Three-quarters of all blindness can be prevented or treated. Avoidable blindness poses an enormous challenge to healthcare system, particularly in low- and middle- income countries. There are nine million people in Africa alone with preventable blindness, out of which 50-75% people are blind due to cataract and 5% due to glaucoma, says Keerti Bhusan Pradhan (Right To Sight) who is heading to Ireland to present his work in Africa at the Irish Forum for Global Health (IFGH) biennial conference next week (29-30 November 2010).
Although blindness in 50-75% people is attributed to cataract, the health response has been appalling. According to the World Health Organization (WHO), cataract surgery is one of the most cost-effective treatments that can be offered in developing countries. It can allow people to increase their economic productivity by up to 1500% of the cost of the surgery during the first post-operative year.
According to WHO, about 314 million people are visually impaired worldwide, 45 million of them are blind. Most people with visual impairment are older, and females are more at risk at every age, in every part of the world. About 87% of the world's visually impaired live in developing countries.
The leading causes of chronic blindness include cataract, glaucoma, age-related macular degeneration, corneal opacities, diabetic retinopathy, trachoma, and eye conditions in children (including those caused by vitamin A deficiency). Age-related blindness is increasing throughout the world, as is blindness due to uncontrolled diabetes. Three-quarters of all blindness can be prevented or treated.
Keerti represents the Right To Sight (RTS) which is dedicated to eradicate preventable blindness through the use of proven techniques in cost recovery, training and surgical practice. One of the major landmarks of Keerti is his contribution to improving eye care and preventing avoidable blindness in India as well as many countries in Africa.
Investing in preventing avoidable blindness is not only a public health imperative but also a smart investment as it saves costs for countries and donors, says Keerti. According to a research done by Frick and Foster, the estimated cost of global blindness and low vision was USD 42 billion in 2000. Without a decrease in the prevalence of blindness and low vision, it was projected that the total annual costs would rise to USD 110 billion by 2020. However, if avoidable blindness is eliminated, this projected cost will be reduced to only USD 57 billion in 2020, says Keerti.
There are many challenges to initiatives that aim to eliminate avoidable blindness and two major ones are inconsistent quality of care and shortage of healthcare workers in Africa, says Keerti.
One of the novel approaches Right To Sight brings in is using private public partnership (PPP) to engage private sector in public health. Most of the healthcare in sub-Saharan Africa is in public sector and Keerti envisions a growing role of private sector in meeting public health needs in the region. According to a research study, USD 20 billion of additional investment is needed for healthcare in private sector to improve health outcomes in Africa.
Keerti believes that operational ownership of eye hospitals by the private sector partners is vital. Right To Sight, a non-profit, works in partnership with Shalina Laboratories which is a pharmaceutical company in Democratic Republic of Congo (DRC). Shalina plans to expand Right To Sight's PPP model of eye care delivery to 18 African countries with six centres planned in DRC in phases.
This pilot would provide road map for many private partnerships to have eye care services in Africa leading towards the goal of eliminating avoidable blindness by 2020 says Keerti.
Preventing avoidable blindness mandates a stronger response at all levels and from all stakeholders. Let's hope that the forthcoming biennial conference of Irish Forum for Global Health (IFGH) next week will be a game changer for evoking the warranted response to eliminate avoidable blindness. (CNS)
(The author is the CNS Policy Adviser and a World Health Organization (WHO) Director-General’s WNTD Awardee 2008. He writes extensively on health and development for Citizen News Service (CNS). Email: firstname.lastname@example.org, website: www.citizen-news.org )