Supporting the one billion people who need eye care will benefit individuals, societies and economies alike
Governments have always known that to give with one hand, they must take away with the other. During the COVID crisis, that truth has become obvious to the public as their leaders juggle with the dilemma of 'lives versus economy': if you tell people to stay at home, businesses will suffer.
This unspoken mantra of 'it costs money to help' haunts every government in every country, but in some cases, it's simply not true. Following on from World Sight Day marked last week, I'd like to share the secret of how to help people and boost the economy at the same time.
The loss to the global economy has been estimated to be US$244 billion per year from uncorrected myopia -nearsightedness, including that caused by cataracts - and $25.4 billion per year from unaddressed presbyopia - short-sightedness due to age. Around one billion people are affected by these treatable conditions. That's a lot of people, and a lot of money.
The losses come from a range of causes, including reduced productivity in industries where good vision makes a difference, and the simple fact that if children can't see properly but are never tested, they won't reach their full potential and contribute to society. The human cost is, of course, huge too, and occupies all of us who work in this field, but for now let's focus on the maths.
The cost of treating this one billion people is estimated to be between $7 billion and $14 billion. That sounds a lot in isolation, but not when compared to the roughly £270 billion losses mentioned above.
There are plenty of examples to back this up. A 2017 study in Assam, India. examined whether giving a pair of glasses to workers picking tea would improve their productivity. It did - by around 25%. For governments looking to boost their economy, the prospect of scaling up this figure should be very tempting.
This impact has also been recognised by the World Bank, which reported that routine cataract surgery is one of the most cost-effective public health interventions. In other words, It's a win-win.
Taking a look at how supporting children can have a dramatic effect, one example is the Sightsavers' School Health Integrated Programming (SHIP) project which was developed to demonstrate how schools can be an effective platform to deliver integrated health interventions, including vision screening. Studies in Vietnam and Ghana, for example, showed that the cost to screen a child was around $1.50, and to correct any refractive error was $230. That's $230 to change a life (and boost the economy!)
Education can be very visual, meaning children with vision impairment can be disadvantaged, but research shows that correcting refractive error with properly prescribed glasses results in a greater impact on academic performance than any other health intervention. One example, a study in China found providing free spectacles resulted in higher mathematics test scores, equivalent to half a semester of additional learning.
In our current reality, COVID-19 has aggravated the health and education landscape. The situation is being exacerbated because the opportunities for many of the most vulnerable children - those living in poor or rural areas, girls, refugees, children with disabilities - to continue their education have been reduced further. Appropriate access to distance learning solutions is still a dream in many communities and its impact on vision impairment will continue to disrupt the education for many.
The bottom line is that investing in systems strengthening to support the billion people who need eye care will benefit individuals, societies and economies alike. Simple, cost-effective and affordable solutions already exist. Enabling them would contribute to more productive societies, support progress towards universal health coverage and help to ensure that we leave no one behind.
To do this, we need to demonstrate the power and high-impact of action and innovation; we need to generate and use evidence and technology to make sure that the right services are provided, to the people in need, in the most-effective way. In this time of building back our health and education systems better, let's commit to making this world 'visibly clear' for all - I'm sure we can all raise our glasses to that.
Sumrana Yasmin, Sightsavers' senior global technical lead for uncorrected refractive error, is currently seconded to the WHO to support its work in that field.