Eighty per cent of the causes of visual impairment are preventable and curable. If just the two major causes of impairment were addressed, two-thirds of the visually impaired could recover good eyesight, the World Health Organisation says.
The WHO’s global action plan for 2014-2019, ‘Universal eye health’, calls on all stakeholders to join in a renewed effort to provided effective and accessible eye care services to effectively control visual impairment including blindness.
Preference should be given to the integration of eye care services in the health system rather than through a vertical programme approach.
WHO assistant director-general Oleg Chestnov, in a foreword to the action plan writes: “There is the potential to streamline health promotion for eye care alongside general health promotion initiatives. There are a number of proven risk factors for some major causes of blindness… which need to be addressed where appropriate through a health-sector wide approach.”
WHO’s vision, Chestnov says, is a global eye health action plan where nobody is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential, and where there is universal access to comprehensive eye care services.
WHO estimates that globally 285 million people were visually impaired in 2010, of whom 39 million were blind. The two main causes of impairment were uncorrected refractive errors (43 per cent) and cataract (33 per cent). Visual impairment is more frequently among older age groups, with 82 per cent of those blind and 65 per cent of those with moderate and severe blindness older than 50. Furthermore, poorer populations were the most affected by visual impairment.
The goal of the action plan is to reduce avoidable visual impairment as a public health problem and to secure access to rehabilitation services for the visually impaired. Five guiding principles underpin the plan: universal access and equity; human rights; evidence-based practice; a life course approach; and the empowerment of people with visual impairment.
There is potential to streamline health promotion for eye care alongside general health promotion initiatives
The WHO draws up three main objectives for its member states and international partners: generate evidence on the magnitude and causes of visual impairment and eye care services and use it to advocate greater political and financial commitment to eye health; encourage the development and implementation of integrated national eye health policies, plans and programmes to enhance universal eye health; address multi-sectoral engagement and effective partnerships to strengthen eye health.
The WHO global target is to reduce the prevalence of avoidable visual impairment by 25 per cent by 2019 from the baseline of 2010. In meeting this target, the WHO expects that the greatest gains will come through the reduction in the prevalence of avoidable visual impairment in those aged over 50.
Describing its target as ambitious, the WHO says that expanding comprehensive integrated eye care services that respond to the major causes of visual impairment, alongside health improvement that can be expected from implementing strategies such as the draft action plan for the prevention and control of non-communicable diseases 2013-2020, plus global efforts to eliminate trachoma, would make the 25 per cent target achievable.