THE RIGHT TO SIGHT 19992020 Victoria M Sheffield Vice President International Agency for the Prevention of Blindness Professor Hugh R Taylor AC Harold Mitchell Chair of Indigenous Eye Health ID: 1045315
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1. Achievements“VISION2020: THE RIGHT TO SIGHT”1999-2020Victoria M. Sheffield, Vice President International Agency for the Prevention of BlindnessProfessor Hugh R. Taylor, ACHarold Mitchell Chair of Indigenous Eye HealthMelbourne School of Population and Global HealthProf. Rupert Bourne, VLEG CoordinatorConsultant Ophthalmic Surgeon, Cambridge, UK Jude Stern, HeadKnowledge Management, IAPB
2. 45 millionCataractRefractiveErrorsTrachomaVit A DefOnchocerciasisDiabeticRetinopathyGlaucomaAMD and otherdiseases60%15%15%10%1994: Global Causes of Blindness
3. 40253038509060025507510019801990200020102020millionsWith VISION 2020Without VISION 20201996: WHO Projections with & without VISION 2020Global Blindness (millions affected, all ages)
4. Promote “A world in which nobody is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential.”“Intensify and accelerate prevention of blindness activities so as to achieve the goal of eliminating avoidable blindness by 2020.”“Focusing initially on certain diseases which are the main causes of blindness and for which proven cost effective interventions are available.”1999: Launch of VISION 2020:The Right to Sight
5. IAPB Partnership Committee, forerunner of the Council of Members, at WHO 1998
6. Goal: The elimination of avoidable blindness by 2020, in order to give all people in the world, the right to sight.1. Effective disease controlCataractTrachomaOnchocerciasisChildhood BlindnessRefractive Error and Low Vision2. Human resource development3. Infrastructure development1999 – VISION 2020: The Right to Sight
7. Technical AssistanceCapacityBuildingNational Partners - National Vision 2020 PlansSustainable program deliveryGovernment, NGOs, civil society working togetherVISION 2020: The Right to Sight
8. 28 May 2003WHA56.26 Elimination of avoidable blindness27 May 2006WHA59.25 Prevention of avoidable blindness and visual impairment21 May 2009WHA62.1 Prevention of avoidable blindness and visual impairmentMay 2013WHA66.4 Towards universal eye health: a global action plan 2014-2019Four World Health Assembly & Executive Board resolutions
9. Global Target25% reduction in avoidable visual impairment from 2010 to 2019IndicatorsPrevalence and cause of visual impairmentCataract surgery rate and coverageEye care personnel by cadreReportingTo WHA in 2017 and 20202013: WHO Global Action Plan, 65th WHA
10. Strategic objectives:Multi-sectoral engagement and effective partnerships for improved eye health strengthenedNational eye health policies, plans and programmes for enhancing universal eye health developed and/or strengthened and implemented in line with WHO’s framework for action for strengthening health systems in order to improve health outcomesEvidence generated and used to advocate increased political and financial commitment of Member States for eye healthEvidenceHealth SystemsCollaboration2014 – 2019: Universal Eye Health, Global Action Plan
11. “The adoption of the global eye health action plan by the Sixty-sixth World Health Assembly opens a new opportunity for Member States to progress with their efforts to prevent visual impairment and strengthen rehabilitation of the blind in their communities.” Dr. Oleg ChestnovAssistant Director-GeneralNoncommunicable Diseases and Mental HealthWorld Health Organizationhttp://www.who.int/blindness/actionplan/en/WHA66.4 Towards universal eye health: a global action plan 2014-20192013: WHO Global Action Plan, 65th WHA
12. * includes blindness and low vision caused by eye diseases and Refractive Error (RE)Based on a world population of 7.33 BillionGlobal Blindness Prevalence 2004-2020 DefinitionEye Disease & RE* 2004Eye Disease & RE* 2011Eye Disease & RE* 2015Eye Disease & RE* 2020BlindPresenting V/A <6/120 (20/400) or corresponding VF loss to <10 in the better eye with available correction 45 million 39 million 36 million43 millionLow VisionSevere visual impairment: presenting V/A <6/60 (20/200) but >6/120 (20/400) Moderate visual impairment: presenting V/A <6/18 (20/70) but >6/60 (20/200) 269 million 246 million 217 million295 millionTotalCombined Blind & Low Vision314 million285 million253 million338 million WHO data 2004 and 2011VLEG data 2015 and 2020
13. GlobalCataract 17 millionOther 16 million (includes trachoma & onchocerciasis)Glaucoma 4 millionURE 4 millionAMD 2 millionDR 1 million* Rounded to the nearest million
14. GlobalURE 161 millionCataract 98 millionOther 61 million (includes trachoma & onchocerciasis)AMD 8 millionGlaucoma 7 millionDR 4 million* Rounded to the nearest million
15. 3M; (75%)1M; (25%)3M; (43%)4M; (57%)6M; (77%)2M; (23%)45M; (74%)16M; (26%)157M; (98%)4M; (2%)81M; (83%)17M; (17%)50M0100M150M200MGlobal number of blind and visually impaired by causeBlind <3/60MSVI <6/18 to 3/60Presenting vision… in the better eyeGlobal
16. The world’s leading cause of blindnessVISION 2020 Partners: WHOIAPB member agenciesWorld Bank loan to India 1982 demonstrating investment in cataract surgery has enormous ROIMove to ECCE and phaco proceduresManufacture of equipment and consumables (IOLs) at affordable pricesVISION 2020: Focusing initially on certain diseases which are the main causes of blindness and for which proven cost effective interventions are available.CATARACT
17. 91%Trachoma remains a public health problem in 44 countriesHowever it is estimated that it will be eliminated in: 2020: 8 countries, 2023: 20 countries, 2025: all 44 countries2019: 142 millionCambodia*China*Gambia Ghana*Iran*IraqLaos*Mexico*Morocco*MyanmarNepal*Oman*Togo Trachoma has been eliminated in:2002: 1.3 billion2019: WHO Trachoma* Validated by WHO
