward when decent men and women say enough is enough and when things are far too serious for us to have a business-as-usual approach. Whether its alleviation of poverty or blindness and vision impairment the best thing we can do is to commit to a lifetime of involvement and to achieving the goal.”
Adding to Dr. Naidoo’s appeal for global commitment, Ms Lalita Ramdas, activist and former President of the International Council for Adult Education, described the link between avoidable vision impairment and poverty as well-established. This draws attention to the fact that the disability has a major impact on people’s lives, creating profound economic disadvantage, affecting education and employment opportunities and creating social isolation. She told the audience, “It is still a sad fact that the numbers of those suffering from malnutrition, poverty, literacy issues and, of course, the need for eye care, are increasing.” She added, “We must get our priorities right. We need greater awareness and partnerships to bring this solution together.”
To read more about The Durban Commitment 2010 – Vision Health and Development; Enhancing our Commitment to the Durban Declaration on Refractive Error go to www.icee.org