“Vision 2020: The right to sight”
Dr.Rajesh Babu B
MS, FMRF, MSc (CEH) ICEH,LSHTM UK
Consultant
Uveitis & Ocular Immunology
Ocular Epidemiology & Community Eye Health
Narayana Nethralaya , Bangalore
“Vision 2020: The right to sight”
• An estimated 45 million people worldwide are blind.
• Every year, an additional 1-2 million persons go blind.
• More than two-thirds of this blindness is treatable and
preventable.
• A majority of the blind live in the poorest section of the
developing world.
• Without proper interventions the number of blind will
increase to 75 million by 2020.
• Restoration of sight is one of the most cost-effective
interventions in health care.
Introduction
• The World Health Organization (WHO) and
the International Agency for the Prevention
of Blindness have developed a global
initiative for the elimination of avoidable
blindness by the year 2020; "Vision 2020: the
right to sight".
“Vision 2020: The right to sight”
Ministries
of Health
International
NGOs
IAPB,UK
Sightsavers international,UK
CBM, Germany
ORBIS,USA
OEU,Canada
Major corporate members
Established 20 years ago,
the MECTIZAN Donation
Program is the single
largest, longest standing
public/private partnership
of its kind and is widely
regarded as one of the
most successful publicprivate health
collaborations in the
world.
Under the VISION 2020
programme Carl Zeiss will
be major supporter for the
establishment of five
training centres within the
next five years. The funds
will be used for training
staff and equipping the
centre.
Seeing is Believing
programme has contributed
substantially to the global
VISION 2020 initiative,
combining awarenesscreating, volunteering as
well as millions of dollars in
fundraising support.
“Vision 2020: The right to sight”
• The name is suggestive both of the goal, the
prevention of avoidable vision loss and
blindness by the year 2020 and the notion of
good vision, 20/20 (6/6) vision as the target.
Five key areas for action
•
•
•
•
•
Cataract,
Trachoma,
Onchocerciasis,
Childhood blindness,
Refractive error and low vision.
Three strategies
Human Resource
Development
Creating a foundation
of well-trained eye-care
workers.
Infrastructure
Development
Creating adequate
eye-care facilities,
particularly in
underprivileged areas
using appropriate
technology.
Creating a foundation
of well-trained eye-care
workers.
Disease Control
Programmes
Implementing specific
programmes to control
the major causes of
blindness.
Specific activities
• Intensified surgical intervention for Cataract,
which at present accounts for half of all
blindness
• Provision of spectacles, especially for school
children.
• Prevention and treatment of nutritional
deficiencies that lead to blindness in children.
VISION 2020 APPROACH
• Groups of communities with high levels of
blindness will be identified.
• Eye-care infrastructure and manpower will be
provided to these communities-within
catchment populations of 500,000 to 1 million
people.
• Affordable high quality eye care services
would be provided using these resources.
Disease Control
Programmes
Cataract
Onchocerciasis
Trachoma
Childhood Blindness
Refractive Error
Implementing specific
programmes to control
the major causes of
blindness.
Diabetic Retinopathy
Glaucoma
Ivermectin distribution, vector control, OCP
SAFE strategy
Childhood Blindness
•To identify areas where childhood blindness from preventable disease is common and to
encourage preventive measures, for example:
(a) Measles immunization;
(b) Vitamin A supplementation;
(c) Nutrition education;
(d) Avoidance of harmful traditional practices;
(e) Monitoring of use of oxygen in newborns.
•To provide specialist training and services for the management of surgically remediable
visual loss in children from:
•(a) Congenital cataract;
•(b) Congenital glaucoma;
•(c) Corneal scar;
•(d) Retinopathy of prematurity.
Childhood Blindness
•To develop low vision services for visually handicapped children.
•To promote school screening programmes for the diagnosis and management of common
conditions, i.e.:
(a) Refractive errors, particularly myopia;
(b) trachoma (in endemic areas).
