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Making the Case for Government Support ICO Advocates 5 th June 2010, Berlin Hugh Making the Case for Government Support ICO Advocates 5 th June 2010, Berlin Hugh R Taylor AC, MD Treasurer, International Council of Ophthalmology Vice President, International Agency for the Prevention of Blindness Professor of Indigenous Eye Health, University of Melbourne

Causes of Global Blindness 1995 45 million Cataract Trachoma Refractive Errors Vit A Def Causes of Global Blindness 1995 45 million Cataract Trachoma Refractive Errors Vit A Def Diabetic Retinopathy Oncho Glaucoma AMD and other diseases 60% 15% 10%

Global Blindness Projections, 1995 millions 100 90 75 60 50 50 40 38 30 Global Blindness Projections, 1995 millions 100 90 75 60 50 50 40 38 30 25 25 0 1980 1990 2000 2010 2020

Goal: The elimination of avoidable blindness by 2020, in order to give all people Goal: The elimination of avoidable blindness by 2020, in order to give all people in the world, the right to sight

VISION 2020 is all about Partnerships WHO Technical Assistance Capacity Building National Partners - VISION 2020 is all about Partnerships WHO Technical Assistance Capacity Building National Partners - National Vision 2020 Plans Sustainable program delivery

“Vision 2020 is all third world stuff. ” “What relevance is it to us? “Vision 2020 is all third world stuff. ” “What relevance is it to us? ” “Look at all the things we can do now… …so blindness is not a problem in my country BUT Vision 2020 is the Right to Sight for all - not for all except Australians or Americans or Europeans…

Visual Impairment and Blindness Australia - 2004 50% 40% Visual Impairment Blindness 30% 20% Visual Impairment and Blindness Australia - 2004 50% 40% Visual Impairment Blindness 30% 20% 10% 0% 40 -49 50 -59 60 -69 70 -79 Age 80 -89 90+ Clear Insight 2004

Prevalence of Vision Impairment, USA Vision Impairment Blindness Arch Ophthal 2004 Prevalence of Vision Impairment, USA Vision Impairment Blindness Arch Ophthal 2004

Years of Life Lost to Disability (YLD) Depression Dementia Asthma Osteoarthritis CHD Type 2 Years of Life Lost to Disability (YLD) Depression Dementia Asthma Osteoarthritis CHD Type 2 Diabetes Vision disorders Oral health Breast cancer Prostate cancer Melanoma HIV/AIDS 0% www. cera. org. au 2% 4% 6% YLD as percent of total YLD 8%

Total Costs of Vision Disorders Australia, 2004 Clear Insight 2004; www. cera. org. au Total Costs of Vision Disorders Australia, 2004 Clear Insight 2004; www. cera. org. au

Life Expectancy Life Expectancy

Vision Impairment and Blindness 2004 - 2024 800, 000 Vision Impairment Blindness 600, 000 Vision Impairment and Blindness 2004 - 2024 800, 000 Vision Impairment Blindness 600, 000 400, 000 200, 000 0 2004 2010 2014 2020 2024

Blindness – Australia, 2004 Others Refractive Error 4% Neuro-ophthalmic 8% Retinitis Pigmentosa 3% 1. Blindness – Australia, 2004 Others Refractive Error 4% Neuro-ophthalmic 8% Retinitis Pigmentosa 3% 1. 5% Diabetes and 10% other Retinal Cataract 12% 14% Glaucoma 48% Macular Degeneration

Vision Impairment – Australia, 2004 AMD 10% Glaucoma 3% Cataract 14% 62% Refractive Error Vision Impairment – Australia, 2004 AMD 10% Glaucoma 3% Cataract 14% 62% Refractive Error Diabetic 2% 3% Retinopathy 2% Other Retinal 4% Neuro-ophthalmic Other

Three Quarters of Vision Loss in Unnecessary • It is preventable or treatable • Three Quarters of Vision Loss in Unnecessary • It is preventable or treatable • It is caused – – – AMD Cataract Diabetic Retinopathy Glaucoma Refractive Error

What do we need to do about it? 3 “Simple” Things 1. Prevent the What do we need to do about it? 3 “Simple” Things 1. Prevent the things we can prevent 2. Treat the things we can treat 3. Solve the remaining problems

1. Prevent the Diseases We Can Prevent Eye health promotion initiatives to reduce avoidable 1. Prevent the Diseases We Can Prevent Eye health promotion initiatives to reduce avoidable vision loss • Regular eye exams • Protection of the eyes

2. Treat the Diseases We Can Treat Adequate funding for services for treatable conditions 2. Treat the Diseases We Can Treat Adequate funding for services for treatable conditions • Cataract surgery • Diabetic retinopathy screening • Low vision support services

3. More Research to solve the present problems Adequate funding for research into causes 3. More Research to solve the present problems Adequate funding for research into causes of vision loss and blindness that at present cannot be prevented or treated • AMD and Glaucoma

Eye Care Intervention Package 3 “Simple” Things 2005 -6 Lifetime Cost Net benefit Total Eye Care Intervention Package 3 “Simple” Things 2005 -6 Lifetime Cost Net benefit Total Savings $188. 8 m $-25. 7 m $911 m Cost Net benefit Total Savings $1, 620 m $662 m $10, 016 m x 6. 2 x 4. 8 www. cera. org. au 2005

National Eye Health Framework Key Areas for Action 1. Reducing the risk 2. Increasing National Eye Health Framework Key Areas for Action 1. Reducing the risk 2. Increasing early detection 3. Improving access to eye care services 4. Improving the systems and quality of care 5. Improving the evidence base 2006 $14 m for 3 years for Australia 2008 $24 m for Australia and $45 m for Pacific Region 2009 $58 m for Aboriginal eye and ear health $50 m for Bionic Eye Research

www. health. gov. au/internet/eyehealth 2009 www. health. gov. au/internet/eyehealth 2009

What can we do to close the gap? • Think globally - act locally What can we do to close the gap? • Think globally - act locally • For the developing world – – Be aware Be supportive or an advocate Change your research Become an Albert Schweitzer • For home – 3 “Simple” Things • glaucoma, diabetes, underserved – Advocacy

What can we do? -- Advocacy • Good data are essential for effective advocacy What can we do? -- Advocacy • Good data are essential for effective advocacy • