VISION 2020 Master Presentation Ppt

VISION 2020:The Right to Sight

Part One: The Need

Magnitude of Visual Impairment

(Visual Acuity <6/18)

153 Million

UncorrectedRefractive Errors

161 Million

Eye Diseases

= 314 Million

People severely visually impaired

517million uncorrected presbyopes

In addition, recent studies indicate that there are:

Refractive Error Awareness

Definition Number of People (Millions)Blind (eye disease)

<3/60-NLP37

Blind (refractive error) <3/60-NLP

8

Sub-Total Blind All Causes 45

Severe Visual Impairment (eye disease) <6/18 to 3/60

124

SVI (refractive error) <6/18 to 3/60 145

Sub-Total SVI All Causes 269

Total Blind + SVI 314

Causes of 45 million cases of blindness (<3/60)

Millions Blind

Two-thirds of blindpeople are women and girls

82% of blind people are aged 50 or above

Prevalence of blindness by age in Nigeria

National B lindness and Low Vision

S u r v e y P r o j e c t

Analysis: Causes of Blindness

45 million Blind

Cataract

Refractive Error

Trachoma

Onchocerciasis

Vitamin A Deficiency

Glaucoma

Diabetic Retinopathy

ARMD

RP

Others

Treatable

25 million

Preventable

3 million

Partly Preventable

7 million

Research

10 million

Part Two: Money

The cure and prevention of blindness contributes to the alleviation of poverty and the achievement of the 1st Millennium Development Goal

The Economics of Blindness

Frick & Foster estimate that:In the year 2000 $42billion of economic productivity was lost due to blindness and low vision;

If nothing is done this will increase to $110billion per annum by 2020;

With VISION 2020 this will only increase to $57billion per annum.

$310billion increase in productivity over twenty years if VISION 2020 is implemented

Total cost of Vision Disorders in Australia, 2004

Clear Insight 2004

Cost effectiveness of eye health programmesThe Gambian Eye Care programme succeeded in reducing Blindness by 40% over ten years. The economic rate of return was estimated to be 19%;

The Onchocerciasis Control Programme prevented 600,000 cases of blindness. It restored 25million hectares of land to productive use. It did so at an economic rate of return of 20%;

The African Programme for Onchocerciasis Control continues and is providing protection to >70m people at an economic return of 17%.

Household per Capita Expenditure ($)

Cataract Impact Study: Kuper, Polack et al 2008

0

5

10

15

20

25

30

Before surgery One year after surgery

Control Operated$ per day

Opportunities & Quality of Life

Cataract Impact Study: Kuper, Polack et al 2008

0

10

20

30

40

50

60

70

80

90

100

Before surgery One year after surgery

Control OperatedQuality of Life Score

Part Three: VISION 2020

Trends & Projections in Global Blindness

Projected Trends in Global Blindness

2000 2010 2020

Without VISION 2020

With VISION 2020

=100M fewer people with blindness

VISION 2020 Partnership

WHOVISION

2020

NGDOs

Professions

Corporations

NATIONAL

VISION 2020

BODIES

IAPB

Ministries of

Health

DISTRICT VISION 2020 SERVICE UNITS

District Level Implementation

Eye Care Team

Equipment & Supplies

Community-Patients

Service Delivery Model for VISION 2020

Advanced Tertiary

Tertiary

Secondary

Primary

80% of eye conditions can be effectively dealt with at primary health level

PrinciplesImplementing VISION 2020 at the District Level:

Integrated

Sustainable

Equitable

Excellent

Implementation Unit

I - SEE

Part Four: IAPB

International Agency for the Prevention of Blindness

Founded in 1975 it now has 108 members: International NGOs

Professional Bodies

Universities

Corporate Companies

Governed by a Board of Trustees and Council of Members

Head office in London, UK

IAPB has seven regions

N. America &The Caribbean

Latin America

Africa

Europe

EasternMed.

S. E. Asia

WestPacific

IAPB’s VISION & MISSION

VISIONA world in which no one is needlessly blind or visually impaired and where those with unavoidable vision loss can achieve their full potential.

MISSIONIAPB promotes the global initiative VISION 2020: The Right to Sight,

which aims to eliminate the main causes of avoidable blindness by the year 2020.

IAPB brings together governments and non-governmental agencies to facilitate the planning, development and implementation of sustainable national eye care programmes based on the three core strategies of disease control, human resource development and infrastructure development, incorporating the principles of primary health care.

IAPB is the partner of the World Health Organization (WHO) in VISION 2020: The Right to Sight

IAPB’s Strategic Plan 2009-12Strategic Aim:“Eye health is given greater priority within overall health policy; becomes integrated into health systems and receives increased budgetary allocations from national governments and other donors.”

