In her address to the World Health Assembly yesterday, Dr Margaret Chan, Director-General of the WHO mentioned the three global Action Plans that will be placed before the Assembly. In her speech, she says,
Philip Hoare runs the IAPB Standard List - the world's only online procurement portal for essential eye care products and devices. In his first blog, Phil writes about his meetings in Australia - and reveals plans for a forthcoming blog.
Procurement Coalition Manager (IAPB Standard List), IAPB
Damian Facciolo, Regional Program Manager, Western Pacific, IAPB, writes on a regional consultation to develop a regional action plan in line with the Global Action Plan, likely to be adopted soon at the World Health Assembly.
Regional Program Manager, IAPB Western Pacific
Peter Ackland writes from a conference on Ageing and Vision loss.
Chief Executive officer
Alessandro Di Capua (with support from B V Tejah) interviews Prof Clare Gilbert after she announces her retirement plans...
- The inclusion of eye care for children into primary health care for children in Africa. If this can be achieved, then eye care will become part of the usual care of children attending Maternal Child Health services, reaching a very high proportion of mothers and their young children
- To develop models of service delivery for glaucoma in Africa, “because we can’t simply wave our hands and say it is too complicated”.
- To help achieve a shift in emphasis with regards to ROP, “with the responsibility for detecting infants needing laser treatment shifting from visiting ophthalmologists to the neonatal team”. This approach has the potential to greatly increase the coverage of screening and treatment.
IAPB Board meetings are an important part of our calendar. Alessandro Di Capua, IAPB's Membership Manager, gives us a peek into the preparations for the next board meeting in April...
Alessandro Di Capua
Day 2 of the post 2015 conference in Bonn.
Chief Executive officer
I am one of 290 representatives of civil society organisations gathered at the very modern but slightly austere Bonn World Conference Centre to discuss the post -2015 and Sustainable Development Agenda - part of the very wide consultation process around what happens after the MDGs.
When all this started apparently the UN Secretary General asked people to think 'Boldly but Practically'. On day 1 there was no shortage of bold, including challenging the hegemony of neo-liberalism i.e. market-led economies - I am reminded fondly of my student days.
Lots of talk about rights - I attended a workshop on health and rights - universal health coverage discussed a lot and I expressed my view that Healthy Life Expectancy (HALE) as an overall indicator has a lot of potential to highlight inequalities if when collected it is disaggregated by gender, wealth quintiles etc. Got a fair few nods...
Slightly odd being a "vision focussed" organisation in a sea of more general development NGOs - I find myself talking about disabilities in general and stressing the importance of vision within it. No one from hearing organisations (I think) - maybe there should be a Hearing & Vision alliance - there would be 500m+ of us...
Tomorrow we will be addressed by Homi Kharas, Executive Secretary to the High Level Panel - looking forward to that.
Chief Executive officer
In the Millennium Development Goals (MDGs) there is not one mention of disability. As the major global framework aimed at poverty reduction, the MDGs created momentum amongst donors and government, but often didn’t reach those most in need, including the disabled.
This is in spite of the fact that about 15% of the world’s population or one billion people have disabilities and that disabled people are disproportionally represented amongst the poor. People who are disabled are more likely to be unemployed, not go to school, and be socially isolated than people without disabilities. Further, for a huge 80% of people living with visual impairment, their condition is avoidable - it could be prevented or if treated their sight could be restored - which means that 4 out of 5 blind people are needlessly impaired.
Whereas MDGs seemed to come out of nowhere, more or less, "Post 2015" - the process to decide what comes next - is a different story. This time there is a major effort to hear the voices of the poor and the marginalised. This time it should be possible to do things better.
IAPB is pitching in with the vast mix: how can we get the best possible development framework so that visually impaired persons' lives can be improved and those at risk of visual impairment can best be helped. With seemingly endless discussions, consultations and drafts – countless NGOs and activists around the world are trying to get heard; trying to identify entry points; using the formal processes; and where possible, lobbying crucial targets.
To push our key messages, and combine strengths, IAPB has set up a Work Group with our members, chaired by Johannes Trimmel. In a nutshell, IAPB’s efforts are focused on strengthening health systems, addressing the causes of ill-health, ensuring equal access to health care for all people, and explicitly addressing disability rights across the framework.
We know that Post 2015, whatever its final form, cannot attend to everything. But to really improve the lives of the poor and the marginalised, it is absolutely crucial that the rights of the disabled and those at risk of visual impairment are accounted for.
A great meeting in the cold but beautiful Budapest, hosted by IAPB’s new Chairman for IAPB Europe – Professor Janos Nemeth. Janos is in the middle of the picture taken in the library at the Dept. of Ophthalmology, Semmelweis University - an illustrious and historic centre of ophthalmology in Hungary.
A small group met to identify strategic priorities for the Europe region – this is a very diverse region with 53 countries stretching from the far east of Russia through to Iceland - not surprisingly eye health issues also vary enormously. The group came up with three main areas for future focus:
- Data collection – we will make available on the new IAPB website page for Europe all the data we have for the region and also stimulate the capacity to conduct RAAB surveys in the region
- A focus on raising awareness and capacity to deliver Retinopathy of Prematurity (ROP) programmes in Eastern Europe – building upon the support we are getting from Shreveport Sees Russia.
