A GROWING GLOBAL CHALLENGE

Over 2 billion people are living with poor vision and, for over 1 billion of these people, this sight loss could have been avoided or treated. This represents a significant and rapidly growing public health challenge. Importantly, it is a challenge that can be effectively addressed as over 90% of vision impairment cases are preventable or treatable through low-cost interventions such as spectacle provision and cataract surgery.

AN ECONOMIC OPPORTUNITY

Good vision is fundamentally connected to both educational attainment and access to employment. Currently, unaddressed vision impairment is estimated to result in an annual global productivity loss of approximately USD 411 billion. In addition, an estimated 6.3 million years of schooling are lost each year, with potential future economic productivity losses projected at USD 173 billion annually. Addressing this issue presents a clear opportunity to unlock substantial productivity gains at both national and global levels.

A WHOLE OF LIFE ISSUE

Almost everyone will be affected by an eye health or vision problem in their life. It is a whole-of-life issue that requires a proactive, coordinated and integrated whole-of-government response. Proven, cost-effective policy solutions are already available to support the prevention, treatment, and rehabilitation of eye conditions and vision impairment across all stages of life.

Infancy and Pre-School: 0 - 5 years old
Good eye health is critical for newborns and toddlers as they use their vision to learn and understand the world around them. It is often key to healthy development and, if recognized late, left undetected or untreated, vision problems can lead to delayed developmental milestones and even permanent sight loss.

Childhood and Adolescence: 5–19 years old
Uncorrected refractive error is the leading cause of vision impairment in school-aged children and teenagers with rates rising due to increased and excessive screen time, close work in education, poor lighting and reduced time spent outdoors. In 2020, 60% of children in Asia and 40% of children in Europe had myopia (nearsightedness)1 with more than half of the world’s population expected to be affected by 20502. Awareness-raising on the importance of eye health and changes to protect vision in school settings is a sound investment as early interventions have the potential to minimise the growing and future burden of myopia. School-based eye health programmes also offer an effective model to deliver eye care and an efficient use of time and resources.

Adulthood: 20 - 65 years old
Poor vision can increase workplace injuries, reduce productivity and lead to economic losses. People with visual impairments experience a 30% decrease in employment, increasing the health and social care burden on the state and having a negative impact not only on those directly affected but also on the global economy.3 Preventive care, regular eye screenings and vision tests can keep older adults in work and support them to continue to be active, healthy, productive members of society. There is also an important connection between eye health and non-communicable diseases (NCDs). Recent studies have shown that people with vision loss or eye health conditions are more likely to have other NCDs than people with good vision, and several of the most prevalent NCDs, including diabetes, hypertension, and coronary artery disease, can lead to eye health conditions if not addressed in a timely manner, and vice-versa.⁴

Older adults: 65+ years old
Vision loss in the elderly and age-related conditions is also linked to increased mortality, co-morbid conditions, cognitive decline, falls, social isolation and limited self-care. And the prevalence of vision impairment is only set to grow, particularly due to ageing populations globally. Cataract remains the leading cause of blindness and a major cause of visual loss across the globe. This is despite the fact that cataracts are easily treated, and surgery is considered as a cost-effective intervention that can increase household income and expenditure and therefore support the wider economy. Whole of life There are interventions that are important for eye health and vision that cut across every stage of life and it is important to recognise and address that there are demographic factors, particularly gender, which will dictate eye health outcomes for individuals. For example, there are more women than men with sight loss in every category of vision impairment, and women are also less likely to have the means or information to access services and treatment. And while addressing avoidable vision loss is rightly a global priority, ensuring the full and equal inclusion of people with unavoidable visual impairment is equally important to ensure no-one is left behind.

GLOBAL COMMITMENTS

Through the 2021 United Nations General Assembly’s Resolution on Vision, as well as other political declarations and commitments over the last decade, there is already agreement that eye health is a critical economic and development issue and integral to achieving Universal Health Coverage and the Sustainable Development Goals.

POLICY REQUIREMENTS

There now needs to be collective and urgent action to implement the already agreed practical steps that will bring these commitments to life. These include:

1. INTEGRATION - Integrate eye health into broader health systems including school health and beyond, and improve access to screenings, services, rehabilitation, equipment and technology.
2. FINANCING - Prioritise sustainable financing for eye health including domestic resourcing, public-private partnerships and support from international financial institutions and donors.
3. MONITORING – Support the tracking of progress against national and global eye health targets through strengthened national monitoring mechanisms.
4. REGULATION – Create the optimum regulatory environment, through tax changes, regulatory reform, standards and practices for example removing regulatory barriers for access to spectacles, enabling innovation and scale in the public and private sectors.
5. WORKFORCE – Increase access to quality eye health services through the recruitment, training, distribution and retention of eye health workers as well as investing in technological advances to expand access.
6. PARTNERSHIP - Partner with the private sector, civil society and academia to promote eye health and deliver services which are aligned with national government plans and policies.
7. INCLUSION - Ensuring equity between population groups in access to services, and including persons with visual impairments in policymaking.

Together, these steps will help ensure there is universal access to eye care as a fundamental aspect of well-being, productivity and prosperity, and that those with unavoidable blindness are empowered to participate in and contribute to society.