Strategic Objective 1Advocating, and holding governments to account, for the implementation of the WHO Action Plan and WHA resolutions on the elimination of avoidable blindness and visual impairment; and national VISION 2020 eye care plans.

Strategic Objective 2Creating and disseminating knowledge of VISION 2020 and promoting learning from good practice in eye health programmes.

Strategic Objective 3Facilitating a collaborative approach amongst all stakeholders involved in VISION 2020.

IAPB and WHO advocacy priorities Two WHA Resolutions on avoidable blindness in 2003 and

2006 (WHA 56.26 and 59.25)

WHO Medium Term Strategic Plan 2008-13. Prevention of visual impairment is included in objective three

WHO Action Plan for the prevention of avoidable blindness & visual impairment - passed at the WHA Assembly in May 2009

IAPB and knowledge/awareness raising of VISION 2020 151 countries have participated in a national VISION

2020 planning workshop

118 countries have established a prevention of

blindness committee

104 countries have a national eye care plan

The advocacy challenge for IAPBThe Indian government recently pledged $265m towards implementing VISION 2020 between 2008-12;

The Pakistan government committed $50m for implementing VISION 2020 between 2006-10;

The Australian government has pledged an initial A$45m for work in the Western Pacific region.

BUT the major advocacy challenge going forward is IMPLEMENTATION of the national plans and holding governments to account for what they have committed to in the WHO Action Plan & resolutions.

Part Five: 10 Years of SUCCESS

Trends in Causes of Blindness 1995 -2002

0.4

1.8

1.9

0.9

4.1

5.9

0 2 4 6 8

Oncho

Corneal Scar

Trachoma

2002 1995

11 to 4 million

Trends in Causes of Blindness 1995 -2002

1.8

4.4

17.3

2

6.3

18.9

0 5 10 15 20

Diab Ret

Glaucoma

Cataract

2002 1995

Cataract , projected to rise to 25, actual = 17

CATARACT

Reduced from a projected 25m to 17.3m Low cost IOLs

Training in ECCE initially and now SICS

High volume surgery in S.E Asia region

Sustainability models

INDIA: Cataract Operations 1985-2005(Data from Aravind Eye Care System)

0.0

1.0

2.0

3.0

4.0

5.0

5% with IOL in 1993 increased to 90% in 2005

Fourfold Increase over 20 years

TRACHOMA

Blinding trachoma reduced from 5.9m to 1.9m Donation of 135m treatments of Azithromycin by Pfizer and

emergence of community distribution programmes

Training of ophthalmic nurses in surgery

Improved water, sanitation and hygiene

Trachoma “S” and “A” 2004-2007

0

20000

40000

60000

80000

100000

120000

2004 2005 2006 2007

0

5000000

10000000

15000000

20000000

25000000

30000000

2004 2005 2006 2007

Global TT surgeries 100,000

Azithromycin Treatments25 million

ONCHOCERCIASIS (River Blindness)

Blinding Onchocerciasis reduced from 0.9m to 0.4m

More than 70m people protected from the disease.

Donation of >1800m Mectizan tablets by Merck

Community Directed Distribution

Partnership between APOC, governments and NGOs

Mectizan treatments for Onchocerciasis

The success of the onchocerciasis control programme and its philosophy of community directed distribution has led to USAID, Gates Foundation, DFID, and other major donor interest in the Neglected Tropical Disease initiative

Prevalence of blindness: declining in some countries

The Gambia Survey 1986 & 1996

Blind people per million population

Overall 40% decrease in

the prevalence of

blindness

Trends in blindness

15 million fewer than projected

Acknowledgements Bruce Spivey – slides 3,4 Allen Foster – slides 5,6,10,16,17,19,20,21,22,25,33,34,36,38,40,43,44 G.V.S. Murthy – slide 9 Hugh Taylor – slide 14

References Global Magnitude of Visual Impairment Caused by Uncorrected Refractive Errors in 2004, Resnikoff S, et al, Bulletin of the World Health Organization 2008,86:63-70

Global Vision Impairment Due to Uncorrected Presbyopia, Holden BA et al. Archives of ophthalmology accepted for publication.

The Impact of VISION 2020 on Global Blindness, Foster A and Resnikoff S, Eye (2005) 0, 000-000.doi:10.1038/sj.eye.6701973

The Magnitude and Cost of Blindness: An Increasing Problem that can be Alleviated, Frick,K.D and Foster A, American Journal of Ophthalmology 2003; 135(4): 471-6

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