Africa: Poor Vision Affects Billions, Costs Trillions – a Feasible Fix

Seeing changes lives and economies.
24 October 2018
guest column

Hong Kong — Try to imagine life – school, home, work – without eyeglasses. Then reflect that poor vision is the world's largest unaddressed disability, affecting an estimated 2.5 billion people, most of them in low-to-middle income countries, costing the global economy $3 trillion.

It is an outrage that so little is being done to address poor vision when, in nine out of ten cases, a simple pair of glasses – costing as little as $1.50 – can be the most effective solution. Vision is not only a health issue. It is essential to attaining quality education and lifelong learning opportunities, facilitating gender equality, ending poverty, and ensuring economic growth and decent work for all.

PROSPER, a study conducted by Clearly – the organization I started in 2016 – and published in the Lancet Global Health, found that eye glasses resulted in the largest ever increase in productivity of any similar health intervention. Collaborating with others, we have started to show that greater access to glasses – an invention over 700 years old – could transform lives.

Signs of change have emerged during the past year. Following the Commonwealth Heads of Government Meeting this year, 53 member-countries pledged to "take action towards achieving access to quality eye-care for all" – the first time, on the world stage, that governments joined in a commitment to tackling poor vision.

This month I was in New York for the inaugural meeting of the UN Friends of Vision Group, joined by representatives from Botswana and Rwanda as well as Dr. Agnes Binagwaho, Vice-Chancellor of the University of Global Health Equity and former Minister of Health in Rwanda.

Peter Holland, CEO of the International Agency for the Prevention of Blindness (IAPB), spoke at the meeting at the UN's headquarters about the intrinsic connection between vision and many of the United Nations Sustainable Development Goals.

Achieving recognition from international bodies and governments worldwide is a substantive step towards what needs to be a universal effort. But businesses, governments, NGOs and individuals can – and should – be doing more.

Rwanda is doing it. Which country will be next?

In the last year, Rwanda became the first low-to-middle-income nation to provide every citizen with access to quality eye care. Working with a local charity I founded, Vision for a Nation (VFAN), the Rwandan Ministry of Health has now provided over two million sight tests.

Working with VFAN and others, the Ministry of Health eliminated restrictions against nurses, teachers and other professionals from delivering sight tests, and by training nurses in just three days to deliver basic sight tests and diagnose poor vision, referring patients to specialists and providing a pair of glasses where needed.

Rwanda is only a small nation. With a third of the world in need of glasses yet unable to access them, we need innovative ways to reach those in need. Rwanda's phenomenal success should be a lesson to the world: this can be done.

Tackling this challenge on a global scale requires broad collaboration. Governments and NGOS alone cannot do it. Everyone has a part to play.

Quality eye-care makes economic sense for businesses. It is time for the largest corporations to step forward and play their part in bringing clear vision to all.

Visionary businesses give their workers vision – and themselves a boost

Many companies – including Uber Kenya, Discovery Health and Williams Sonoma – are implementing work-based sight tests. I have committed to providing free sight tests to the people employed by my family's businesses and, this year, I am urging other businesses to do the same.

Momentum is building. On World Sight Day on 11 October, I wrote to 120 CEOs of the world's largest businesses – from Adidas to Uber – outlining the benefits of providing work-based sight tests to all their employees. If these 120 companies were to act, this could transform the lives of 20 million employees. And employers would benefit from gains in productivity.

Clearly's petition calling on CEOs around the world to provide free work-based sight tests gained over ten thousand signatures in the first few days, with many more expected to show their support in the coming months.

Studies from Rwanda and Bangladesh found an average return of 30:1 on investments in improved vision. Among tea-pickers in India's Assam region, wearing glasses boosted productivity by 22 per cent. For those over 50, this increase was as high as 31.6 per cent – the largest-ever increase in productivity from any similar health intervention.

If the Indian agricultural sector provided their workers with eye tests and glasses, it would add an extra $19 billion to the economy. Worldwide, the projected potential productivity increase to the agricultural sector alone is upwards of $180 billion in value.

Vision is an issue that will take innovative technology, changes in government legislation and much more support from the business sector before we see global change.

But the benefits are exceptional. Taking care of vision and eye health is a win-win for everyone. It is straight-forward economics for businesses and provides a big boost to governments and the Sustainable Development Goals. And workers enjoy better health and well being, plus higher earnings in older age.

James Chen, born in Asia and raised in Africa, is a venture philanthropist, overseeing his family's foundation, which focuses on early childhood literacy, and he chairs a third-generation family-owned manufacturing group. His personal passion is improving eyesight for the 2.5 billion people who lack glasses. He co-founded Adlens, which makes adjustable-lens readers, and launched Vision for a Nation and the Clearly campaign to promote awareness of "the problem the world forgot".

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