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IAPB's Blog

Romania's first ROP Workshop

I am just back from Bucharest where IAPB supported the first national Retinopathy of Prematurity (ROP) symposium. This is part of the IAPB ROP programme for Russia and Eastern Europe which is funded by Eye Samaritans International, our newest IAPB member.
IAPB had been asked by the host, Dr Cristina Nitulescu to support her to raise awareness of ROP across the Neonatal Intensive Care Units (NICUs)  in Romania, particularly to look at recent research findings and the implications for how pre-term babies are cared for, when they are screened and what treatments to give. 
It was a very full day, the host had done an exceptional job of promoting the symposium and we had about 200 people there, representing every NICU in Romania of which there are 20 ‘level 3’ units and 45 ‘level 2’ units. The symposium brought together the teams who are involved in the care of babies at risk of ROP - the neonatal nurses, neonatologists and ophthalmologists, as each are critical in the treatment and care of babies at risk of ROP. To have an effective ROP programme these cadres need to work as a team and this symposium was the first opportunity for my Romanian hosts to come together to discuss their national ROP programme.
Thanks to Cristina’s energy and commitment, and the host, the Institute of Mother and Child (IOMC), both the Presidents of the National Society of Ophthalmology and the National Society of Neonatologists were present. At the end of the workshop Cristina was asked by the President of the National Society of Neonatologists to help her write a special issue on ROP for the Romanian Journal of Neonatology and the President of the National Society of Ophthalmology has asked her to present on ROP at their next meeting. 
So I think the ROP ball is rolling in Romania with a lot of momentum coming from the symposium and Cristina is now looking at how to channel this into developing a National ROP Committee. 
I think one of the most important parts of this symposium was to see the floor given over to presentations from nurses. Julie Flanaghan’s (the U.K.) presentation had some hard hitting messages on the importance of nurses and parents and how much nurses can do if empowered. 
The symposia ran on by about an hour and a half as so much discussion was generated – much of it in Romania so I won’t elaborate here -  but just to say that we all left in high spirits and were treated to a feast and a glimpse of Bucharest by night. I’d like to thank the hosts and our team – Julie Flanaghan – senior nurse, Shad Husain – neonatologist and Clare Gilbert who gave up their time to do this.
Robin Percy
Robin Heber Percy
VISION 2020 Workshop Programme Manager

Urgent call: DR Barometer Survey

DR Barometer survey infographic

If you are a patient with Diabetic Retinopathy, or are a care provider, please take the survey.

SDGs: what's in it for eye health?

This is a crucial year for the future of development as efforts to design a new global framework to replace the Millennium Development Goals (MDGs) culminates as the UN readies to adopt a new set of Sustainable Development Goals (SDGs) at a high-level plenary meeting in New York on 25-27 September 2015.

Here Peter Ackland, Chief Executive of IAPB, talks about the relevance of the post-2015 debates for eye health and blindness prevention, the work IAPB and member organisations have been doing and the opportunities for the whole sector.

What is the current consensus on what the new SDGs should look like?

Most authorities seem to believe that the recommendations of the Open Working Group (OWG) which were presented in July 2014 will form the heart of the new SDGs, when they are finally approved at the forthcoming UN General Assembly in September 2015. The OWG identified 17 overall goals and beneath them 169 sub-goals/targets. Work is going on currently by the UN statistical commission to identify the main indicators that will be used to monitor progress against these goals and there are high level discussions about how this ambitious agenda might be funded.

With so many conflicting priorities and ambitious areas of work, how can SDGs benefit our agenda?

The OWG report made nine references to people with disabilities in the 169 sub-goals and targets. An important principle is the stated need to apply and monitor progress against all relevant targets for the least wealthy and most vulnerable members of society. Additionally the 3rd  goal, related to health, contained two sub-goals of particular interest to our work – a target around the elimination objectives of the Neglected Tropical Disease movement (which includes trachoma and onchocerciasis work) and the promotion of universal health coverage which provides opportunities to include eye health services. Being a part of the SDGs is important as the SDG framework will guide and prioritise the development agenda and allocation of government resources and overseas development assistance for the next fifteen years  to 2030.

UHC is certainly a ‘powerful concept’ – to use Margaret Chan’s own words – but can it ever be achieved? Where does one start to monitor progress for example?
The core idea behind the UHC sub-goal is that by 2030 there should be 80% coverage of essential health services for everyone and, crucially, no-one having to miss out on health services because they are unable to afford them. The indicators to measure this are yet to be finalised but one will relate to a measure of financial protection / levels of out of pocket expenditure for health services. The second indicator proposed by the WHO and World Bank is to monitor the coverage of essential health services by looking at the coverage of a small number of core or “tracer” treatment and preventative health interventions.

Peter Ackland

We all know the old quote “what gets measured gets managed”; with so many health services competing for a place in the ‘measurement sun’ then, can eye care ever be considered?
Although cataract surgery was not included in the initial small list of tracer interventions proposed by WHO and the World Bank to be used to monitor UHC, IAPB has been presenting the case that it should be, and that the Cataract Surgery Coverage (CSC) fits all the criteria required of the “ideal” UHC indicator. I have been to see key people in the WHO and World Bank about this and presented to them our case, and the considerable amount of CSC data that we have been able to compile from the many population surveys (mainly RAAB studies) that have been conducted in recent years. We understand that WHO is producing a 2015 baseline report on UHC, to be published in May, and I have been led to believe that this will include data on CSC. I am not one to “count my chickens before they are hatched” but if we can get CSC into this first UHC monitoring report then, as you say, what gets measured, gets managed.

So, how hopeful are we the SDGs may in the end include an eye care indicator, and what would be the opportunities from that?
We have to be realistic – none of the nine sub-goals under the heath goal are going to specifically make reference to eye health. However infectious blinding conditions will be included within the overall NTD sub-goal and as explained above if we can get cataract surgery included in the small basket of treatments that are monitored within the linked UHC process then that will be a major breakthrough. Governments will want to show progress against the indicators used to monitor the SDGs so we can expect to see investment in the health systems needed to deliver both NTD control and cataract surgery. As we know an investment in cataract surgery is always a good start for the development of wider eye health systems. In terms of disability it would a major disappointment at this late stage if there are not some very specific targets related to realising the rights of persons with disabilities – this will benefit people with irreversible sight loss in terms of their education and employment opportunities as well as other areas.

How can IAPB members help make this a reality then?
Over the next 2-3 months governments are negotiating the final content of the SDGs. Our advocacy work continues as we need to retain the positive references to disability and the favourable health references made by the OWG in the final framework. Members can help by reinforcing these messages with their government officials involved in the SDG debate, and particularly by promoting eye health firmly incorporated and integrated within universal health policies, such as national insurance schemes or similar. In the future members can help by funding RAAB studies to ensure we keep CSC on the radar as a useful indicator to monitor UHC, as would promoting its collection and reporting in national health management information systems.  

RAAB Repository: a new resource for eye health research and planning

Rapid Assessment of Avoidable Blindness (RAAB) has established itself as a standard population-based survey methodology for blindness and visual impairment. It is intended to collect baseline data for planning new interventions or to measure progress over time of ongoing programmes. RAAB data are used to estimate global and regional prevalence of blindness and visual impairment, for example in the Global Burden of Diseases study.

At present we know of over 137 RAABs, 11 RAAB+DR (which include a module to estimate the prevalence of diabetic retinopathy) and 36 RACSSs (the predecessor of RAAB), which have been conducted in 70 countries. Many reports from the findings have been published, but many others have not. Even when published, only a fraction of the available data can be shown and much information is not available to other researchers. There have also been instances where reports and the original data were lost because the computers where it was held crashed, the investigators moved on, etc.

It was clear that a safe storage for all this precious data was necessary – this is now available through the web portal RAAB Repository.

Not only the repository minimizes the risk of data being lost through its centralized back-up system, but it brings as many as possible RAAB findings into the public domain.

There is a strong trend in the academic world to make research data available to other researchers so that it can be optimally used. Such ‘open access’ stimulates researchers to combine data from different surveys over time or from the same country or region, to identify trends or relationships. RAAB data, for example, have recently been used to test mathematical models to estimate the required Cataract Surgical Rate in different countries, or to assess requirements for low vision services.

The Repository is very much in line with this open access ethos. If you are planning a RAAB and no survey was ever done before in your area, you can look at findings from nearby countries with similar socio-economic status and health systems to estimate the prevalence of blindness in your country. The same applies for other states or districts in larger countries.

You can search by the name of the country, state (province), district (county) or year in the table or locate a RAAB on a map. For individual studies you can view the main findings, abstracts of publications and, if the principal investigator permits, download the reports generated by the RAAB software and the original data files. If the reports cannot be downloaded directly from the website, the principal investigator can be contacted for permission. All data shown in the repository are either available from publications, or shared with written permission of the principal investigator.

Even if the principal investigator does not want the reports or data files to be shared, we do request a copy of the reports and survey data for safe keeping. These files are stored on a safe server and not accessible to visitors of the website. With this we prevent that these valuable data is lost.

The development of the RAAB Repository was funded by The Fred Hollows Foundation and Sightsavers. I also like to thank the organisations which have supported the development of RAAB: Sightsavers, Orbis, CBM, IAPB, Fight for Sight, the Fred Hollows Foundation and the International Centre for Eye Health.

