VISION 2020 – 2,020 days to go!
By Professor Allen Foster, Professor of International Eye Health, Co-Director of the International Centre for Eye Health for London School of Hygiene and Tropical Medicine and former President of CBM International.
The World Health Organisation in 2010 estimated that there are 39 million blind people in the world, but in 80% of these cases the blindness can be prevented or treated. In the year 2000 the WHO together with a group of International Non-Government Organisations, including CBM, launched “VISION 2020 – the right to sight”, a 20 year initiative to eliminate avoidable blindness in the world. So what are the results?
There have been good successes, in fact in 2000 the projected number of blind people in the world for 2010 was well over 50 million, so the actual 2010 figure of 39 million has to be seen as an improvement. There have been good results to control diseases like river blindness (onchocerciasis), vitamin A deficiency (in children) and trachoma, all of which were major causes of blindness in poor countries. There have also been improvements in the delivery of eye care services generally around the world, but particularly in the middle income countries of Asia and Latin America. However the fact remains that about half of all blindness, around 20 million people, is due to cataract which is very treatable.
Cataract occurs when the clear lens in the eye opacifies, becoming like a frosted window. There are a variety of causes, but most cataract is associated with the aging process – the older we get the more likely we are to develop cataracts.
The good news is that the cataract can be removed and its function to focus light on the retina can be replaced by a small artificial lens placed inside the eye (intra-ocular lens) at the time of surgery. The operation is safe and has a very high success rate so that most people have excellent restoration of sight providing the eye has no other problems.
So if the operation is so good why are there 20 million people around the world blind with cataract? The main reason is poverty. Many low income countries do not have enough trained eye specialists. For example in the UK there are about 20 eye specialists for every million people while most African countries have only 1 to 3 eye specialists per million people; and those that are available, for family reasons, tend to work in larger cities which is often far away from poor people living in rural areas.
In order to make cataract surgery available to blind people CBM has been supporting the training of ophthalmologists, cataract surgeons, eye assistants and nurses throughout Africa for many years. A lot has already been achieved; for example in Tanzania there used to be 5 ophthalmologists when CBM started to support eye training and now there are 35 together with over 60 trained cataract surgeons and more than 300 eye nurses / assistants; however there is much more to be done if the goal of VISION 2020 to eliminate avoidable blindness by 2020 is achieved.
It is estimated that Africa needs another 2,000 eye specialists (to achieve 4 specialists per million population) by 2020, but at present less than 100 are being trained each year. Without the eye surgeons, people will not be able to receive cataract surgery and the problem of blindness from cataract will continue. CBM in partnership with other like-minded organisations and Ministries of Health in Africa is seeking to address this urgent health need to train eye health workers for low income countries particularly in Africa.
Professor Dr. Allen Foster, former CBM International President (2006-13) and Medical Consultant/Director (1985-2005), is Professor in International Eye Health and Co-Director of the International Centre for Eye Health at the London School of Hygiene and Tropical Medicine. From 1975-1985, Allen was a general medical officer in a mission hospital in Tanzania. In 1998 he received an O.B.E. (Order of the British Empire) ‘For services to Ophthalmology in the developing world’.