18. Highly communicable, the world’s leading cause of blindness for millenniaVISION 2020 Partners: WHOIAPB member agenciesInternational Trachoma InitiativeMedication donation: Pfizer, azithromycin for mass distributionVISION 2020: Focusing initially on certain diseases which are the main causes of blindness and for which proven cost effective interventions are available.TRACHOMA2020: less than 1% of the world’s blindness
19. WHO Onchocerciasis: 2020SDG NTD Road map – Feb 2020
20. Commonly known as river blindnessParasitic disease; mainly Africa & parts of Latin America VISION 2020 Partners:WHO’s African Programme for Onchocerciasis Control (APOC) in Ouagadougou, Burkina FasoWorld Bank funding to APOC (21 major donors-mainly governments)IAPB Member AgenciesMedication donation: Merck and Company, Mectizan® Donation ProgramVISION 2020: Focusing initially on certain diseases which are the main causes of blindness and for which proven cost effective interventions are available.ONCHOCERCIASIS6 countries declared “oncho free” by WHO: Colombia 2013, Ecuador 2014, Mexico 2015, Guatemala 2016
21. ICEH Vitamin A Deficiency: 2020Twenty years of childhood blindness: what have we learnt?Vitamin A deficiency and measles“During the 1980s, it was realised that vitamin A deficiency was an important cause of child mortality and that high-dose vitamin A supplementation significantly reduced child deaths, even in communities with low levels of clinical xerophthalmia. Intermittent high-dose vitamin A supplementation is an important public health intervention and approximately 500 million doses are given annually throughout the world at a cost of approximately US $1 per dose. As a result, the prevalence of vitamin A deficiency has declined in many regions of the world.” “Measles immunisation is another large-scale public health intervention to reduce childmorbidity and mortality. Since the launch of EPI in 1974, coverage with measlesimmunisation has increased to target levels in most regions. The numbers of measlescases and measles-related deaths have declined as a consequence. Measles epidemicsare now relatively rare and measles-related corneal blindness has also declined.” Clare Gilbert Professor, International Centre for Eye Health, Medical Advisor, SightSavers, UK.Mohammed Muhit Clinical Research Fellow, International Centre for Eye Health, UK.http://www.cehjournal.org/article/twenty-years-of-childhood-blindness-what-have-we-learnt/ 1/29/2016
22. VISION 2020: Focusing initially on certain diseases which are the main causes of blindness and for which proven cost effective interventions are available.Blinding MalnutritionOnce the world’s leading cause of blindness in childrenVISION2020 Partners:WHO/UNICEF/FAONutrition & gardening partnersIAPB member agenciesInternational Vitamin A Consultative Group (IVACG)Medication donation: DSM and its predecessor F. Hoffmann-LaRoche, high dose vitamin A capsules (200,000 IU) for mass distribution
23. VISION 2020: Focusing initially on certain diseases which are the main causes of blindness and for which proven cost effective interventions are availableUNCORRECTED REFRACTIVE ERRORIncluded as cause for blindness and vision impairment in 2006Leading cause of vision impairmentSector wide strategy is a key focus of post Vision 2020 strategy
24. 2015
25. http://www.iapb.org/advocacy/sustainable-development-goals3.3 By 2030, end AIDS, Tb, malaria, NTDs and other communicable diseases.3.c Increase health financing and health workforce 3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
26. Directed at ministries of health, development agencies, civil society organizations and researchers, practitioners and policy-makers from the field of eye care.Shape the global agenda on vision.Assist Member States and their partners in their efforts to reduce the burden of eye conditions and vision loss andAchieve the UN Sustainable Development Goals (SDGs), 1,2,3,4,5,8,10,11,17, particularly SDG target 3.8 on universal health coverage.https://www.who.int/publications/i/item/world-report-on-vision2019: WHO launched World Report on VisionWorld Sight Day, October 10, 2019, WHO Geneva
27. 2019
28. 2019: World Report on Vision
29. Train more ophthalmologists is obvious, but not the whole solutionTrain eye care teams to meet community needsIntegrate comprehensive eye care into health care systemIntegrate community-level primary eye care into primary health careProvide eye care teams with:infrastructuresupport continuing professional development2019: Integrated People – Centered Eye Care
30. https://www.iapb.org/vision-atlasIAPB Vision Atlas Version 2.0 - Launched World Sight Day 20202020: Vision Atlas 2.0 launched
31. IAPB believes in a world in which no one is needlessly visually impaired, where everyone has access to the best possible standard of eye health; and where those with irreparable vision loss achieve their full potential.Key priorities:Global advocacy: Raise the profile of eye care with key international institutions to receive the attention and resources needed to achieve universal access to eye health.Connecting knowledge: Underpinning activities is IAPB’s role in providing authoritative data and information and enabling access to up-to-date knowledge, information and practice.Strengthening the network: IAPB supports active partnership building both between members and with other key sectors to tackle the barriers to delivering eye care for all.Providing services: IAPB aims to provide high quality, economically viable services which add value to members. Photos: https://www.flickr.com/people/iapb/IAPB’s network includes over 150Eye health NGOsUniversities and research centresProfessional bodiesPrivate sectorTo see the full list of IAPB members, visit www.iapb.org
32. Thank You