Ahead of the upcoming Commonwealth Heads of Government Meeting, Prospect and vision campaign Clearly convened a roundtable discussion to address the issue of poor vision across the Commonwealth. The event brought together policymakers, NGOs, academics and businesspeople to consider what the world’s most common treatable disability remains.
Two and half billion people around the world suffer from correctable poor vision, most of them having never had access to an optician or having ever received even a basic eye test. Almost one billion of these suffers live in a Commonwealth country and Clearly is determined to see the issue rise up the Commonwealth’s list of priorities.
Entrepreneur and founder of Clearly, James Chen opened the discussion. He outlined how he came to found Clearly and ran through their achievements so far. In particular, he spoke about the experience of Vision for a Nation. In Rwanda this non-government organisation has trained general nurses to administer eye tests, by prioritising some of the world’s poorest people and operating in an innovative manner (using nurses rather than traditional eye specialists) over 2 million people have already been helped.
As Chen noted for many people the ability to see clearly is something they take for granted and for those afflicted by poor vision in the developed economies, access to treatment is often straight forward. But 90% of sufferers without access to treatment are in developing countries. Improved vision makes a huge difference not only to the day to day lives of individuals but to economies as a whole through the impact on productivity. Despite this, vision has often been relatively low on the priority list - unlike pneumonia, HIV or malaria, poor vision is not directly fatal and much of the effort from governments has traditionally gone into directly saving lives rather than transforming them.
Clearly works, as mentioned several times during the discussion, by tackling hurdles known as the “four Ds”. Their approach to combatting poor sight begins with “diagnosis” – and whilst the traditional approach of healthcare professionals has been to concentrate efforts on eyesight specialists, they have regularly argued that this approach is too narrow. They then move onto the “distribution” phase – how to make sure that the appropriate treatments are available. The third stage is “dollars” – how will this be funded? Finally, they are concerned with “demand” – namely how to ensure that potential sufferers come forward for treatment? Only by being concerned by all four “Ds” can an effective solution be found.
Kirsty McNeill, Executive Director of Policy, Advocacy and Campaigns at Save the Children and former senior UK government official, noted that poor vision fits into the categories of both “potentially solvable” and “transformative” – it is one of the genuinely few issues where governments both have the capacity to act and where that action can lead to measurable and widespread positive change. This is, she noted, exactly the right sort of issue for the development community to push for action on: they can present governments with a problem and a solution – a solution for which they can then take some credit.
Pauline Latham MP – a member of the International Development Committee – broadly agreed. She also noted how the issue of poor vision was a very gendered one, with women far less likely to get treatment than men in many countries.
Caroline Harper, the Chief Executive Sightsavers, noted that this was an issue which was beginning to attract much attention from global business. In one recent examples, the global insurance industry had realised that funding the provision of treatment for truck drivers in India had the potential to reduce accidents and hence insurance claims.
A broad discussion was held on the responsibilities of businesses, especially large multinationals often based in the advanced economies, on the extent of their responsibility for providing screening and treatment for their employees in developing countries. In almost all cases, the gains from increased productivity would outweigh the direct costs.
Alan Tinger, a board member at Eyecare Trust charity noted that in some regions of the world there were still cultural barriers to seeking eyecare treatment – wearing glasses was often seen as unfashionable or even an admission of weakness. Responding to this, James Chen noted the importance of the “final D” or “demand”. In some regions it was important to work harder at overcoming cultural barriers to treatment.
There was broad agreement around the table that this was an issue the Commonwealth would do well to take forward – and Commonwealth representatives present at the discussion took this on board.
In some ways this can seem like an “easy” issue to fix. Unlike other problems afflicting the world, in the case of vision medical professionals at least know how to go about diagnosis and treatment. In addition, the costs of correcting poor vision are almost outweighed in pure economic terms, leaving aside the immense and non-economic benefits to individuals. But, despite this being one of the “low hanging fruit” of international development it has yet to be picked by the global community has a whole. The opportunity is there, it was felt, for the Commonwealth to lead on this agenda.
