The Sustainability Network Project
Center for Innovation in Eye Care
Seva Foundation
The first phase of the Sustainability Network Project includes activities proposed
for the Global Philanthropy Forum Social Entrepreneur Marketplace award.
BACKGROUND: The Center for Innovation in Eye Care is a global action network of eye
health organizations and affiliated professionals who seek to reduce avoidable blindness through
sustainable programs. The Center is positioned to target strategic issues vital to the success of
the World Health Organization campaign: Vision 2020 – The Right to Sight. Collaborations
among a wide range of international service providers, research and training institutions, and
donors will create breakthroughs required to rapidly expand and sustain service programs.
THE PROJECT: The Sustainability Network Project takes on the entrepreneurial challenge of
shifting the orientation of international service program donors from service development to
sustainability development. A unique phenomenon in developing country eye care is the capacity
for programs to become financially self-supporting. Numerous programs already demonstrate
that the social mission of community eye care can be fulfilled within a sustainable system. A
leading goal of the Center is to help successful, sustainable programs adapt and export these
systems to programs that need them. The result will be more resilient quality services for
communities that today are underserved.
CHALLENGES: Today’s growing efforts to expand eye services lack a vital component:
integral planning for long term sustainability. Robust programs require strong quality services,
management systems, leadership, social mission, and financial viability. The focus of the
Sustainability Project is to strengthen all of these features, with a focus on financial sustainability.
This requires a significant change in how service programs and their financial supporters plan
and act. Therefore, the Project itself will involve many of the international organizations and
local programs that prioritize sustainability as a goal.
STRATEGY:
 Create the Sustainability Network to catalyze refinement of sustainability models,
promote of transfer strategies to new settings, and popularize sustainability-building
practices within eye care programs.
 Adapt and export successful models to fast-track service expansion and sustainability.
 Strengthen current regional resource and training enters and create new Centers to
conduct training, technical support, and operations research required for robust service
delivery programs.
 Make strategic grants and loans, coupled with sustainability planning, to local service
programs to rapidly step-up services within a sustainable framework.
 Utilize technological developments in communication and web, eg. tele-conferencing,
for training and information transfer across programs.
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Leverage international eye care organizations, academic centers, and professional
societies in contributing funds, human resources, and other inputs to promote
sustainability.
MAJOR ACTIVITIES:
I. Establish Sustainability Network for International Eye Care
The first members of the Sustainability Network will be eye care programs in India, Nepal,
Tanzania, and Egypt which have demonstrated effectiveness at delivering quality services on a
sustainable basis. Some have achieved a high degree of financial sustainability through systems
which can be transferred and adapted to other private and public institutions. The Sustainability
Network addresses all aspects of program sustainability and growth including leadership, vision,
local clinical and management staffing, fixed and recurrent needs, and financial sustainability.
Participating institutions and other participants will rapidly identify common elements of their
working models and strengthen the models in order to transfer them to other eye care institutions.
Many regions of the world have no background in sustainability planning. This Network will
improve access to these principles and strategies. The Network will rely heavily on web-based
communications and well as on joint projects that will require cross-program travel and
collaboration.
II. Expand Regional Capacity-Building Centers:
Each organization participating in the network has initiated, or is developing, a capacity-building
training center. Each of these centers need increased resources to enable them to work with large
numbers of eye hospitals in their region and to continuously improve training and consultation.
Overtime, more eye care programs and institutions will join the network.
This phase of the Sustainability Network Project will:
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Strengthen and initiate training/consulting programs
Fund training fellowships for faculty and other participants
Strengthen sustainability model development and fund consulting services
Lions Aravind Institute for Community Ophthalmology, India: The Aravind Eye Care
System’s Lions Aravind Institute for Community Ophthalmology, India is the central resource
and driver of these regional center activities. Building upon 30 years of experience, Aravind Eye
Care System is the world’s highest eye care institution providing more than 200,000 eye
surgeries annually. Two out of three Aravind cataract surgery patients are operated free of
charge, with costs covered by the one-third who pay. The cross-subsidy models developed by
Aravind have been transferred to selected programs around the world and have inspired other
models. Aravind’s operations research, management training, and skillful consultation with
client hospitals has improved the quality, volume and accessibility of eye care in many countries.