Do explore the site and don’t hesitate to contact me for any comments or suggestions for further improvements, including if you know of any RAAB not currently listed.



Hans Limburg,

Freelance Consultant Community Eye Health



Five minutes with… Damian Facciolo

Guest blog post, republished from the Asia and the Pacific Policy Society.

Asia and the Pacific Policy Society members are located all around the region in a wide range of roles. As part of our series profiling the work of some of our members ‘Five minutes with…’,  Asia and the Pacific Policy Society member Damian Facciolo talks about his work with the International Agency for the Prevention of Blindness and the challenge of managing non-communicable and chronic diseases in the region. 

D Facciolo photo

Tell us about your work for the International Agency for the Prevention of Blindness?

Four out of five cases of blindness can be prevented and treated. Blindness and visual impairment can easily be avoided with more resources for cataract surgery, screening and spectacle programs and improved national planning. I manage advocacy work for the International Agency for the Prevention of Blindness (IAPB), a global coalition of more than 120 NGOs, the private sector and research and training organisations. IAPB works in partnership with its member organisations and the World Health Organization to influence decision-makers, contribute to better policy, gather evidence and build networks.

What is the most interesting part of your job?

I manage a regional program that spans WHO’s Western Pacific region, taking in around a dozen countries of Asia, as well as smaller countries across the Pacific. Each country has very different strengths and challenges when it comes to eye health policy, so it can be hard to stay on top of developments across the region. But it’s also very exciting, I get to travel and work with highly skilled health workers and policymakers, many of whom have an infusive passion for better public health.

In 2013, member states at the World Health Assembly endorsed ‘Universal Eye Health: A Global Action Plan 2014-19’, a document which has renewed the momentum for blindness prevention and given health ministries globally a clearer target and a more tangible direction.

What do you think are the biggest policy challenges for eye health in Asia and the Pacific?

The biggest challenge region-wide is the management of non-communicable and chronic diseases. Many national health systems have evolved with a focus on infectious disease and health crises, and governments are now rethinking delivery approaches to provide ongoing care for ageing populations and chronic condition such as diabetes. Alarmingly, six of the top 10 countries for diabetes prevalence are Pacific Islands. This rethink will require long-term investments and thinking beyond clinical models for treatment with a focus on prevention, lifestyles and social determinants.

The good news is that many countries in Asia are building and expanding insurance and social protection programs and over time, many of the cost-related barriers – particularly for cataract surgery – will decrease. Countries like China, the Philippines, Vietnam, Cambodia are joining wealthier nations like Japan, Malaysia, Singapore, Australia and the Republic of Korea where cataract surgery is included in national health insurance schemes. Training has been a focus of activity for blindness prevention in the Western Pacific for many years, but work is still required to ensure doctors and nurses reach rural and marginalised communities, and sub-speciality training programs ensure more complicated eye conditions can be managed in the future.

Read the original article


Tackling human resources for eye health challenges

One of the most striking aspects I’ve witnessed on my visits to projects with IAPB is how committed the eye health personnel are, in spite of often having to work in extremely difficult and overstretched conditions. Whether in Africa, Asia, or elsewhere, it is evident how crucial all members of the team are to the delivery of quality eye health services across all levels, primary to tertiary, and how important it is to have sufficient, relevant, well trained and well-motivated staff to do the job – whether that is to help people see, or to provide people who are irreversibly vision impaired or blind the assistive devices and/or support needed to be as independent as possible. 

The Global Health Workforce Alliance (GHWA) held an online consultation from September to November this year to develop a global strategy on human resources for health – as a means to tackle the global health workforce crisis. I prepared a submission with considerable support from the IAPB regions, including drawing from policy and position papers from IAPB Africa, where human resources for eye health is the main focus of work due to the sheer scale of the problem in the region.

The papers provided by GHWA to inform the consultation and new strategy, cover many important issues – the need for sufficient, well-trained, and appropriately skilled health personnel (mainly referring to doctors and nurses) including in rural and remote locations, the need for personnel and health systems to respond to inequities in health access and changing demographics, the need for greater emphasis on social determinants, attention to risk factors, promotion, and prevention, amongst many others. 
Ciku Mathenge, Photo: Kabir Dhanji; Courtesy Fred Hollows Foundation
All of these are extremely important issues – but the papers are weakened by the complete lack of attention to specialised areas of health, including eye health personnel, and also mental health, dental health amongst others. The IAPB submission sets out the wide range of reasons why eye health needs to be explicitly accounted for within human resource strategies – highlighting that high prevalence rates of avoidable blindness cannot be tackled if there is a failure to do this.
The submission closes with the following recommendations:
  1. The Strategy must place emphasis on tackling the global health workforce crisis within strengthened equitable health systems and multisectoral integrated approaches, via significantly greater investment and more sustainable approaches to health financing.
  2. The Strategy must guarantee the adequate levels and distribution of well-trained personnel to tackle health comprehensively across diseases, taking account of national, sub-national and local health needs. This must include specialised personnel including personnel involved in delivering eye health at all levels. 
  3. The Strategy should involve broadening the eye health recruitment pool, by developing flexible routes into the workforce, and generating more and better data for workforce planning. 
  4. The Strategy must promote the inclusion of specialised health areas, including eye health, so that they become integral to Ministry of Health HRH plans.
  5. The Strategy should promote the participation of eye health (and other specialised health) stakeholders in design, delivery, and the monitoring of national health and HRH strategies and policies that include task-shifting, training, and retention efforts. 
Zoe Gray
Zoe Gray,
Advocacy Manager

Reflections on the launch of DFID’s new ‘Disability Framework’

On 3rd December - International Day of Persons with Disabilities - I was fortunate to chair an event in Parliament at which the Parliamentary Under Secretary of State for International Development, Baroness Northover, launched the UK Department for International Development (DFID)'s first ever 'Disability Framework'. This is a crucial step forwards in ensuring that persons with visual impairment are included and prioritised in future development efforts.
The event was organised by the Bond Disability & Development Group, a coalition of UK-based mainstream and disability organisations, and alongside the DFID Minister, we heard excellent speeches from Fiona O’Donnell MP (member of the International Development Committee), Dr Ray Lang from Leonard Cheshire Disability, Vladimir Cuk, who leads the International Disability Alliance, and it was also the first public engagement for Beverley Warmington, in her role as DFID’s new ‘Senior Managerial Disability Champion’.
DFID's Disability Framework meeting
The launch of the framework comes after many months of much-needed progress towards a strengthening of focus on disability-inclusion in aid. In May 2013 the report of the UN High Level Panel on the Post-2015 Development Agenda broke new ground by calling for a Post-2015 framework that ‘leaves no-one behind’, by ensuring that no goal can be considered to be met unless it is met for all population groups, including people with disabilities. 
In September 2013 at the UNGA convened High Level Meeting on Disability and Development, then UK Parliamentary Under-Secretary of State for International Development, Lynne Featherstone MP called on the international community to tackle the ‘great neglect’ of persons with disability. Following on from this, the UK pledged that it would address disability exclusion within international development and from now on all schools built with assistance from UK Aid would be fully accessible to children with disabilities. 
In April 2014 The International Development Select Committee inquiry into ‘Disability and Development’ reported, urging DFID to take steps to ensure disability inclusion within the Department’s work. The IDC recommendations included that DFID should produce a cross-departmental disability strategy in consultation with disabled people; should disaggregate its aid programmes measuring the extent they reach and support disabled people; should increase its specialist staffing on disability; provide training and guidance to all DFID staff on disability-inclusion; encourage partner governments, multilateral organisations and civil society to strengthen disability-inclusion; and should champion an inclusive post-2015 development framework that leaves no-one behind.
In June 2014, DFID responded by agreeing to appoint a senior level disability champion and produce the department’s first “Disability Framework’, setting out a clear commitment, objectives and timescales for strengthening its work with disabled people. 
The event on December 3rd, therefore, represents the culmination of a year of progress in raising this issue up the political agenda, with tributes paid to Lynne Featherstone MP, the former DFID Minister who first announced that the department would do more to prioritise disability.  I would recommend to everyone that they read the new Disability Framework themselves. It is an impressive document that lays out a vision and practical actions that will be undertaken by DFID. I particularly welcome the fact that DFID have laid out work-streams for focusing on key issues including addressing stigma and discrimination, improving access to education for people with disabilities, and importantly, strengthening health systems to improve people's health to prevent diseases including NTDS - which can cause blindness. I also welcome the fact that DFID are explicit that the document reflects a process of learning for them and their partners. Crucially, they plan to review and re-publish the document every 12 months to monitor progress, and make sure that momentum is maintained. 
In the House of Lords last week, I spoke in a debate about the Post-2015 development agenda and welcomed the Disability Framework as a concrete example of how DFID and other development agencies must take forward the “leave no-one behind” agenda. The launch of the framework is a new beginning we must all keep a close focus on and support the department to turn the document into real change on the ground for people with disabilities.
Lord Low of Dalston CBE, President of ICEVI (International Council for Education of People with Visual Impairment)
Lord Low of Dalston CBE,
President of ICEVI (International Council for Education of People with Visual Impairment)

Access to health is not a luxury it’s a right


UHC day logo

The push for UHC creates a major opportunity to radically improve health access and outcomes for all people everywhere, tackling the gross health inequalities that persist. In effect UHC accounts for the fact that all people have the right to the highest attainable physical and mental health, one of the fundamental rights enshrined within the United Nations bill of rights.

