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Why tackling poor vision can help advance the human rights agenda

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The Universal Declaration of Human Rights (UNHR), adopted by the United Nations General Assembly on 10 December 1948, was the foundation for the growth of global development activity, providing a road map of objectives to NGOs, charities and government for the last 60 years. However, as a vision that has to transcend political and cultural boundaries, it is difficult to translate it into concrete action that is scalable across the globe.

In September last year, the UN attempted to change that – announcing an ambitious new global commitment to anchoring development targets within human rights principles and standards through its Sustainable Development Goals.

Officially known as ‘Transforming our world: the 2030 Agenda for Sustainable Development’, it was a set of 17 aspirational global goals which set out to end poverty, improve health and education, protect the planet and ensure prosperity for all.

Each goal defines specific targets to be achieved over the next 15 years, offering a vital step forwards to ensuring the tangible realisation of the human rights enshrined within the declaration.

From ‘eradicating extreme poverty for all people everywhere’, to ‘ending all forms of discrimination against all women and girls everywhere’, to ‘ensuring that all girls and boys complete free, equitable and quality primary and secondary education’, the goals undoubtedly aspire to phenomenal global progression.

However, laying out cross-border policy priorities for the world’s leaders and central institutions is a gargantuan task. Too often, the macro-level approach of these global agenda-setting summits means that vital issues fail to make it on to the global agenda.

Tackling poor vision

Poor vision is one such issue. Based on the latest UN data available, the Vision Impact Institute has estimated that a staggering 2.5 billion people across the world suffer from poor vision, with no means of correcting it.

That makes it the largest unaddressed disability in the world, affecting the equivalent of the combined populations of India, China and Japan. And the situation is only set to worsen – an international team of researchers has recently revealed that, if current trends continue, almost 5 billion people (half the world’s population) will be short-sighted by 2050.

It’s a problem that is costing the global economy dearly. According to a 2010 report by Access Economics, an estimated $3 trillion a year is lost to poor vision – more than the total gross domestic product of the entire African continent. 

As a non-life-threatening and often unacknowledged condition, poor vision is considered non-urgent and tends to drop off the global priority scale when measured against life-threatening communicable epidemics such as HIV, Ebola and malaria – all of which are directly referenced in the Sustainable Development Goals. As demonstrated by its absence from the UN’s latest goals, the drive to treat poor vision has historically failed to hit the global policy agenda, and therefore to attract development funding, innovation and investment. As a result, there has been little advance in our approach to vision, since the humble spectacle was invented some 700 years ago.

And yet failing to tackle poor vision is preventing global humanitarian agencies from making headway on the sustainability goals, and therefore to safeguard our human rights. In particular, poor vision is hampering progress in the fight to reduce global poverty and income disparity, and to ensure equal access to educational opportunities for all.

For example, last year a team of ophthalmologists and optometrists visited a cotton spinning and textile factory in Madurai, South India. A series of basic eyesight tests revealed that around 80% unknowingly suffered from poor vision. All those in need of vision correction were then provided with prescription glasses, and just one month later 44% of the spinners involved demonstrated a marked increase in productivity.

Current rates of poor vision are a crippling impediment to the economic growth of developing countries – reducing employment and productivity.

With the WHO estimating that the impact of poor vision on global productivity is currently costing US$272 billion, directing the focus of global humanitarian efforts and funds towards improving access to eye care offers a remarkably simple, affordable and scalable first-step towards addressing development targets.

Workplace productivity is not the only factor to consider. Though difficult to quantify, poor vision is also having a widespread impact on education – impacting school attendance, literacy rates and personal development.

In rural China last year, a different team of researchers ran a trial of 3,000 students from 250 primary schools to test the impact of vision on children’s educational outcomes. It was found that the act of supplying glasses to children suffering from myopia, or short-sightedness, had a greater effect on their performance at school than factors such as family wealth or parental education.

Article 26 of the UNHR stipulates that ‘everyone has the right to education’, and access to quality education and literacy targets sits at the top of the global health and social agenda. Indeed, they are a top priority within the 2030 sustainable development agenda, with the fourth goal dedicated to ‘ensur[ing] inclusive and quality education for all and promot[ing] lifelong learning’.

Yet, increasing school and university enrolment is not enough – we must address the underlying factors inhibiting access to education. While vision problems remain unaddressed, there continue to be millions of people across the globe who are prevented from accessing the benefits of education, even where the resources are available to them.

If we want to maximise global development in a manner that enacts and facilitates the principles enshrined within the UNHR, it is vital that this nonurgent, and often imperceptible, disability be placed at the top of the global list of priorities.

Taking on this problem and rethinking the approach to world vision will require the backing of influential figures from all corners of society and from across the globe – from leading innovators and technologists, to governments and NGOs, investors and big business.

It may seem like a daunting task, but investment in poor vision pays off. Figures from a recent PwC report commissioned by The Fred Hollows Foundation revealed the high returns on investing in improving vision – with every US$1 invested bringing an average US$4 of economic gain. In Pakistan for example, a country set to become one of the world’s largest economies, the estimated US$11.6 billion cost of eliminating avoidable blindness would be outweighed by a US$70 billion boost to the country’s economy.

Finding a solution to a global problem of this nature and prevalence requires an entrepreneurial approach, one that re-imagines the traditional healthcare model for the developing world. The solution lies in doing away with a reliance on established health infrastructure, specialist ophthalmic staff and highlevel equipment, and instead concentrating on maximising existing resources and expertise.

I have personally witnessed the incredible potential of this approach. Eight years ago I founded Rwandabased charity Vision for a Nation, which invests in lowcost equipment like adjustable glasses and trains local primary care nurses with basic eye-care expertise. By reducing the need for specialist staff and equipment, we have ensured each and every one of Rwanda’s citizens now benefits from our eye-care services.

A number of hugely promising innovations in technology and telecommunications are also emerging across the globe, with the aim of addressing some of the most common barriers to universal access to vision.

I founded the Clearly campaign in April 2016 with the aim of accelerating a revolution in eye care. As part of the campaign we ran a global competition seeking to unearth and support eye-care innovation in the areas of diagnosis, training, supply chain and distribution, and big data. The start-ups we discovered affirmed for me that solutions are well within our reach.

Remote-diagnostics app Vula is one such cuttingedge innovation. Launched by Dr William Mapham in 2014, Vula seeks to address the widespread problems caused by a shortage of specialist eye-care consultants in developing countries, by allowing primary healthcare workers to remotely chat to on-call specialists, and share with them patients’ scans and results. In countries like Kenya, where there are only two ophthalmologists for every million people, Vula can make all the difference.

With proper funding and support, I firmly believe that these innovations – from diagnostics apps like Vula, to smart delivery tech and low-cost, origami-style eye-screening devices that put the power of diagnosis into patients’ own hands – will lead the way in revolutionising eye-care provision across the globe.

In a world that can build driverless cars, develop unimaginable cures for the deathliest diseases, and even plan to put mankind on Mars, it is evident that we have the means within our reach to ensure the whole world can see clearly.

Conclusion

Vision is fundamental to our human experience, affecting everything we do – from work to education to our interaction and relationships with our families. I believe that tackling the global problem of poor vision holds the key to achieving and even surpassing the Sustainable Development Goals, and therefore to advancing the effort to achieve universal human rights for all.

It is vital that global leaders and influencers realise that this is an issue which must be addressed as an immediate priority. The solutions are in sight – we just have to harness them.

If we do, the effect could be genuinely transformative.

This article first appeared in Philanthropy Impact Magazine issue 15. Download this article as a PDF.

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