- Facilitation and support for the coalition that has been created to promote better eye health in the 27 countries of the European Union.
I am confident that with the leadership of Janos, who will be supported administratively by Erika Tátrai, and with the co-chairs for the region we have a strong team that will make real progress in the region.
ROP has got to be one of the worst nightmares of all parents – imagine having a premature baby, the joy at your child surviving, but then to find out that the very treatment that saved your baby’s life made her blind. This is a growing concern in Eastern Europe and the urban centres of many emerging economies – it’s something we can solve – no child needs to be blinded from ROP.
Chief Executive officer
(14-15 February 2013)
IAPB's regional team from Latin America met with our newly elected Chair for Latin America, Dr. Juan Batlle, in the amazing melting pot of Miami. With its Latin influence and multicultural complexion, Miami was the perfect backdrop for focusing our minds and to articulate our aspiration for IAPB's work in Latin America over the next three years.
We now have a growing presence in the region: we welcome our new chair Dr Juan Battle, Medical Director, Centro Laser, Santo Domingo, Dominican Republic; Dr Van Lansingh, our long-standing regional coordinator was joined in January 2012 by Cristina Sanchez, our representative in Bolivia and Christina Sanko, now located in Mexico, IAPB's Development Manager for Latin America.
We focused on how we most effectively can contribute to the newly developed VISION 2020 Latin American Strategic Plan for 2013-2016 that was developed in Lima (2012) in consultation with members and stakeholders including PAHO, PAAO and national VISION 2020 members. We focused around five key pillars from the Plan: advocacy, communications, capacity building, research and resource management.
We had very positive discussions of how IAPB can most effectively work to contribute to the Strategic Plan and make a difference for eye health in the region. We also discussed ways that IAPB can improve our communications on our key eye health messages. In line with this we have recently published three editions of the Community Eye Health Journal in Spanish that cover subjects of Diabetic Retinopathy, Instruments and supplies and Low Vision. If you work in the field and would like to receive future editions please contact us
During our meeting we also recognised that it is very important to raise awareness of public eye health within the ophthalmological community. One way to achieve this can be a dedicated Latin American IAPB award to recognise prevention of blindness efforts. To help promote eye health messages amongst the general public we are planning new initiatives around World Sight Day and will have more on this later
Fundraising and Partnerships Manager
(21 February 2013)
Komal Ram, Regional Project Manager for the International Agency for the Prevention of Blindness (IAPB) Western Pacific Region, blogs about her recent trip to Fiji where she visited and accompanied a surveillance team as part of the Pacific Elimination of Trachoma Programme. The original blog post appeared on the IAPB WPR blog and is re-produced with permission.
In early August the Pacific Elimination of Trachoma Program (PacET) team surveyed 20 clusters for trachoma in the Northern Division of Fiji, on the island of Vanua Levu. Trachoma is the result of infection of the eye with Chlamydia trachomatis. Infection spreads from person to person, especially where there are shortages of water, many flies, and crowded living conditions. Infection often begins during infancy or childhood and can become chronic. If left untreated, the infection eventually causes the eyelid to turn inwards, which in turn causes the eyelashes to rub on the eyeball, resulting in intense pain and scarring the eye. This ultimately leads to irreversible blindness, most commonly between 30 and 40 years of age.
The PacET team was headed by the National Trachoma Coordinator and made up of a local Ophthalmologist, eye health nurses, and public and village community nurses. We were based in the main township of Labasa, but surveyed a number of areas on the island. The terrain outside of the main township of Labasa in the North is a mix of village communities and houses in the sugar cane belts. The team worked tirelessly to screen children between the ages of one to nine starting their survey walk at 9am and finishing at 6pm. In some areas of the North, the survey team screened children who had active trachoma, especially in the older age group.
Formal analysis of the data commenced in October for all divisions surveyed in Fiji and will be presented to key stakeholders to inform implementation of the second stage of PacET.
One of the first survey areas about 40kms out from the main township Labasa. This village was identified by the local public health nurse as lacking in basic facilities and a proper rubbish disposal area.
Dr Vara screens an 8 year old for active trachoma.
9 year old child screened for trachoma. Trachoma follicles (TF) were detected.
Children from the community school arriving for their screening and educational talk on Trachoma. The talk is based on the SAFE strategy and features components F and E. The SAFE Strategy is an innovative public health approach designed to treat and prevent trachoma. Endorsed by the World Health Organization, the components of SAFE are: S for Surgery for in-turned eyelids; A for Antibiotics to treat and prevent active infection; F for Facial cleanliness to prevent disease transmission; and E for Environmental change to increase access to water and sanitation.
The team conducting surveys in one of the clusters in the sugar cane belt. With houses quite spread out, this meant a lot of walking around with equipment.
Pacific Elimination of Trachoma Program (PacET) data forms.