This coming year, the international community will establish the Sustainable Development Goals to replace the Millennium Development Goals. It is essential that Universal Health Coverage is incorporated into this Post 2015 framework, and in a way that ensures that the poorest and most marginalised are reached.
Why is this so crucial for IAPB members and for eye health?
In our work overseas and closer to home, it is immediately evident how common it is for people to face barriers to eye health services whether for financial reasons, physical, sensory barriers or others. Tackling avoidable blindness will not be possible without a significant shift in focus towards equity, inclusiveness, accessibility, responding to need, ensuring that governments take responsibility for progressively realising the right to health.

Further to make progress towards UHC will necessitate better governance, strengthened health systems, improved more sustainable approaches to health financing,  essentially a solid basis to integrate comprehensive eye health and promote universal eye health, as called for in the Global Action Plan for Eye Health. 

We strongly encourage members to support UHC day and get involved in health networks at national, regional and international level to promote equitable strengthened health systems and within these to advocate for integrated comprehensive approaches to eye health.
Zoe Gray
Zoe Gray,
Advocacy Manager


Bayer HealthCare Supports World Sight Day Event

On October 9, Bayer colleagues worldwide came together to support World Sight Day (WSD) – an international day to promote awareness of avoidable blindness and its prevention – with various activities.

About 285 million people are visually impaired worldwide. About 90 percent of those affected live in developing countries. Preventable causes are as high as 80 percent of the total global visual impairment burden. With this in mind, Bayer was proud to be the sponsor of the World Sight Day event that was celebrated in Mexico City with top eye-health organizations paired with a series of lectures by renowned Mexican and international ophthalmology specialists. Hosted by the International Agency for the Prevention of Blindness (IAPB) and the Mexican Society of Ophthalmology (SMO), this event showcased IAPB’s – and indeed the health sector’s – commitment to support the World Health Organization’s (WHO) ”Global Action Plan for the Prevention of Blindness & Visual Impairment - 2014-19.” 
Bayer and group
“We are delighted to have helped in putting such an event together,” said Gerhard Albrecht, Medical Director Mexico, Head Medical Hub Mexico/Central America/Caribbean. “Bayer is committed to preventing avoidable blindness in the region and the world.”
Pictures provided with support from Bayer
Michelle, Bayer
Michelle Sylvanowicz,
Global Advocacy, Bayer

Bob McMullan on the IAPB WSD14 Event - and the future

Bob speaking at the WSD14 event in Mexico City
My first response to the proceedings on World Sight Day in Mexico is one of gratitude. Gratitude to the organisers, of course, but also to the many government, professional and NGO representatives who made it so successful.
What did we learn?
First: that with the cooperation of the range of professional eye health bodies and the relevant government we can put on an event which will draw significant attention to the issues surrounding eye health.
Second: that it is possible to extend this impact to a broader region than the host country with the cooperation of the regional WHO and IAPB offices. Third: that we will need to do more to mobilise international media attention.
We have erected a solid basis on which to build. We have learnt some important lessons. It is now up to us all to build on this basis for 2015 and beyond.There are critical challenges over the next twelve months.
The international community will establish the Sustainable Development Goals to guide international development issues and policies for the next decade. It is vital that disability issues are recognised in these goals and that there is at least one eye health measure among the agreed schedule of indicators.
The next twelve months will also be vital for the successful implementation of the WHO Global Action Plan for the prevention of blindness and visual impairment.
This plan was achieved due to the advocacy of a number of countries, including a prominent role by Mexico. But this will only be a piece of paper unless we move on the critical issue of country level implementation. It is extremely important that all regions prioritise their advocacy efforts to maximise our impact globally.
These are big challenges.
With the enthusiasm and commitment I saw during World Sight Day in Mexico I am sure we can rise to these challenges. By next World Sight Day we will need to have made some measurable progress on achieving our key objectives. That is our challenge going forward. To build on our success in Mexico to serve the interests of those who are visually impaired wherever they may live.
Pictures provided with support from Bayer
Bob McMullan
Bob McMullan,
President, IAPB

Vietnam's first Optometry School

The first four year Optometry Degree programme has just been launched in Vietnam by a collaboration between Pham Ngoc Thach University of Medicine, Ho Chi Min City Eye Hospital and the Brien Holden Vision Institute, with support from the Australian Government’s Avoidable Blindness Initiative Program.  
It was an absolute delight to meet Vietnam’s first 20 optometry students. These young people, who will be joining Vietnam’s current optometrists (only three), have an immense opportunity to make an impact on the provision of vision care in their country. 
An estimated 21 million people in Vietnam have blindness or impaired vision due to uncorrected refractive error; three million of whom are children. It is the leading cause of vision impairment in the country and the main cause of childhood blindness. 
It is estimated that these young people will each provide vision care for 80,000 Vietnamese people during their professional lifetimes; the 20 students caring for the vision of over 1.5 million people. Vietnam will need at least 5,000 more optometrists from at least five Departments of Optometry. The next optometry program is being planned by Hanoi Medical University for opening in 2015.  
Historically, ophthalmologists aided by eye care nurses, ophthalmic technicians and refractionists, 600 of whom were trained by the Institute, have worked to try to address the refractive error needs of the country. However, these dedicated professionals cannot respond to the increasingly high numbers of people requiring services for refractive error and primary eye care.
The optometry course is the culmination of a ten year plan to introduce optometry to the country, with the primary goal of alleviating the burden of uncorrected refractive error in Vietnam in line with the Vietnamese National Eye Health Plan. One of the great successes of the project has been the spirit of the collaboration, all of the different organisations and teams coming together with one common goal – eliminating avoidable blindness through better vision care.  
As we look to the future joint collective quest for excellence in vision care for all Vietnamese people, I look forward to the graduation ceremonies of these first pioneers of Vietnamese optometry and their many successors.

Prof Brien Holden, Brien Holden Vision Institute
Prof Brien Holden, CEO,
Brien Holden Vision Institute

VISION 2020 Workshops 2014 - South East Asia

The IAPB South East Asia region will have delivered five country-level VISION 2020 workshops by the end of 2014 - in Bangladesh, Bhutan, Indonesia, Nepal and Sri Lanka. The objective of these workshops was to roll out the WHO Global Action Plan (GAP) 2014 – 2019 at the country level in this region. Three workshops (Sri Lanka, Bangladesh and Bhutan) have been organised and two more will be conducted in the coming months. VISION 2020 Workshops, South East Asia
The key insight from the three completed workshops was that many were not adequately aware of GAP, its goal and objectives. There was also ambiguity on the role IAPB plays in prevention of blindness at the country, regional and global level. Many (mistakenly) believe IAPB is a global funding agency in prevention of blindness!

Yuddha Sapkota

The workshops showcased steps to be taken at the country level to support GAP implementation and were a good opportunity to also clarify IAPB’s role. There was a high level of interest and involvement demonstrated by the presence of Director General of Health service from the Ministry of Health in each country-level workshop. It was heartening that they not only agreed with GAP recommendations, but also promised to incorporate them in their forthcoming eye health plans - a benchmark achievement for these workshops.
I quote a report from Dr Ngawang Tenzin, VISION 2020 Focal person in Bhutan, who played a key role in the Bhutan workshop's success:

"On 24th October 2014 the Ministry of Health, Royal Government of Bhutan conducted the first ‘National Advocacy and Consultative Workshop on VISION 2020’ as a country-specific IAPB VISION 2020 workshop. The main objective of the workshop was to brief the participants on Global Action Plan (GAP) and roll out the first draft National action plan. The workshop received whole-hearted support from the regional IAPB office and ministry of Health. The participants included key officials from the Ministry, technical advisors, programme officers from relevant progammes in Health ministry and ministry of Education, district health officers and eye care providers and the representative from the WHO country office. There was a high level of participation and this workshop came up with lots of important recommendations for the national VISION 2020 action plan, including commitment and support from the various stakeholders. All in all, the workshop was timely and a great success."

I also have a quote from Dr. Palitha Mahipala, Director General of Health Services, Ministry of Health, who participated in the Sri Lanka workshop:

"The recent workshop conducted in Sri Lanka from 15 – 16 October 2014 has given us immense inputs on the WHO Global Action Plan of prevention of blindness. The ophthalmologists, health planners, provincial and district health authorities participated in this meeting have personally expressed the enormous experience and confidence gained on the future of VISION 2020 programme. On behalf of the Government of Sri Lanka and citizens of the country I pay my tribute to IAPB for this noble endeavour."

We know anecdotally that usually the implementation and monitoring part of the plan are not effectively carried out in many developing countries. So, in the coming days, we will work to strengthen monitoring mechanisms. This should give us much-needed evidence for the successful outcomes coming out of these workshops. 
Yuddha Sapkota Yuddha Sapkota,
Regional Coordinator, IAPB South East Asia

VISION 2020 Latin America meeting, Mexico City

As we get ready for the World Sight Day Gala event in Mexico City tomorrow, here are a bunch of pre-meetings and interviews going on. These are pictures from the VISION 2020 Latin America meeting that will see almost all Latin American countries represented here. With Ecuador being declared Onchocerciasis free, among other achievements, and the preparations for the Global Action Plan, this region has a lot to plan for and celebrate!