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Lumbini Eye Care Program, Nepal: This rural eye center in Nepal has been one of the first
beneficiaries of Aravind’s systematic training and consultation over the past two decades. The
Lumbini team performs more than 30,000 per year and runs an extensive community-based
program to reach rural blind people. Within two years of initiating a cost-recovery model, patient
fees at Lumbini began to cover all recurrent daily operating costs. Within five years the hospital
became fully financially self-reliant for daily running costs of its large base hospital and most of
its rural programs. This year the Lumbini Eye Institute is being inaugurated to expand Lumbini’s
training programs for ophthalmologists, allied eye health personnel, managers, and community
service supervisors. The Lumbini team already offers strategic planning assistance, consultation,
and hands on staff support for eye care programs in the region that seek sustainability.
Strengthening from the Sustainability Network Project will expand all of these activities.
Kilimanjaro Center for Community Ophthalmology/ Tanzania: Although it is based in
Moshi, Tanzania, the Kilimanjaro Center for Community Ophthalmology (KCCO) is a resource
for the entire eastern region of Africa. Although it is only three years old, KCCO is
demonstrating a remarkable capacity for launching community eye care service pilot studies,
studying obstacles experienced by blind people in need of sight restoring care, and analyzing
local communities’ capacity to pay for a portion of their services. KCCO works closely with the
Kilimanjaro Christian Medical College Department of Ophthalmology, and has had a hand in the
upgrading of clinical activities and their volume. Through natural networks among African eye
care institutions, KCCO is learning from others and sharing what it finds. The capacity building
component of the Sustainability Network Project will enable KCCO to strengthen staffing in
sustainability studies and development of training and research programs.
Al Noor Foundation, Egypt: The Cairo-based hospital established by the Al Noor Foundation
offers the full range of ophthalmic services, which are provided from the free section as well as
the paying patient hospital. Practical community research conducted with other partner
organizations has guided development of outreach services. Staff development and expansion
will enable Al Noor to add training in community ophthalmology and other courses to its
schedule of educational activities. By becoming a member of the Sustainability Network Project,
Al Noor will be able to more rapidly adapt service strategies from Asia and Sub-Saharan Africa
to the unique situational needs of Egypt and the surrounding region.
III. Manage Pooled Fund for Sustainable Eye Care Development (still in planning stage):
Fundraising for this Fund is underway. Sustainability-building grants will be awarded to eye
hospitals that have a consultation and training relationship with one or more of the regional
capacity-building centers. Grants will be recommended by the regional centers who, in turn, will
work with recipients on using funds for optimal impact. The Center for Innovation will grant the
funds. Sustainability Network Project staff associated with each regional center will monitor and
support the process. Grants fund sustainability-building planning, system development, training,
equipping, construction, and service delivery. Grants are designed for maximum impact on
increased quality service and long term sustainability.
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Sustainability grants will be co-funded by the recipient institution and other partner organizations.
RESULTS
 Sustainability-building resource centers in every region for training, technical support,
program improvement, monitoring & evaluation.
 Strong local service programs with quality, high volume comprehensive services that are
sustainable to the maximum extent feasible in each setting.
 Effective use of internet and other modalities to increase availability and reduce cost of
services.
 Paradigms for financial sustainability and international collaboration that can be applied
to other international health and development issues.
THE CENTER FOR INNOVATION AND
THE SUSTAINBILITY NETWORK PROJECT:
The Center was launched by the Seva Foundation in 2004 as a special 25th Anniversary year
initiative. The Founding Director of the Center, Suzanne Gilbert, PhD, MPH, brings 25 years of
experience in this field, ten of them as former Director of Seva Sight Programs. Seva is highly
collaborative and sustainability-oriented organization. Program partnerships in Asia have yielded
breakthroughs in the analysis and solution of seemingly intractable problems in eye care service
delivery. These activities have involved a wide circle of local and international organizations,
each contributing its resources and unique expertise. The Sustainability Network Project is one
of the first initiatives of the Center.
A core group for this Project is being formed. Leaders from the Aravind Eye Care System,
Lumbini Eye Care Program, Project Impact, BC Centre for Epidemiology and International
Ophthalmology, Al Noor Foundation, Kilimanjaro Center for Community Ophthalmology, and
other international institutions are ready to expand sustainability models around the world.
Contact:
Suzanne S Gilbert, PhD, MPH
Director, Center for Innovation in Eye Care
Seva Foundation
1786 Fifth Street
Berkeley, CA 94710 USA
suzgilbert@earthlink.net
+1-510-845-7382 ext 314
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