Industry profile

A solvable global problem: addressing access to eye care around the world

Peter Holland, chief executive for the International Agency for the Prevention of Blindness, on the ambition to raise the profile of eye health beyond World Sight Day

School children
We want to make World Sight Day a much more high-profile day – the day for people to recognise how important sight and, crucially, eye care, are. There are three things we want to achieve through World Sight Day, which is on 13 October. Firstly, getting everybody to recognise how important eye health is to them, and to prioritise getting their eyes tested. Then, we’re encouraging people to draw the connection from their own personal eye health to the scale of the issue worldwide. Over one billion people worldwide have sight loss because they don’t have access to the eye care that they need. World Sight Day is an opportunity to make people aware of the magnitude of the problem.

One billion

people worldwide have sight loss

We also want to communicate that this is a problem that is solvable. For the vast majority of people, it’s about access to glasses or a cataract operation. These are some of the simplest and most cost-effective interventions in the whole of healthcare. It is not a complicated issue to solve.

In the month running up to World Sight Day we want everybody to make a pledge to have their sight tested. We had a target of a million last year and got over three and a half million pledges. This year we want to go even bigger and have a target of five million. But we’re also bringing this home to decision makers, holding a series of sight screenings in parliaments and assemblies around the world, including at the UK Parliament.

We also want to communicate that this is a problem that is solvable


Our Love Your Eyes global campaign has launched this year. It encompasses our objectives, starting from the individual and loving your eyes, but also recognising that this is a global problem. As a campaign it’s quite adaptable to different contexts. In the UK we think in the context of High Street opticians, but in many environments you don’t have that. Indeed, there is often quite a lot of stigma associated with simply wearing a pair of glasses. The feedback and experience we’ve had is that it provides quite a helpful way of challenging some of those issues as well. Having a positive message about caring for your own eye health allows people to use it in contexts where it is less straightforward.

You need effective policy advocacy to influence decision makers. But ultimately, politicians listen to voters and their communities. If they are getting messages that people think this matters, then they are more likely to listen to us, and our members, about how important it is to invest in eye care. That is what is critical for the billion people who need investment in services.

We are within reach of eliminating trachoma as a public health issue across the world. A small country, Vanuatu, has just declared that it has managed to eliminate trachoma. But you have to keep investment in that. Like any of these public health problems, if you let up, even as you get very close, then the problem comes back. It’s crucial that we keep going. Of course, it is that last mile that is always the most difficult.

We’ve introduced 2030 In Sight as a new strategy. The sector strategy has three elements to it: elevate, integrate and activate. It is based on the principle that this is a solvable problem. A crucial message of the strategy is that this isn’t just a health issue, but a developmental, economic and social issue as well.

Having good eye health means you can improve your education, stay in work, or just participate in daily life. The evidence is there that in education eye care is probably the single most effective intervention for improving children’s access. Research from China [Ma et al, Effect of providing free glasses on children’s educational outcomes in China: cluster randomised controlled trial] suggests it might be equivalent to as much as half a semester’s additional learning. In work and productivity, the Lancet Global Health Commission, published last year, estimated conservatively that globally the world loses US$411 billion (approx. £386 billion) a year in lost productivity due to vision impairment. They said that the figure was likely many multiples higher.

The world loses US$411 billion a year

in lost productivity due to vision impairment

There are very practical impacts. The other side of the equation is that the World Health Organization estimated that providing access would cost about US$25 billion a year. The return on investment is really significant. That was recognised at the United Nations (UN) last year when the General Assembly adopted a resolution on vision. This was the first time that the UN has had a resolution about vision.

To optometrists I would say: pledge your eye tests for World Sight Day. Optometrists could also write or speak to local MPs and highlight the global, solvable problem.

The importance of collaboration

Collaboration is one of the areas we highlight in 2030 In Sight as being crucial. I think we can talk about partnership and collaboration in a number of different ways.

There are partnerships across the sector. The non-governmental organisation (NGO) sector as a whole is not always the most collaborative – people are competing for funds – but increasingly, we see people coming together to partner, recognising that they can’t do everything individually.

As an example, recently we’ve backed the founding of the Coalition for Clear Vision. This is a group of NGO and private sector partners who work in problems around refractive error. The focus is how we scale up solutions to reach the almost one billion people who need access to glasses. This recognises that any individual organisation in the coalition can’t do it themselves.

This points to the second area, which is increasingly partnerships between NGOs, governments and the private sector. I think that cuts to one of the things that is fairly unique about eye health – the private sector has a really important role. In many other areas of healthcare it is a public provision, but in eye care, particularly because of access to glasses, the private sector plays a fundamental role.

The third area, and probably a newer one for the sector and more challenging, is that we need to work outside of the sector. I went to the Commonwealth Education Ministers meeting earlier in the year to talk to them about eye health. You need education ministers, not just health ministers, to be interested in this. Another example is businesses. Building those partnerships, not just within the sector but outside of it, will make a real difference.

A crucial message for us is about integrating eye care as part of mainstream health systems