Focus on #Sight

LIGHT FOR THE WORLD is delighted to launch an awareness campaign in the run-up to WSD 2014.LFTW sidebar
On October 9, World Sight Day 2014 will focus on avoidable blindness. In the run-up to this event, LIGHT FOR THE WORLD, together with friends and partners, have launched a social media campaign called FOCUS ON #SIGHT, centred on Facebook, to raise awareness for the basic facts on avoidable blindness:
  • There are currently 39 million blind people world-wide 
  • 90% of them are living in economically deprived regions
  • 80% of all blindness is preventable
  • Medical eye care must be made accessible to everyone, everywhere!
Participants in the campaign are asked to symbolically ‘see the world through different eyes’ on and around World Sight Day and to document their support by changing their Social Media profile pic.
Help us draw the public eye to our concern: Change your social media profile picture for World Sight Day on October 9th 2014 and make a stand for a world in which eye sight is no luxury but a basic right.
A facebook app provided by LIGHT FOR THE WORLD makes branding profile pics a doddle: https://apps.facebook.com/focus-on-sight
Please help spread the campaign and create awareness for preventable blindness! For further informations, contact Alexandra Zotter at a.zotter@light-for-the-world.org.
Albert Bock, Online Editor, Light for the World
 Albert Bock,
Online Editor,


The current outbreak of Ebola Virus Disease (EVD) in West Africa has been declared a ‘public health emergency of international concern’ by the World Health Organization. First identified in Guinea, it has spread to Liberia, Sierra Leone and Nigeria – all in West Africa. The outbreak has led to a lot of concerns and anxieties around travel and associated risks in the region, despite the WHO clarifying that the risk of infection while travelling to West Africa is extremely low
IAPB has been closely following developments around Ebola. While it has no eye care implications, it does affect travel, logistics and conference plans in the region. IAPB Africa has had to postpone a Workshop planned in Johannesburg – in South Africa – because of growing anxieties around Ebola. Travel bans (by airlines) to affected countries and the general atmosphere of anxiety and concern is having an out-size impact on our work and travel in the region.
We believe that the current outbreak of EVD is a serious public health concern. The WHO and its partners have now launched a multi-million dollar international strategy and we wish it all success. There are now travel restrictions on the four affected countries and their immediate neighbours. 
It is important that we fully realise the extent of this outbreak – and its physical limitations. EVD is a fierce, rapidly lethal condition. But, it also seems to be limited to specific geographic contexts. IAPB is in touch with our members and partners across Africa and is watching the situation and working to understand its implications – if any – to our work. 
Joanna Conlon,
Director of Development, IAPB

Mexico City to host global World Sight Day event

IAPB is gearing up to celebrate World Sight Day 2014 with a gala event in Mexico City
I have had the pleasure of calling Mexico my home for the past couple of years. Mexico City, with its great culture, has become one of my favourite cities in the world. So, I am excited to have played a key role in this event’s development. On 9 October 2014, important stakeholders in eye health from across the world and the region will come together to discuss ideas, exchange success stories and commit to working towards the objectives of the WHO Global Action Plan.
Organized in partnership with the Mexican Society of Ophthalmology, the event will commence with a press conference for the Mexican and regional press, and will be followed by a full-day programme of seminars organized under the leadership of the Chair for Vision 2020 Mexico, Dr Francisco Martinez. The day will culminate with a gala event hosted by IAPB's president Mr Bob McMullan featuring distinguished speakers including Dr Serge Resnikoff and Dr Enrique Graue from the International Council of Ophthalmology; Dr Susan Cooper from the World Council of Optometry; Dr Ivo Kocur, the World Health Organization; Dr Benito Celis and Dr Juan C Silva from the Mexican Society of Ophthalmology and Pan American Health Organisation amongst others. 
The celebration will also feature a panel discussion with representation from International Diabetes Federation and leading eye care corporations on the economic burden of blindness. 
UNAM Medical Palace
We are incredibly fortunate to be able to host the event at UNAM's stunning Old Medical School in the down-town area of Mexico City - a place not only with huge significance in Mexico history but enormous relevance as Mexico’s largest Medical school was once located here.
Please feel free to write to me (csanko@iapb.org) for more information about the event or for more information about our World Sight Day campaign for this year.
I look forward to welcoming many IAPB members, partners and friends in Mexico City on the 9th of October.
Bienvenidos a México!

Christina Sanko


Christina Sanko,

Development Manager


Advocating to help Vietnam have better access to eye health

In late June I visited Vietnam to work together with Damian Facciolo, (Regional Program Manager, IAPB Western Pacific) to deliver an advocacy workshop in Hanoi, with support from Australian Aid. 
During the workshop we discussed key problems and objectives. We worked to help NGOs on Vietnam’s Eye Care Partners Working Group to come up with some key messages to deliver to the Vice Minister for Health, Professor Nguyen Viet Tien who participated in the latter parts of the meeting. Representatives from the WHO Vietnam Country Office were very active in the workshop, as was the Vietnam National Institute of Ophthalmology (VNIO) who have worked hard over the past 12 months to draft a National Action Plan for Universal Eye Health. 
Earlier in the week, Prof Do Nhu Hon, the director of VNIO and an IAPB co-chair, brought us around Hanoi’s main eye hospital and impressive training facilities. We passed huge numbers of people as we walked around the different wards lining up to wait for treatment, receiving treatment, or recovering - almost 2000 people were being attended to that day, by the time we left in the afternoon, according to the visitor counter. 
During the morning of the workshop, I facilitated a problem-solution tree session, to help NGOs participating to consider the key eye health and vision problems in terms of how they impact on people in Vietnam, beginning with the end in mind. Participants from CBM, Orbis, Fred Hollows Foundation, Eye Care Foundation, Helen Keller International, Brien Holden Vision Institute, all highly knowledgeable and accustomed to working together, enthusiastically got stuck in developing their trees, to determine in some detail the causes, effects, solutions of these problems. We reached some important advocacy objectives and messages in a short time (Damian Facciolo’s presentation of these messages can be found here).
Progress is being made in Vietnam in response to the high prevalence of eye health conditions, cataract surgical rates are up, but there remain many problems, cataract surgery needs better quality control (Fred Hollows have produced a very useful monitoring tool which was presented in the meeting).  Further, there is a dire need for optometrists and many people are getting low quality refraction services. Brien Holden Vision Institute is working on a pilot degree program in optometry to be delivered at universities in Hanoi and Ho Chi Minh City, the first of its kind to be offered in Vietnam. Eye health is poorly integrated into primary health care and much more can be done to ensure accessibility for marginalised communities and persons with disabilities. 
Vietnam’s Vice Minister for Health, Professor Nguyen Viet Tien spoke very encouragingly about the government’s commitment to eye health. The approval of the Action Plan will be an important step on the way to fulfilling its aims. 
Zoe Gray, Advocacy ManagerZoe Gray,

Advocacy Manager

New Eye Clinic in Mozambique

A guest post from the Light for the World on a new New Eye Clinic To Serve 2 Million people in Mozambique. (Read the original post here)

A few days ago, the Central Hospital in Beira, Mozambique, saw the groundbreaking ceremony for our new Invicta Eye Clinic which will serve as eye-care hub for 2 million people. Prof. Gerald Schuhmann of LIGHT FOR THE WORLD and Eva Kohl of the Austrian DevelopmentGroundbreaking ceremony for new LIGHT FOR THE WORLD eye clinic in Beira, Mozambique Agency were invited to attend the celebration.
"Healthcare is a key factor in socio-economic development. Today's ceremony brings us a step closer to our goal: nobody, neither here in Mozambique nor anywhere else, should lose their eye-sight to preventable blindness. At Invicta Eye Clinic, we will be able to perform 1,200 surgeries and treat a total of 25,000 patients per year", Prof. Schuhmann stated at the ceremony.
LIGHT FOR THE WORLD would like to give special thanks to Mag. Peter von Bertalanffy and Invicta foundation who contributed significantly to the project. The name of the new clinic will reflect this.
A hub for both eye care and professional training
In Mozambique, just 18 ophthalmologists and 54 ophthalmic nurses serve a population of 23 million. Therefore the training of professionals is a crucial milestone in our fight for improved eye health for all. The concept for our new eye clinic reflects this: it will house training facilities that will enable the graduation of 10 eye care professionals every two years.
LIGHT FOR THE WORLD has been active in Mozambique since 2003. In cooperation with Beira Central Hospital we are implementing a blindness prevention programme for Central and Northern Mozambique.
Albert Bock, Online Editor, Light for the World
Albert Bock,
Online Editor, Light for the World



Regional Institute of Ophthalmology, Peru, marks 20 years

A guest post from Joan McLeod-Omawale, ORBIS International: a window to the good work ORBIS has been doing over the years in the Latin American region.

I had the opportunity to participate in the 20th Anniversary Celebrations of our long-term partner, Regional Institute of Ophthalmology (IRO) in Trujillo, Peru on July 10-12. The IRO is a government institute and referral center in northern Peru that provides specialized ophthalmic services and is the second largest ophthalmology residency training institute in the country. IRO now has over 140 staff members in all departments including administration, statistics, biomedicine, ophthalmology, and nursing.