•To promote education about "How to look after your eyes" as part of the normal school
curriculum for children.
•To make sure that all children in blind schools are examined by an ophthalmologist (using
the WHO form where possible) and receive medical,surgical, optical or low vision service to
maximise potential vision.
Vitamin A deficiency.
To work closely with nutrition, immunisation and PHC systems to achieve and sustain elimination of
vitamin A deficiency.
To establish surveillance systems to identify any new cases of blinding xerophthalmia and report the
occurrence for action by child survival programmes.
Refractive Error and Low Vision
• Create awareness and demand for refractive services through
community-based services/primary eye care and school screening.
• Develop accessible refractive services for individuals identified with
significant refractive errors.
• Training in refraction and dispensing for paramedical eye workers if
ophthalmologists and/or refractionists are not available in sufficient
number.
• Ensure that optical services provide affordable spectacles for individuals
with significant refractive errors.
• Develop and make available low vision services and optical devices for all
those in need, including children in blind-school or integrated education.
• Certain low vision devices can be manufactured locally, or purchased
externally in bulk supplies to reduce costs.
• Include the provision of comprehensive low vision care as an integral part
of national programmes for the prevention of blindness, or rehabilitative
services for the visually disabled.
Infrastructure Development
Infrastructure
Development
Creating adequate
eye-care facilities,
particularly in
underprivileged areas
using appropriate
technology.
Creating a foundation
of well-trained eye-care
workers.
•Development of district-level eye care services, with
primary eye care integrated into the PHC system for a
population of between 0.5 and 2 million people.
•To provide practitioners, hospitals and clinics with
information on good-quality and affordable
appropriate technology.
•To provide appropriate donated equipment to
countries which cannot afford its purchase.
•To assist users to evaluate, select and purchase
appropriate equipment using methods which will help to
prolong its useful life.
•To introduce new technologies such as computers and
computer networks to improve management efficiency
and information exchange.
•Conduct feasibility studies on new technologies to
ensure cost-effectiveness.
Human Resource Development
Human Resource
Development
Creating a foundation
of well-trained eye-care
workers.
•Create one ophthalmologist post and facility per 250
000 population through government and/or private
•Sector with equal distribution for urban and rural
populations.
•Where there are insufficient ophthalmologists, train
OMAs and ophthalmic nurses for secondary eye
care.
•All medical graduates to be trained in basic eye
care.
•Train sufficient and appropriate staff for refraction of
underserved populations.
•Provide training in basic principles of management for
medical/paramedical staff.
•Develop manpower for equipment
maintenance/repair, low-cost spectacle production
and eye drop preparation.
Achievements
•
Thanks to VISION 2020 advocacy, all 193 WHO member states are formally committed to
investing in eye care
•
Two World Health Assembly resolutions have urged WHO member states to develop and
implement VISION 2020 national plans, and WHO to provide technical assistance
•
A WHO Action Plan for Prevention of Blindness and Visual Impairment has now been prepared
and was unanimously adopted at the 2009 World Health Assembly
•
135 countries have participated in a VISION 2020 workshop
•
107 countries have formed national VISION 2020 committees
•
91 countries have drafted national eye care plans
•
To date, 15 million fewer people are blind compared with projections made when the initiative
was launched *
The many successes of VISION 2020 have been achieved through a unique, cross-sector
collaboration, which enables public, private and philanthropic interests to work together, helping
people to see, all over the world.
•
Useful resources
•
•
•
•
•
•
•
•
•
•
http://www.vision2020.org/main.cfm
http://www.iceh.org.uk
http://www.iapb.org/
http://www.who.int/blindness/partnerships/vision2020/en/
www.v2020eresource.org
www.seeingisbelieving.org.uk
www.worldblindunion.org
www.sightsavers.org
www.cbm.org
www.icoph.org
MSc (Ocular Epidemiology & Community Eye Health)
Batch of 2008-09
ICEH, LSHTM UK