The VISION 2020 Global Initiative was complemented and built upon by a series of additional plans. In 2006, VISION 2020 stakeholders developed an action plan for the period 2006-11, which extended the remit to focus not only upon the elimination of avoidable blindness, but to include visual impairment – particularly that caused by uncorrected refractive error.
World Health Assembly resolutions
In addition, four World Health Assembly resolutions (2003, 2006, 2009 and 2013) have reinforced the aim and objectives of VISION 2020. The last two resolutions were accompanied by WHO Action Plans which have provided more detail on how the objectives were to be achieved. They also helped refine some of the implementation approaches.
The most recent action plan “Universal Eye Health: A global action plan 2014 – 2019“ (GAP) was unanimously adopted by Member States at the World Health Assembly in 2013 as part of WHA resolution 66.4.
A 2020 World Health Assembly resolution urges integrated people centred eye care to be embedded within the principal health agenda of UHC and to expand the scope of eye care into the mainstream as an integral issue for sustainable development.
The long-term goal of both the GAP and VISION 2020 remains the same – to reduce avoidable blindness and visual impairment. It is a shocking fact that in the 21st century there are still some 285m visually impaired and blind persons and that most of these cases could have been prevented or treated.
World Sight Day
An important factor leading to success of VISION 2020 has been the advocacy work of many stakeholders, including during events such as World Sight Day.
World Sight Day (WSD) is an annual day of awareness held on the second Thursday of October, to focus global attention on blindness and vision impairment.
World Sight Day became an official VISION 2020: The Right to Sight event in 2000. It has become the major annual public relations and advocacy event in eye health for eye care organisations around the world.
At the launch of VISION 2020, the goal was to double the NGO funding base. This goal has been exceeded – during the last two decades, funding for prevention of blindness and eye care multiplied several times, both through governmental and non-governmental sources.
Various governments around the world have increased funding for prevention of blindness and eye care programmes. Many developed nations supported developing countries via the work of dynamic eye health NGOs and corporations from different countries.
Through the efforts of IAPB and VISION 2020, additional support was mobilised from the corporate sector, such as programs focusing upon elimination of onchocerciasis and trachoma. Donation of medicines by Merck (Mectizan – ivermectin) and Pfizer (Zithromax – azithromycin) worth hundreds of millions of dollars for the elimination of onchocerciasis and trachoma respectively have been huge contributions. These programs have made elimination of these potential blinding conditions a possibility (Rao 2020).
National plans and data
Commitment to VISION 2020 has been shown through the creation of national VISION 2020 committees and plans. In the first five years, 53 countries drafted VISION 2020 National Plans and 78 formed VISION 2020 National Committees (Rao 2020). By 2012, more than 100 national plans to achieve the elimination of avoidable blindness had been developed (Ackland, 2012).
Many eye health research studies, both intensive epidemiological surveys as well as Rapid Assessment of Avoidable Blindness (RAAB) surveys were conducted over the past 20 years, increasing the quality of eye health data available for advocacy and planning purposes.
The latest Vision Loss Expert Group data shows that in 2020, an estimated 43 million people were blind, 295 million had MSVI, 257 million had mild VI, and 507 were VI from uncorrected presbyopia. Disparities due to socio-economic status, geography and gender remain.
It is encouraging that age-adjusted prevalence of blindness has reduced over the past 3 decades, yet due to population growth progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages, as services are often not available, accessible, acceptable, or affordable.
Eye care services need integrated with the mainstream health system to form a core part of universal health coverage (UHC).
VISION 2020 has made a huge difference to global eye health. It has created a major focus in the countries and districts where action is needed.
Awareness of the VISION 2020 brand remains strong. The aims, aspirations, principles and approaches that were at the heart of the original Initiative remain in place to this day.
The elimination of avoidable blindness can be achieved, but to achieve the aspiration of VISION 2020 a significant scaling up of current activity is required. We need more programs, better programs and we need faster progress toward our goal (Ackland, 2012)