Orbis has partnered with IRO since 2002 in various capacity building programs. Orbis’s collaboration with IRO ranges from supporting the establishment of the first pediatric ophthalmology unit in Northern Peru to providing both in-country and external training opportunities for their eye care teams.

Throughout our partnership, all Orbis capacity building strategies have been used including the Flying Eye Hospital and our telehealth initiative Cybersight. All ophthalmologists, nurses, biomedical technicians, anesthesiologists, and the administrative staff have benefited from training in Peru, the U.S.A. and several Latin American countries. We have provided local hospital-based training programs as well as financial grants for equipment and supplies, research, and management improvement change processes to reduce avoidable blindness and promote eye health.

I was invited to present on Orbis’s and IRO’s 12-year relationship at the anniversary celebration, among several other presenters from Bolivia, Chile, Colombia, Costa Rica, Mexico, Peru and the U.S. who led scientific courses on various topics. Special guests included former Orbis Flying Eye Hospital Staff Ophthalmologist and past IRO resident, Dra. Roxana Rivera, and FedEx fellow Dr. Patricia Chirinos, and leaders of the National University of Trujillo and private universities. We had the opportunity to experience social and cultural events, including choir and dance performances put on by the Universities in the evenings, and a media-publicized 4K run/walk in honor of IRO.

I am proud all of IRO’s accomplishments and Orbis’s 12-year participation in their success, and I look forward to the institution continuing to grow and improve eye health in northern Peru. 

Joan McLeod-Omawale, ORBIS InternationalJoan McLeod-Omawale,

Regional Director LAC Program

Regional Action Plan: PAHO

It’s often difficult to point to tangible and direct outcomes from advocacy actions – but the results from the Latin American Regional workshop hosted by PAHO in April 2013 certainly delivered on eye health.  Supported by IAPB Latin America and Orbis, the three day workshop of Ministry of Health officials, V2020 LA, Orbis, CBM and other regional stakeholders, the workshop initiated progress on eye health on a number of fronts.  
Most immediately the Bolivian Ministry of Health returned from the meeting and committed to developing a national eye health plan – this largely on the realisation that that they alone in the region had no plan in place. 
The impetus gained through the workshop prompted the Mexican Ministry of Health to re-establish their PBL committee and actively engage with the World Sight Day event in Mexico city. 
Perhaps most importantly of all PAHO acknowledged the importance of the workshop in helping formulate their Regional Action Plan for the Prevention of Blindness and Visual Impairment, endorsed by the PAHO Executive in June of this year. 
So with a bit of distance we can look back and see the range of positive outcomes through this advocacy – the next phase is to identify better implementation of eye care services.    
John Trevelyan    
John Trevelyan,
Fundraising & Partnerships Manager, IAPB

Universal Eye Health: Three important documents

The Global Action Plan for Universal Eye Health was adopted last year. The focus now moves to the regions and implementing countries. 
Here are the 3 key regional documents that focus upon implementing GAP at the regional level – from the regions of Eastern Mediterranean, Latin America and North America ( together as PAHO) and the Western Pacific

Regional Plan for Universal Eye Health: Western Pacific

After many months, the WHO Western's Pacific Regional Office (WPRO) has officially launched Towards Universal Eye Health: A Regional Action Plan for the Western Pacific (2014–2019).

The plan was developed through consultation with Member States, international partners and experts during 2013 and was endorsed by the Western Pacific Regional Committee Meeting in Manila last October. In a first for the Western Pacific, blindness featured on the Committee agenda and more than 16 delegations spoke on the importance of eye health during the Committee session. 

The vision, goal and the main objectives of the Regional Action Plan are in line with "Universal Eye Health: A Global Action Plan 2014-2019" (also known as the GAP).Cover Regional Action Plan WPR

This Regional Action Plan provides a regional context, with specific activities based on the strengths and needs of countries of the Western Pacific Region. Generating evidence for advocacy, strengthening mid-level workers, integration with primary health care, tools to improve cataract outcomes, and new partnerships for diabetic eye disease are a few of the priorities listed.

Already, many countries in the Western Pacific Region are advanced in their work to implement and deliver on the Regional Action Plan, and the GAP as well. Last year, Vietnam drafted a national plan using very similar objectives. In Solomon Islands, the national plan was recently reviewed and stakeholders are preparing to draft a new one. China, Australia and the Philippines are planning national prevalence surveys to collect evidence, as outlined in the first objective. 

IAPB supported the development of the Regional Action Plan. We work closely with Dr Andreas Mueller and others at WHO on a joint programme of support for blindness prevention in the Western Pacific Region, funded by the Australian Government. 

Member states will be asked to report progress against the implementation of the Regional Action Plan during the Regional Committee Meeting in 2015.  It is our hope that the Regional Action Plan will be a guide to help strengthen national eye care programmes, raise the profile of blindness prevention and support the development of national plans to improve eye health across the Western Pacific.

Damian Facciolo
Damian Facciolo,
Regional Program Manager, IAPB Western Pacific

Australia funds its first 'National Eye Health Survey'

This is great news from Australia. The following post is an abridged version of Jennifer Gersbeck's full post on the Vision 2020 Australia website.

UPDATE: China and Philippines are also preparing national surveys of blindness, writes Damian Facciolo, IAPB Western Pacific

We’re often told that governments strongly support this initiative or that programme, but sometimes it is hard to know exactly what that means. It is only when the government actually demonstrates its support through funding or policy change that we truly see the strength of commitment. Well, that is exactly what happened recently when I received a call from Australia’s Commonwealth Department of Health to advise that the Federal Government is contributing $1.126m to support the first ever National Eye Health Survey (NEHS).
In the current political and fiscal climate within Australia -  with the Federal Budget clawing back major Government spending – it is important to recognise the Minister for Health, Hon Peter Dutton’s understanding and commitment to eye health and vision care. 
Nation-wide population health data on the prevalence and causes of vision loss and vision impairment for both Indigenous and non-Indigenous Australians does not currently exist; extant data is nearly two decades old. Australia has committed to a reduction in prevalence by twenty-five per cent but we don’t even have a starting point with which to measure our progress; and without a strong evidence base for determining what specific services are required and where, we’re stabbing in the dark with our efforts.
I therefore commend the Australian Government for acknowledging the significance of this data and, more importantly, for recognising how this data will enable frontline services to be delivered where they are most needed. I also acknowledge the support from Vision 2020 Australia’s members in achieving this outcome.
These outcomes are a truly outstanding display of sector collaboration that continues to show that together, we can not only imagine what is possible, but also achieve it. 

Jennifer Gersbeck, CEO, Vision 2020 Australia


Jennifer Gersbeck,

CEO, Vision 2020 Australia

'Neglected Sensory Diseases' – the NSDs (you heard it here first)

I have just returned from the Coalition for Global Hearing Health conference in Oxford. There are 360 million persons in the world with disabling hearing loss – and just like vision loss - most of this is avoidable through treatment and prevention. Although much remains to be done to counter avoidable vision loss the evidence suggests that our efforts over the past two decades have borne some fruit and we are beginning to see the global prevalence of blindness and low vision declining. However the provision of hearing services, particularly in the low and middle income countries, is extremely thin and as a consequence the prevalence of hearing loss is still increasing. This is something we need to reverse and do something about.
At the conference I gave a presentation on how vision and hearing services could be combined particularly at the primary level. There is a particularly important initiative in Nepal where Nepal Netra Jyoti Sangh are rolling out the addition of basic ear services through the NNJS eye care service system. We must monitor the progress of this programme as I am sure there will be many lessons that we should all draw upon. 
Eye health campaigners should mount a joint campaign with our cousins in the ear and hearing world – the NSDs – the Neglected Sensory Diseases.
Peter AcklandPeter Ackland,

IAPB Advocacy Training Workshop, Accra, Ghana

In the pursuit of its primary change objective “Every country with a ‘Human Resources for Health’ (HRH) strategy has a ‘Human Resources for Eye Health’ (HReH) strategy integrated within it” IAPB Africa held an Advocacy Training Workshop in Accra, Ghana, to train HReH workshop, Accra Ghana - Image 1candidates from five pilot countries as advocacy advisors.  
The goal of the workshop was to build advocacy capacity at a national level with the advocacy advisors going on to develop national advocacy plans for HReH and carrying out the implementation thereof, with support from the lead agencies, in their respective countries.  The five pilot countries are Cameroon, Ghana, Kenya, Mozambique and Senegal.  
The workshop which took place over five days was facilitated by Advocacy Consultant Mr Ian Chandler and along with the advocacy advisors was attended by members of the lead agencies from the five pilot countries and IAPB co-chairs.  
HReH workshop, Accra Ghana, Image 2Proceedings began with HRH Consultant Dr Mollent Akinyi Okech presenting on the key stages in national HRH planning by governments and how HReH can be integrated within it.  Thereafter Mr Ian Chandler took over with the advocacy training that would eventually enable the participants to develop an advocacy strategy on HReH.  The workshop was very participative with the advocacy advisors, lead agency members and co-chairs all equally involved.  Key principles for effective advocacy were recognised and then under Ian’s guidance and through a series of activities the participants made use of a range of advocacy planning tools with national advocacy platforms on HReH.  Progressing, they moved to a stage where they could map out their respective processes for involving stakeholders in developing national advocacy strategies for HReH and in a final exercise action plans were prepared along with a schedule of next steps which had participants primed to move forward in their various roles.
HReH Workshop participants
True to the form of a workshop, using tools and techniques, capacity was built.  The next steps are to excel at advocacy and influence change.
Penny Hartin, CEO, WBUSimon Day,
Regional Programme Coordinator,
IAPB Africa

IAPB runs in the 'Great City Race 2014'

IAPB was proud to participate in Seeing is Believing's 'Great City Race 2014' yesterday. A team comprising Susan Evans, Celene Leong and Robin Percy joined more than 2000 runners in the running challenge which takes place around the closed off streets of the City of London. Seeing is Believing is the official race beneficiary and all funds raised will be matched by the Standard Chartered Bank.

