The WHO has implemented an action plan amongst its member states to promote the prevention of avoidable blindness and visual impairment.
WHO Universal health eye screening programme
In 2010 the World Health Organization (WHO) estimated that 285 million people worldwide were visually impaired, with 39 million of those being blind1. 80% of these cases were estimated to be avoidable, with the two main causes being due to uncorrected refractive errors and cataracts1, both of which have well-established effective treatments. An uneven distribution of eye services globally has resulted in 90% of the world’s avoidable visual impairment being found in the developing world1 and even within these countries inequality of access to healthcare means that visual impairment is greater amongst disadvantaged groups2.
Between 2009 and 2013 the WHO implemented an action plan amongst its member states to promote the prevention of avoidable blindness and visual impairment with the goal of eventually achieving universal eye health3. A follow-up action plan was published, laying out key objectives for 2014-2019, which aimed to advance progress in achieving universal eye health and build on lessons learned during the 2009-2013 action plan.
The three objectives stated that member states, international partners and the secretariat:
- Addresses the need for generating evidence on the magnitude and causes of visual impairment and eye care services and using it to advocate greater political and financial commitment by Member States to eye health.
- Encourages the development and implementation of integrated national eye health policies, plans and programmes to enhance universal eye health with activities in line with WHO’s framework for action for strengthening health systems to improve health outcomes.
- Addresses multisectoral engagement and effective partnerships to strengthen eye health.1
The WHO have set out an ambitious goal for the 2014-2019 global action plan to reduce the prevalence of avoidable visual impairment by 25%1. However, it is evident from the continued unequal distribution of visual impairment that accessibility and provision of effective eye services are the major barriers to achieving universal eye health. In order to achieve this reduction in the prevalence of visual impairment, member states must prioritise investment in research, healthcare and implementation strategies to promote equality of access and provision of eye services.
Current strategies for universal eye health
The WHO highlights the need for generating evidence for eye services in their first objective of the 2014-2019 global action plan1. Despite this there is currently very little research available on the effectiveness of implementation strategies for eye services. A recent article in the British Journal of Ophthalmology emphasised the importance of national health information systems for data collection on the provision of eye services and patient outcomes4. Such systems enable researchers and policy makers to evaluate the effectiveness of available services, to develop strategies for scaling of effective interventions and to avoid resources being spent on the adoption of strategies proven to be unsuccessful elsewhere. However, implementation of such systems can be protracted and costly and until such research systems exist, universal eye health is likely to be a difficult goal to achieve.
Creating a global community
MedShr is an app and web platform that allows healthcare professionals to discuss clinical cases in a global community in compliance with GMC and HIPAA regulations. The use of social media enables the development of accessible global networks within which to share best practice and discuss innovative strategies for tackling global health problems. Currently MedShr is used by 600,000 doctors in 185 countries providing a wide breadth of experience and knowledge to help advance services and reduce the inequality of care across borders. In addition to this, analysis of the use of such platforms enables an understanding of the magnitude and distribution of global health needs and health services. In using technology to collaborate across nations, we can help to understand and address the challenges and contribute to making both universal eye health and global health equality a reality.
1. World Health Organization (2013) Universal Eye Health. A global action plan 2014 – 2019.
2. Ramke J, Zwi AB, Lee AC et al. (2017) Inequality in cataract blindness and services: moving beyond unidimensional analyses of social position. British Journal of Ophthalmology 2017;101:395-400
3. World Health Organization (2010) Action plan for the prevention of avoidable blindness and visual impairment 2009-2013
4. Ramke J, Evans JR, Gilbert CE Reducing inequity of cataract blindness and vision impairment is a global priority, but where is the evidence? British Journal of Ophthalmology 2018; 102:1179-1181