At each village we entered there was the ceremonial sevusevu, which is an official Fijian ceremony for meeting and greeting visitors by the Chief or the head person of the village. The sevusevu is a ritual which allowed the survey team to ask permission and show appreciation for screening kids in the village. Kava is usually offered to drink in a sevusevu. Komal Ram drinking ceremonial kava.
All photos courtesy of the Fiji Ministry of Health and the PacET Project.
Regional Project Manager,
(24 January 2013)
Geneva in January is always a spectacular and beautiful place to be with the mountains covered in snow and the lake gleaming in the bright winter sunshine. But two days ago, the Executive Board meeting room deep in the heart of WHO was an even sunnier place to be for those of us interested in the prevention of avoidable blindness. The 34 Member States that make up the EB were discussing the proposed new Action Plan 2014 - 2019 "Towards Universal Eye Health" and an accompanying resolution to go to the World Health Assembly for adoption in May.
The plan received fulsome report - the resolution was proposed by Mexico, Costa Rica and Saudi Arabia and in the discussion Panama, USA, PNG, Australia and Yemen all expressed their co-sponsorship. All countries that spoke in support of the plan and resolution , did so extremely positively and all stressed just how important the issue of avoidable blindness and visual impairment is - In total 18 countries spoke including Mexico, Lithuania, Panama, Seychelles (on behalf of all 46 African countries), Cuba, USA, PNG, Myanmar, Morocco, China, Australia, Iran, Yemen, Nigeria, Venezuela, Italy, Thailand and Saudi Arabia
The contents of the Action Plan and the indicators and global target were commended with just a couple of comments about areas that might be stressed further (onchocerciasis, trachoma, glaucoma, AMD and DR plus Childhood Blindness and affordable medicines). The resolution was passed with just a few "friendly" amendments, though the commitment to increasing resources was, not un-expectedly given the current financial climate in WHO, slightly watered down.
At the end Dr Chan the Director General was effusive in her support - noting how 50% of the people in the room had a visual impairment but were lucky enough to have these corrected - but that many people living in poorer countries were not so lucky. She stressed the value of low cost cataract surgery in India, China and Cuba; how ageing and diabetes were factors likely to contribute to an increase in eye health problems and spoke about the importance of school health programmes including eye health reminiscing on her own experience in Hong Kong of providing glasses to school children that needed them.
Overall we left with the winds in our sails and confident about receiving very positive support in May at the WHA. I have to say so much of this is down to the inside knowledge of Lesley and Sanjeev - they seem to know everyone who represents the country delegations plus the excellent work done by our regional staff and Members in making contact with key countries and winning their support. The IAPB work group has really been effective - a blue print for other advocacy objectives I feel.
Chief Executive officer
(24 January 2013)
The very successful 9GA saw greater focus on the many successes of the South East Asia region. The region’s new regional chair, Dr Tara Prasad Das (TPD), is an indefatigable champion of blindness prevention and has years of experience in the field.
I have always known Dr Das to be a hands-on manager. His contributions at many eye hospitals – including the two big South Indian ones, Aravind and LVPEI – are testimony to his passion and attention to detail. TPD has an infectious enthusiasm and deep understanding of the eye care issues of the region – a great choice for the Regional Chair!
TPD had called for a fresh assessment meeting on the eve of the giant APAO-AIOS 2013 conference in Hyderabad, India. The group was to see how best IAPB could support and promote avoidable blindness efforts in the 11 countries of the S E Asia region, without duplicating the many ongoing efforts in the region with the highest prevalence of vision loss in the world. The attendees included heads of major eye care NGOs active in the region, and representatives from India, Nepal, Thailand, Indonesia and reports sent in from Bangladesh. Peter Ackland, CEO and John Trevelyan, Fundraising and Partnership Development Manager, IAPB and I joined the group with inputs about work in other regions.
The stress at the meeting was to ensure that there was follow-up from this meeting; that things don’t quieten after people go away from here. Everybody felt that a regional coordinator would be great help in ensuring the momentum is sustained, and IAPB hopes to seek funding to support this position. I was impressed to note the years of experience and friendship among the group; though they worked in different countries and settings, they were quick to note novel ideas that worked – and were politely dismissive of systemic issues that throttled change in the region.
In the first year, the group decided to focus initial efforts on 3 countries – Indonesia, Myanmar and Bangladesh and to also develop a regional theme, by focusing on key issues across the region such as primary eye care or the increasing incidence of diabetic retinopathy. IAPB will be hosting a region-focused webpage on the IAPB website to help promote exchange of data and information, and I will be working TPD in making it live over the next few weeks.
John Trevelyan came away from the meeting with a sense of purpose and opportunities to support this fledgling group. He noted, “It was valuable to identify the key priorities and programmes needed in the region. I look forward to working with the regional team in developing fund-raising opportunities so that there is measurable progress”.
Peter Ackland too is enthusiastic about the group’s focus on outcomes and plans for the future. Signing off after a long but fruitful day, he said, “It was great to see a knowledgeable and highly-experienced group coming together. I came away with the feeling that we have a tangible way forward. I hope this will go on to positively impact the people of this region”.
B V Tejah,