The weather was great, and the atmosphere was one of fun, energy and accomplishment. Kudos to all the runners!

Susan Evans    Celene Leong   

Susan Evans (Project Officer, Seeing is Believing), Celene Leong (Finance Administrator) and Robin Percy (VISION 2020 Workshop Programme Manager) during the run.

WBU attends 7th Conference of States Parties to the UNCRPD

The WBU was represented at the 7th COSP to the CRPD by WBU President Arnt Holte, 1st Vice President Fredric Schroeder, Immediate Past President Maryanne Diamond and CEO Penny Hartin. Maryanne Diamond was officially part of the International Disability Alliance delegation as IDA Vice Chair and incoming Chair, effective July 2014. The COSP was preceded by a Civil Society Forum on June 9th and the WBU hosted a side event on the Marrakesh Treaty on November 11th.  
While the WBU delegation was small, it is fair to say that our presence was significant and visible.  There were a significant number of blind and partially sighted persons present at the event as part of government or civil society delegations.  It was reported that 147 countries have now ratified the UNCRPD; there was also a commitment to hear from civil society as well as governments and that commitment was upheld.
A key theme throughout the Civil Society Forum and the COSP related to the importance of inclusion of disability in the goals and targets of the Post 2015 development agenda.  
Some specific sessions included in the Civil Society Forum addressed the following topics:
  • Main Conclusions from the Open Working Group on Sustainable Development Goals and the Post-2015 Development Process
  • Aligning national, regional and global conversations
  • Forging Partnerships: Building Alliances with other vulnerable groups, including women, children, youth, Aging and indigenous peoples
  • Looking Ahead: a roadmap for advocacy to ensure inclusion of persons with disabilities in the post-2015 development framework and concrete asks
During the COSP, a special roundtable was held on incorporating the provisions of CRPD in the post 2015 development agenda.  Representatives from relevant UN Departments gave the status of the Post 2015 agenda, key provisions in the Open Working Group report and milestones to September 2015 at which time the current MDGs will end.  
Some of the key messages heard throughout the 4 days included the following:
  • The need to push for inclusion of disability in the new development agenda and targets.
  • The need for disaggregated data that includes disaggregation by disability; a quote that was frequently repeated: “if we are not counted then we don’t count”
  • The importance of engaging with national governments to advocate for disability inclusion in the final version of the new development agenda.  
Therefore it will be critical to engage and advocate with national governments over the course of the next year to ensure disability inclusion and disaggregated data.  Since most governments who presented during the COSP sessions emphasized the importance of disability inclusion in the Post 2015 agenda, these presentations can be used as part of our advocacy strategies.
We had a number of panelists who focused on the need for countries to ratify the Marrakesh Treaty and how the treaty related to the implementation of the UNCRPD.  The session was moderated by Fredric Schroeder on behalf of Arnt Holte and specific presentations included:
  • Maryanne Diamond - Chair WBU Right to Read Campaign and Immediate Past President WBU - Why we need a treaty, what it is and what it means for persons who are blind or partially sighted
  • Senator Kerryann  Ifill – Consultant/Facilitator Technology Services for the Blind/Visually Impaired, Barbados  - What the treaty means for blind or partially sighted persons living in developing countries
  • Martin Babu Mwesigwa - CRPD Committee Member - The linkage between the Marrakesh Treaty and the CRPD
  • Geidy Lung - Senior Counsellor, WIPO Copyright Law Division - How the Marrakesh Treaty fits with other WIPO treaties and what WIPO is doing to have it ratified
  • Ambassador Guilherme de Aguiar Patriota  - Deputy Permanent Representative of Brazil to the United Nations - The role of a champion member state in the development of the Marrakesh Treaty and the importance and urgency of member states ratifying it
  • Scott C. LaBarre – Lead, North America Treaty Ratification Campaign - What the United States is doing to progress the ratification of the Treaty
For further information about the Conference of States Parties, access to webcasts and documents, please see the UN Enable website
Penny Hartin, CEO, WBUPenny Hartin,
CEO, World Blind Union

Durban Calling

10GA. Some of you are possibly thinking that the next Assembly – 18-20 September 2016 - is ages away. But the IAPB team are determined that we will build on the success of Hyderabad 2012 and that means starting our planning even earlier this time round.
Alessandro Di Capua, IAPB’s Membership Manager, will be playing a key role in delivering 10GA. Blandine Labry, IAPB’s Finance Controller, has the experience and expertise to help plan for and manage the complex environment that we will be operating in. With 1000+ delegates and a new country every time, getting the correct systems in place and understanding the tax and financial landscape of the host country is critical to the GA’s financial sustainability. 10GA Save teh date
In May, the three of us set out for Durban, South Africa; home to the IAPB Africa team and the Brien Holden Vision Institute. As you know, Durban will be hosting 10GA in 2016 and the trip was to meet with partners, suppliers and a whole range of stakeholders involved. Over a packed work-week, we visited the venue, met with event suppliers and PCOs, our staple friends - eye health experts and enjoyed some great food (no detail too small!). 
Our partnership with L V Prasad Eye Institute in Hyderabad may seem a tough act to follow; 9GA’s resounding success sets a high bar. But we returned inspired by a beautiful city and the energy and creativity of the team at the Brien Holden Vision Institute in Durban. A huge thank you to Kovin Naidoo, our ever charming host, and Petronella Nichols and her fantastic team, we are so excited about working with you.
A big thank you to Ronnie Graham and IAPB Africa team too. We camped out in their office, took over flip charts, desks and the demand for tea doubled!
The teams in London and Durban are now set on a course of collaboration and partnership to deliver the next General Assembly. There is a lot of work to do but we are determined to make 10GA the ‘must-attend’ event in your calendar in 2016.  
Joanna Conlon,
Director of Development, IAPB

GAP Update

July 2014

This is the first in what will become a regular feature from Peter Ackland updating you on latest developments that are contributing to the implementation of the WHA resolution 66.4 “Universal Eye Health: A global action plan 2014 – 2019”. 

Where better to start this new series than the very first action articulated in the Global Action Plan (GAP) – Action 1.1 “Undertake population based surveys on prevalence of visual impairment and its causes.”

RAAB Training

I have just signed the ‘certificate of attendance’ for 11 people trained in the Rapid Assessment of Avoidable Blindness (RAAB) methodology, at a Trainer of Trainers workshop funded by IAPB. At these sessions, people with some RAAB experience look in detail at the theory and methodology of the RAAB tool. Following the training, individuals then have to participate in a RAAB study in the field. During this study, their performance is assessed by an experienced RAAB accreditor and, assuming all is well, the individual becomes a “certified” RAAB trainer – i.e. someone whom we are confident can not only conduct a good quality survey but also support and train others.

This training follows similar workshops held when RAAB was first introduced some ten years ago and more recently in Latin America in December 2012 and in West Pacific in  March 2014. There are now a total of 19 certified RAAB trainers and a further 29 people who have completed the theoretical training and will be certified as they engage in RAAB studies in the field. 

Resource for IAPB Members

So this is one way IAPB Members could help – if you are planning a RAAB study please do inform ICEH, Hans Limburg, or IAPB so that we can see if one of the people awaiting certification can be involved in the study.

RAAB Repository

Another recent development is the RAAB repository, which Hans Limburg has developed with support from the Fred Hollows Foundation. Please go to www.RAABData.info and explore the site, I know Hans would welcome your feedback. This is a work-in-progress and data is still being uploaded, but you can find information on all the RAAB studies to date. The repository will be a great resource for epidemiologists, advocates and programme managers.

DR Module

Over the past couple of years a DR module has been developed by ICEH that is an optional module to the standard RAAB v5 or v6 methodology.

Including this does add complexity, cost and time to a standard RAAB but with the enormous increase in diabetes globally, the need for data on diabetic retinopathy becomes ever more important. IAPB has recently secured funding from Bayer to add the DR module onto two RAAB studies in Mexico – we hope preliminary results will be available for the major World Sight Day event in Mexico that IAPB is planning – more news elsewhere.

Other Prevalence Studies

Of course, RAABs are not the only methodology that can be used for prevalence surveys. I was really pleased to hear recently about the plans to conduct prevalence studies in 10 provinces of China. ORBIS is putting a considerable sum into supporting this which is being conducted under the auspices of, and in close partnership, with the National Health and Family Planning Commission.  The studies will start soon and give us a veritable goldmine of information about the prevalence and causes of blindness in the most populous country in the world.

Why is this important to the sector?

IAPB and IAPB Members are investing in this aspect of the GAP because apart from the valuable epidemiological data provided, we believe it can be a catalyst for change and increased investment in eye health.

