Address by Regional Director at the Regional Expert Group Consultation - Accelerating Actions for Prevention of Blindness
13 December 2016, Hyderabad, India
Distinguished delegates, ladies and gentlemen,
Well-designed public health policies and investments drive socio-economic development.
As economic growth rates across the Region soar, and as talk of the ‘Asian century’ abounds, we must emphasize the public health gains that made this possible: advances in public health inspired higher growth rates, while higher growth rates provide the means to create ever-healthier populations.
One group that must be included in this cycle, and who has too often been left out, is those suffering visual impairment and blindness. Apart from its interference with daily activities, visual impairment jeopardizes access to education, opportunities for gainful employment and participation in civil, political and social life.
While it may be difficult to quantify visual impairment’s impact in monetary terms, its socioeconomic impact and effect on quality of life is all the more unconscionable given it is largely preventable.
Within our Region the issue is of particular concern: About one-third of the 285 million people estimated to be visually impaired worldwide are from South-East Asia. This is despite impressive success in reducing trachoma and vitamin-A deficiency-associated visual impairment and blindness.
Importantly, those with lower levels of income are most affected by the problem. Refractive errors that have not been corrected are the main cause of moderate and severe visual impairment, while cataract remains the leading cause of blindness. Both of these conditions can be solved by pursuing available cost-effective interventions like spectacles, low vision aids and surgery for cataract.
As populations across the Region age and the prevalence of noncommunicable diseases increases, this will become vitally important: If unchecked, diabetic retinopathy and age-related macular degeneration, for example, are likely to grow. Put simply, we need to act now to prevent pain later.
As outlined in the Sustainable Development Goals, the pursuit of universal health coverage provides an excellent platform to reinvigorate public health action in a range of areas. This includes promotive, preventive, curative and rehabilitative eye care services, and the provision of assistive technology for all persons at an affordable rate.
Ladies and gentlemen,
The Sixty-sixth World Health Assembly’s adoption of the global eye health action plan opened a new opportunity for Member States to accelerate their efforts to prevent visual impairment. It commits Member States to reduce the prevalence of avoidable visual impairment by 25% from the 2010 baseline by 2019. This target, though ambitious, is achievable. After all, 80% of all causes of visual impairment are either preventable or curable.
With requisite political will and coordinated action by relevant stakeholders – including ministries of health, professional bodies, and civil society organizations among others – we can achieve the targets set by the global plan and bring change to the lives of millions of people.
There are a few key interventions that can help us on our way.
First, better information on the magnitude and causes of visual impairment should be generated. Systems must be devised to monitor visual impairment prevalence, as well as the effectiveness of existing eye care and rehabilitation services. These should be integrated with national epidemiological data as part of a system-wide approach to enhancing public health.
Second, priorities should be identified and political and financial commitment secured. Amid a host of competing policy goods, ‘best buys’ to address visual impairment and blindness include enhancing cataract surgical coverage and implementing school vision care programs. Research, too, is important, and requires adequate funding, while innovative strategies to strengthen services for ‘last mile connectivity’ need to be developed.
Third, effective multisectoral engagements and partnerships should be forged. The education, finance, welfare and development sectors must be an integral part of efforts to tackle visual impairment and blindness. Partnerships with the NGO and INGO sectors should likewise be aligned with national priorities, policies and programmes, while poverty reduction and disability inclusion programmes should be integrated.
In each one of these areas, the continued and deep involvement of affected communities themselves is crucial.
Ladies and gentlemen,
I am sure these points will form much of the discussion throughout this consultation. I am also sure that by the end of it you will be able to recommend innovative and cost-effective strategies that Member States can then implement. As we all know, business as usual is not an option.
But there is one point that I really want to stress here, and that is the importance of integrating comprehensive eye care into existing health systems.
Since there are a number of proven risk factors for visual impairment – including diabetes, smoking, premature birth and rubella – health services, especially at the primary level, have a fundamental role in preventing and managing these risk factors and avoiding complications. Strengthening primary health care is the best way to make significant inroads into the burden of visual impairment and blindness. It is something we should all strive for.
I also want to note that disease control programs related to visual impairment will also help our cause. As I mentioned earlier, trachoma remains a major cause of visual impairment and blindness. It is among a number of neglected tropical diseases that WHO is working with Member States to eliminate by 2020. Within the Region, Myanmar and Nepal are already reported to have eliminated trachoma, and will undergo validation next year. That would leave India as the last country in the Region where the disease is endemic.
With strong political commitment and donor support we have the power to change this, and to give a major boost to alleviating visual impairment and blindness.
Indeed, creating a world in which nobody is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential, and where there is universal access to comprehensive eye care services, is something we have the capacity to achieve. I urge you to ensure the success of this consultation, and to lay the foundations for lasting change across our Region.
Thank you very much, and have a pleasant stay in Hyderabad.