Introduction
Why have VISION 2020: The Right to Sight?
In 1975, the first global analysis of data on blindness indicated that there were 28 million blind people, i.e. visual acuity less than 3/60 in the better eye with best correction. This figure has been increasing ever since, from 38 million in 1990 to 45 million in 2000. Projections, based on the global population increase and ageing, predict 58 million blind in 2010 and 75 million blind by 2020. Low vision - i.e. cannot see 6/18 but can see 3/60 in the better eye - is estimated to affect approximately three times as many people.
Of the 45 million blind people in 2000, approximately 60% of blindness was due to cataract and refractive errors (treatable); 15% was due to trachoma, vitamin A deficiency and onchocerciasis (preventable); another 15% was due to diabetic retinopathy and glaucoma (partly preventable, although more difficult); and the other 10% was attributable to age-related macular degeneration and other diseases (research phase).
Five conditions - cataract, refractive errors and low vision, trachoma, onchocerciasis, and vitamin A deficiency and other causes of childhood blindness - are responsible for 75% of all blindness. For each of these five conditions, effective and cost-efficient intervention strategies are available. However, shortages in human resources, training, facilities, equipment, and funds have limited the capacity of intervention strategies to reach the people that need them most.
It has been calculated that of the estimated 45 million blind people
in 2000, 1 million per year have had their sight restored through medical
intervention, and 6 million will die blind each year. An estimated 8 million
new cases of blindness (i.e. the ‘incidence’)
are added each year, a net increase of 1-2 million blind people annually.
Of all blind people, 90% live in poor communities, 60% of their blindness
is treatable and another 20% is preventable.
VISION 2020, a joint initiative by the World Health Organization (WHO)
and the International Agency for Prevention of Blindness (IAPB) and its
constituent members, provides guidance and technical and resource support
to countries that have formally adopted its agenda. At the national level,
a strong partnership between the ministry of health, national and international
organizations involved in eye care, professional organizations, and civil
society groups - brought together in a national prevention of blindness
and/or VISION 2020 committee - should facilitate the implementation of
effective and efficient eye-care services in all districts of the country.
The strategy of VISION 2020 is built upon the foundation of community participation, with three essential components:
- cost effective disease control interventions;
- human resource development (training and motivation); and
- infrastructure development (facilities, appropriate technology, consumables, funds).
If this strategy is successfully implemented, blindness due to cataract, refractive errors, trachoma, vitamin A deficiency and onchocerciasis, and some due to diabetic retinopathy and glaucoma, should be eliminated. This would mean that the projected increase in global blindness to 76 million by 2020 could be reduced to approximately 24 million.
A recent study calculated that a successful VISION 2020 programme will prevent 100 million people becoming blind by the year 2020, thereby saving US$150 billion in lost productivity. On average, this would mean that per 1 million population, 15 000 people would be spared from blindness, thereby, saving US$25 million in lost productivity.
The slide show provided in the links is an illustration of the text. These slides may be used to convince colleagues, policy-makers, and funding agencies of the need to combat blindness in a focused and coordinated way.
Documents
The
magnitude and cost of global blindness: an increasing problem that can
be alleviated - abstract
Articles
The
magnitude and cost of global blindness: an increasing problem that can
be alleviated
Slideshow
Start
slide show that goes with this text