An example of this was that recently I was able to enjoy a private dinner with Mr. Jun ZHOU - the Director-General in the Medical Administration Bureau, National Health and Family Planning Commission of the People's Republic of China. To get such an intimate and prolonged period with someone so senior in the government is a unique opportunity – we talked about the upcoming prevalence studies and the need to use the evidence generated from them to frame future government investment and policy in eye health.  We also talked about the government’s million cataract campaign and the need to build on this to increase the national cataract surgical rate. Mr Zhou was highly engaged and talked of personally attending the prevalence survey results dissemination workshop and supporting potential IAPB meetings in China.  

Peter AcklandPeter Ackland,

Commonwealth Health Partnerships & Avoidable Blindness

Commonwealth Health Partnerships 2014, the essential overview of health in the Commonwealth, has a great paper on Avoidable Blindness.

Put together by the Queen Elizabeth Diamond Jubilee Trust with significant inputs from IAPB, the article gives a great overview of the situation on the Commonwealth countries, IAPB and the Trust's efforts to address them and the impact that the Commonwealth can have on global prevalence of avoidable blindness. The full article is available on the Commonwealth Health website.

"...A big push on the prevention of avoidable blindness will yield major gains. To sustain these gains, eyecare must be permanently strengthened, not separate from but as part of health care, and made accessible to all – this is the way forward."

"...[The Global Action Plan has] a global target of a reduction in prevalence of avoidable blindness and low vision by 25 per cent by 2019, from the baseline of 2010. For the Commonwealth this means we need to reduce the number of persons with blindness or low vision to no more than 78 million by the year 2019, some 20 million fewer than there are now."

A must read.

VISION 2020 Workshops 2013-14 Update

VISION 2020 Workshops programme image

IAPB and the WHO, through the VISION 2020 workshops programme, are focussing on four priority areas in the implementation of the Global Action Plan (GAP). These are:
  • Convening regional workshops to promote implementation of the Global Action Plan in countries across regions. 
  • The development of an eye care services assessment tool by WHO and its subsequent roll out at regional and country level. 
  • The generation of evidence on the prevalence of visual impairment and its causes, through RAAB studies. 
  • Updating the eye medicines included in the essential medicines list. 
The workshops play an important role in the delivery of these and in 2013/14 (See 2013 Report) this has been in two ways. 

Workshops to promote GAP in the IAPB regions

In December 2013 IAPB and WHO held a joint GAP-themed workshop in Brazzaville, Congo to identify priorities for the Africa region and to develop a joint plan of action. The success of this workshop was certainly due to the strong representation from WHO and the representatives from the Ministries of Health from 15 countries. In this workshop the critical areas identified for Africa were Human Resources for eye Health (HReH), Primary Eye Care (PEC) and Health Management Information Systems (HMIS). 
In 2014 a regional workshop to roll out GAP and to develop ways to implement it at national level was held in Cairo, Egypt for the Eastern Mediterranean countries. This workshop recommended that all countries in the region develop their national eye health plans by 2014. Several countries in the region had already developed their plans earlier in the year and were able to provide case studies for others to learn from
We hope to have a South East Asia regional workshop in partnership with WHO to do the same for countries in that region.

Workshops to support GAP delivery

The programme will support generation of evidence on the prevalence of visual impairment and its causes by supporting a RAAB Training of Trainers (ToT) to train 12 new RAAB trainers for the regions of Europe, Africa, South East Asia and Eastern Mediterranean.  This will be the third such training and will help build up a pool of certified RAAB trainers to meet the demand for RAABs from Governments and members. These 12 people will need to be supervised on a RAAB following their training before they can be certified as ‘RAAB trainer’. We are particularly excited that we have 2 Francophone candidates to service this underserved area. 
The VISION 2020 workshops programme, running since 1999, is a well-recognised brand, with a pool of committed and loyal supporters from throughout the eye health world – and now further afield in recognition of the importance of a Health Systems approach. These people, who share their time and expertise, are key to the programme’s success.  The programme is flexible, locally owned and can respond to meet the needs expressed locally whilst delivering targeted workshops identified by IAPB and WHO on topics essential to the delivery of GAP. 
We have learnt many lessons over the years and I hope we have responded to meet the challenges. We are now strengthening our partnership with WHO, linking GAP, but to also assess longer term results. 
Interested in the VISION 2020 Workshops programme? Download the 2014 programme here.
Robin Percy
Robin Heber Percy
VISION 2020 Workshop Programme Manager

The 'Diabetic Retinopathy Barometer' project launch, Madrid

The Diabetic Retinopathy Barometer project is gathering information on DR specifically on health practitioners’ and patients’ awareness of Diabetic Retinopathy and access to needed treatment and services, across 40 countries globally. 
I attended the Press Launch on DME and on the DR Barometer Project, supported by Bayer, in Madrid on 12th May, to speak about the DR Barometer project in particular its impact, alongside panellists Lydia Makaroff from International Diabetes Federation (IDF) and Greg Shaw from International Federation of Aging (IFA), the organisations collaborating with IAPB on this innovative project. 
Press event, Madrid
The numbers that are available on DR paint a challenging picture:  on average (and taking into account that some of the data is based on extrapolations) 1 in 3 people with diabetes has diabetic retinopathy, 1 in 10 has sight threatening DR. With changing demographics and epidemiological threats, increasing aging populations, and the projected huge rise in prevalence of diabetes (described by Sir Michael Hirst of the IDF speaking at the event as a health Tsunami): the numbers of people at risk of sight loss from DR are set to increase on a major scale. 
To stop this threat in its tracks evidence can help to develop the appropriate policy and advocacy responses: health promotion and education to prevent diabetes occurring in the first place, better diagnosis and management of diabetes (blood control/ lipids/ blood pressure) to reduce the risk of co-morbidities including DR, annual national screening programmes, and making the right treatments accessible, affordable, and timely are essential so that prevention of permanent sight loss is possible. 
Some of the main points that struck me during the meeting were the need for sensitivity in raising patient’s awareness of potential risks in a manner which encouraged them to take the appropriate steps to manage their health, and also the importance of making treatments affordable and straightforward to use. 
The numbers per location now and in the future are and will be hugely determined by patient responses and by the health systems in place – is there adequate investment in health and eye health in country ensuring accessibility for all people, are there sufficient personnel, and to what extent are models of care integrated. 
Zoe Gray, Advocacy ManagerZoe Gray,

Advocacy Manager

WHO and World Bank disappoint in the latest Post-2015 thinking

At the 67th WHA, Assistant Director General Marie-Paule Kieny unveiled WHO’s latest thinking with regard to the health goal in the post-2015 thinking – there is an overall goal of “Ensure healthy lives and universal health coverage at all ages” together with four sub-goals (click on image).Sub-goals
Overall, this appears to be shaping up well with some important entry points for those of us especially interested in the health of persons with disabilities, but with one, potentially hugely damaging, omission
Some references in the initial targets and indicators outlined for the four sub-goals are very helpful – “80% coverage of NTD interventions”; “treatment of diabetes”; “non-use of tobacco”; “assistive devices for persons with disabilities” and others.  However it is in the detail related to the monitoring of progress towards universal health coverage (UHC), published separately by the WHO and World Bank (Also available in multiple languages) that a serious omission is found. Table 1 on page 9 summarises the indicators and for the important equity measures, data is “stratified by wealth quintile, place of residence and gender” - but no mention of people with disabilities.
When challenged about this at the WHA, ADG Kieny’s response was that wealth, residence and gender were the “essential minimum” measures and that countries would be “encouraged” to collect more extensive data that included groups such as persons with disability.
This tepid response risks marginalising the 1 billion persons with disability from the otherwise largely commendable ideas contained within the draft health goal thinking.  We all know that anything excluded from the data that must be collected in the final list of targets and indicators for post 2015 will simply not get measured by most countries and nor will it get the development attention required to improve people’s health. 
Ironically less than 24 hours later the WHA adopted the excellent “WHO global disability action plan 2014 – 2021: Better health for all people with disability”. The Action Plan states that:

"...men and women with disabilities are twice as likely to find that health care facilities and providers’ skills are inadequate, three times more likely to be denied health care and four times more likely to be treated badly in the health care system. Half of persons with disabilities cannot afford required health care and they are 50% more likely than those without disability to suffer catastrophic health expenditures."

