London School of Hygiene & Tropical Medicine


Lead Organization

London School of Hygiene & Tropical Medicine

London, England, United Kingdom

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Project Summary

Worldwide, 253 million people are visually impaired, 36 million of whom are blind. Sight-loss increases poverty and dependence, impedes learning and reduces quality of life. Although 75% is avoidable with existing solutions, one third of the world cannot access basic eye-care. Those with greatest need have least access: 89% live in low- and middle-income countries (LMIC).Our vision is a world without avoidable visual impairment.Since 2014, our Consortium of leading training centres and professional societies, in partnership with Ministries of Health, has strengthened eye health systems in 42 LMICs, increasing access to high-quality services for millions.We work together in partnership to deliver a coherent programme of human capacity-building for health systems strengthening; knowledge generation and sharing; and development and deployment of new affordable technology for eye care: PEOPLE---KNOWLEDGE---TOOLSWe now propose to expand the scope and scale of this proven model, leaving no one behind.

Problem Statement

Worldwide, 253 million people are visually impaired, 36 million of whom are blind. One million children are blind and 10 million have poor vision from short-sightedness. One billion adults struggle with uncorrected near visual impairment. Most sight-loss (89%) occurs in LMICs, disproportionately affecting the poor, young, old and females; people with limited access to services. Numbers are projected to triple by 2050.Sight-loss increases poverty, impedes learning, shortens life and harms quality of life, independence and mental health. Carers, including children, spend less time on economically productive activities or at school. The economic loss of sight-loss is enormous, estimated at $3 trillion/year. However, 75% of sight-loss is treatable or preventable, with highly cost-effective interventions. Addressing avoidable sight-loss contributes towards achieving several Sustainable Development Goals.For millions of people living in LMICs accessible, affordable, effective, good quality eye-care, a basic human right, is scarce. In Sub-Saharan Africa, for example, there are only two eye doctors for every million people. Eye health services are under-developed, under-resourced, unevenly distributed and poorly integrated into the general health system. Many changes are needed, requiring a broad health system strengthening approach: •Expand public health leadership skills.•Evidence for policy, planning and advocacy from contextually-relevant research. •Training and resources to grow the eye health workforce.•Integrate eye health services into the health system and expand to rural areas.•Improve access to affordable diagnostic and treatment tools.•Integrate eye health into health financingAddressing these critical issues catalyses sustainable improvements.

Solution Overview

Long-term improvement of eye health in LMICs requires substantial strengthening of eye health services within the mainstream health system. Our solution is: PEOPLE––KNOWLEDGE––TOOLSThe Consortium works through an extensive global network of partnerships to deliver an integrated, demand-led programme that fundamentally strengthens the system and people working within it. Investment in people and systems catalyse sustainable progress, leading to lasting change. Our proposed programme has several integrated, synergistic themes:•OPEN EDUCATION: developing and delivering online courses which are scalable and adaptable, reaching >100,000 practitioners globally.•PUBLIC HEALTH LEADERSHIP TRAINING: for a new generation of eye health leaders through Masters-level courses, leadership network and mentoring.•STRENGTHENING CLINICAL TRAINING: through clinical training fellowships; development of regional training faculty; mentorship; Training-The-Trainers; simulated surgical skills courses for safer-better-faster training. Surgical training for 800 trainee eye doctors, in five years positively impacting >200,000 patients having sight-saving eye surgery, with >8,000 fewer people having surgical complications.•SERVICE DEVELOPMENT NETWORKS: interdisciplinary, multi-country, MoH-led networks developing and delivering new services for major eye health problems: child eye health, diabetic eye disease, glaucoma, cataract and cornea disease. Evidence-generating and evidence-led. The broad positive impact would be >300,000 extra people referred for timely treatment.•RESEARCH CAPACITY DEVELOPMENT: training and mentorship to nurture eye health researchers, delivering contextually-relevant research guiding policy and effective implementation.•TECHNOLOGY: development and deployment of tools for diagnosis and referral in primary care settings.Since 2014 we have made demonstrable, externally evaluated progress. We prospectively collect data on each theme to monitor progress and impact.

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Project Funders

  • The Queen Elizabeth Diamond Jubilee Trust

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