What is the Global Action Plan?

GAP has a global target – the reduction in prevalence of avoidable blindness and visual impairment by 25% by 2019 from the baseline of 2010. To monitor progress a small number of key indicators are to be monitored:

  • Prevalence and Causes of VI;
  • Numbers of Ophthalmologists, Optometrists and Allied Ophthalmic Personnel;
  • Cataract Surgical Rate and Cataract Surgical Coverage

Infographic GAP

How can this target be achieved? National Eye Health Plans must be geared to:
  • Collect data on prevalence of Visual Impairment through RAABs (Rapid Assessment of Avoidable Blindness)
  • Assess a country’s eye health system using ECSA (Eye Care Service Assessment)
2. Train more eye care professionals
  • Address acute shortage in every cadre of eye health – nurses, optometrists, ophthalmologists etc.
  • Ensure equitable access to eye health personnel
3. Provide comprehensive eye care
  • Eye care is well funded and integrated in to health care
  • Covers all major causes of visual impairment & rehabilitation
  • Increase cataract surgical rate and coverage
4. Eliminate social and economic obstacles
  • Point-of-care payment should not prevent access and should be free for the poorest
  • Gender disaggregated data should be collected at all levels
The Action Plan provides us with ‘indicators’ to measure progress at the national level:
  1. the prevalence and causes of visual impairment;
  2. the number of eye care personnel; and
  3. cataract surgical rate and coverage (1)
Importantly, The Action Plan has an overall measure for the success of this Action Plan: reduce the prevalence of avoidable visual impairment by 25% by the year 2019 from the baseline of 2010.
Challenges:
High proportions of people cannot access eye health services around the world.
  • Serious shortages in trained personnel, particularly in Africa.
  • Low surgical rates and irregular outreach to the poorest and rural populations.
  • For many poor and marginalised people the cost of treatment can be prohibitive.
  • Transport, lack of appropriate technologies and discrimination cause further difficulties in access to eye health for vulnerable groups of people such as the poor, minorities, persons with disability and women
  • Changing demographic and health trends – Ageing populations and Diabetes, for example.

To meet the Action Plan’s objectives, it is important that an active and effective Eye Health (or VISION 2020) national committee is in place at the country level. The Guidelines for Eye Health Committees suggests good practices for constituting and operating a national Eye Health Committee to achieve the Action Plan’s mandate.

The GAP builds upon VISION 2020: The Right to Sight, the Global Initiative for the elimination of avoidable blindness, a joint programme of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB).

WHA Resolution 66.4 containing the GAP is the latest of four recent WHA resolutions (2003, 2006, 2009 and 2013) that have reinforced the aim and objectives of VISION 2020. The 2009 resolution, WHA 62.1, also had an Action Plan spanning the period 2009-2013.

GAP’s Areas of Focus

  • Generating evidence on the magnitude and causes of visual impairment and use it to advocate increased commitment from countries – both political and financial.
  • Integrated national eye health policies, plans and programmes to enhance universal eye health
  • Multisectoral engagement and effective partnerships to strengthen eye health

These areas of focus (or “objectives” as GAP calls them) also reflect IAPB and its Members current strategies for eye health, vision impairment and rehabilitation and our efforts to establish the services required to bring eye health to the most marginalised and poorest groups in society. Important though the new Action Plan is, it will only add value if it is now taken up at country level and national governments take responsibility for implementing the GAP in their country.


(1) Cataract surgery rate – number of cataract surgeries performed per year, per million population and coverage – number of individuals with bilateral cataract causing visual impairment, who have received cataract surgery on one or both eyes.