WHO and the World Bank need to rethink – the equity indicators for UHC must be stratified to include persons with disability and other marginalised groups. Failure to do so undermines the fundamental principle of UHC.
Peter AcklandPeter Ackland,

The Disability Action Plan at the World Health Assembly 2014WHA67 - image of posters

It’s been heartening to witness the strong support for the “WHO global disability action plan 2014 – 2021: Better health for all people with disability” which was adopted at the 67th WHA this morning (Friday, 23 May 2014). Some 33 countries spoke, all to support the Action Plan, and the resolution, eloquently promoted by Ecuador, was agreed without amendment.
The Action Plan lays down an approach that will be strongly supported by members of IAPB and it was good to see some of the points raised by IAPB in the consultation period – such as the inclusion of eye glasses in the section on assistive technology and the strong references to universal health access. The challenge now will be to get some of the approaches of the Action Plan embedded in the post 2015 targets and indicators.
Peter AcklandPeter Ackland,

The Trust seeks Commonwealth's Support on Avoidable Blindness

98 million people in the Commonwealth are blind or have low vision.
In November 2013, avoidable blindness featured at a Commonwealth Heads of Government meeting possibly for the first time. Commonwealth Heads of Government endorsed the focus of the Queen Elizabeth Diamond Jubilee Trust on avoidable blindness, and encouraged it to work with others with the aim of making a “decisive contribution” to the elimination of avoidable blindness.  An ambitious mandate, which the Trust can only deliver with the engagement and support of many others – and first and foremost, Commonwealth Governments themselves.
Thus we were delighted that the Trust’s Chief Executive, Dr Astrid Bonfield, had the opportunity to address Commonwealth Health Ministers at their annual gathering on the eve of the World Health Assembly in Geneva, and seek their advice and support.
CHOGM 2014
Dr Bonfield spoke about the Trust’s five-year programmes on avoidable blindness across the Commonwealth:
  • The Queen Elizabeth Diamond Jubilee Trust Trachoma Initiative, tackling blinding trachoma in Commonwealth countries in Africa and the Pacific, and in Australia;
  • The Queen Elizabeth Diamond Jubilee Trust Diabetic Retinopathy Initiative in South Asia, the Caribbean and the Pacific;
  • The Queen Elizabeth Diamond Jubilee Trust Retinopathy of Prematurity Initiative in India;
  • The Queen Elizabeth Diamond Jubilee Trust Fellowships, Research and Technology Initiative to strengthen eye care, including the creation of the Commonwealth Eye Health Consortium, a group of respected eye health institutions from across the Commonwealth 
The World Health Organisation’s Global Action Plan sets out a blueprint for strengthening eye care – essential to sustain and amplify the gains made through the Trust’s and other programmes.  It includes a global target of a reduction in prevalence of avoidable blindness and low vision by 25% by 2019, from the baseline of 2010.   
For the Commonwealth this means reducing the number of persons with blindness or low vision to no more than 78m by the year 2019, some 20m fewer than there are now. 
Dr Bonfield said:  “Advances in science and knowhow make this achievable.  Numbers are already going down. With commitment and a vast store of varied experience the Commonwealth is well placed to show the way. There should be substantive progress to report to the next Commonwealth Heads of Government meeting in Malta in November 2015.”
Eleanor Fuller, QEDJT
Eleanor Fuller OBE
Director of Advocacy and Commonwealth Engagement
The Queen Elizabeth Diamond Jubilee Trust

‘Vision 2014’: Seizing the Opportunity

A few months ago, Maryanne Diamond [Immediate Past President, World Blind Union] invited me to speak at ‘Vision2014’, the International Society for Low Vision Research and Rehabilitation's 11th International Conference on Low Vision in 2014 in Melbourne, Australia, earlier this month.
As I have never been able to refuse any “request” from Maryanne I accepted quickly (and I am very glad I did)! Of course, I also enjoyed the opportunity to visit the beautiful city of Melbourne in April, and I learnt a lot from listening to the other speakers.
My problem: I was the last speaker at a conference which had enjoyed high quality contributions from a succession of expert practitioners - How could I contribute anything in such a context?
Rather than pretending to know more than the experts, I decided to issue a ‘call to arms’: Let us work to maximise the impact of our efforts to the advantage of those whose interests we serve.
With collective effort, we have opened some ‘windows of opportunity’ to mobilise resources for vision-related issues; it is now essential that we seize them. The new WHO Global Action Plan, UNCRPD, the post-2015 agenda and bilateral opportunities in countries such as the UK and Australia create the potential to do more and to do it better.
The challenge is implementation, particularly at the national level.
As President of IAPB, I consider it my duty to advocate that all organisations working in the interests of the vision impaired, need to explore or strengthen partnerships with allied campaigns. Issues like ageing, diabetes and broader disability issues will demand more attention and resources. Rather than competing with them, we should support them and seek to ensure that vision-related issues receive their due care and attention.
If we can get the priority - national implementation - right and build the global partnerships we need, we will be able to say we have seized the opportunity. We will be able to feel confident we have maximised the opportunities for a better life for vision impaired people around the world.
Thanks for the invitation Maryanne.
BoB McMullan, IAPB President
Bob McMullan,
President, IAPB

IAPB Board meets in Singapore

The IAPB Board of Trustees met in Singapore on 28-29 March for their first meeting of 2014. The meeting began with the formal approval of new members (listed below) and appointment of new trustees.IAPB BoT at SERI

Peter Ackland gave the CEO report, in which he highlighted the development of an infographic and short video to support advocacy for the Global Action Plan. He also talked about the proposals to the Qatari Government to fund pediatric eye care in South East Asia and trachoma elimination in the Eastern Mediterranean.

The theme and call to action for World Sight Day 2014, falling this year on 9 October, were also presented: the rolling theme of ‘Universal Eye Health’, in line with the focus of the new Global Action Plan, continued, with the call to action being ‘No more Avoidable Blindness’ – this would allow organisations to focus on disease areas relevant to them by customising the call to, for example, ‘No more Cataract’ or ‘No more Trachoma’.

A large part of the meeting was dedicated to discussing the ongoing membership and governance review. Richard Bennett, the consultant leading the review, reported on the results of the consultation in which members were asked about four different scenarios for IAPB’s membership and governance models. The responses pointed towards a desire for some degree of change, particularly to increase members’ engagement and ownership, and foster transparency of processes and decision-making. The board discussed at length a few key aspects such as the role of the board and its composition, ways to balance participation and engagement in governance with effective decision-making, the role of regional chairs and fee structures. Detailed feedback will soon be circulated to the members.

The dates for the 10th General Assembly (10GA) were also announced – the quadrennial key gathering for the eye health community will take place on 18-20 September 2016 in Durban, South Africa.

IAPB staff and board would like to thank the Singapore Eye Research Institute for hosting the meeting. Their work, support, contributions and warm welcome were instrumental to make this a successful, productive and enjoyable event.

(A more detailed version of the report is available here)

Welcome to our latest members:


Alessandro Di Capua

Membership Manager, IAPB



New UK Govt report focuses attention on disability

The UK House of Commons’ International Development Committee has recently released a report on its inquiry into disability and development. The report includes a number of recommendations to strengthen the UK government’s response to disability in its development and humanitarian work. Disability & Development report, IDC
One element of any successful medium term strategy for mobilising more global resources for the prevention of blindness must include convincing the major donors to lift their priority on disability and development. Therefore the decision by the International Development Committee to conduct an inquiry into disability and development was a welcome and important opportunity.
A number of IAPB members had made submissions and it is clear from the report that those submissions had an impact.
I had the opportunity to appear before the Committee to provide evidence this January. In the context of a broader contribution on disability and development, I was able to stress the importance of prevention and rehabilitation in addition to the essential focus on rights and services.
I am pleased to see this priority reflected in the final report.
Very positively, the report recognises the importance of considering prevention and treatment to “minimise the adverse impact of disability on development.” The report also makes the link between access to prevention, rehabilitation and treatment and access to other rights for people with disabilities.
While the focus is more general than specifically about vision issues, the combined impact of IAPB’s contributions can be seen in the references to the significance of sight restoring surgery and to the importance of trachoma amongst neglected tropical diseases.
The committee did a conscientious and intelligent job.
Most importantly they called for DFID to develop a Disability and Development Strategy so disability inclusion and attention to these significant challenges are made a priority. The next key step is to see DFID’s response. It is vital that we work with others in the disability and development community to ensure the potential generated by this important report is realised.
BoB McMullan, IAPB President
Bob McMullan,
President, IAPB

GBD Data: A good news story

We now have two sets of global estimates on the magnitude, prevalence and causes of blindness – the Global Burden of Disease (GBD) Vision loss expert group and the World Health Organization’s Prevention of Blindness and Deafness Unit (WHO PBD) estimates.

graph from Briefin paper on GBD

The WHO PBD team released their estimates in 1995, 2002/4 and 2010. The GBD group has now created a ‘global vision database’, the largest systematic review of population-based published and unpublished data on vision impairment and blindness published between 1980 and 2012, and has brought out detailed estimates covering the period 1990 to 2010.
(A comparison of these datasets is available here: IAPB Briefing Paper on GBD data by Dr Kate Taylor)
A caution: Using estimates of the number of blind persons in the earlier PBD studies and comparing them with estimates for the number of blind persons from the 2010 GBD data set is not appropriate and can give rise to spurious claims.
The GBD data set presents a “good news” story:
  • In 2010 there were nearly 100 million people fewer people who were blind or having severe or moderate visual impairment than would have been expected. 
  • Prevalence of blindness and visual impairment over the past twenty years – both globally and in every region – is declining. This is the most powerful evidence that the fight to eliminate avoidable blindness and vision impairment is being won
  • The underlying rates of blindness in the low income countries is considerably greater than in high income countries
  • The number of blind people in the world – 32 million. Those with moderate and severe visual impairment – 191 million. Total: 223.4 million
The GBD vision loss data can be used for the setting of priorities, advocacy, development of policies and planning.
IAPB now has a new Briefing Paper that builds a case for using the GBD data for these purposes. Do download the new IAPB Briefing Paper on GBD Numbers and Prevalence and use it in your work.
Peter AcklandPeter Ackland,

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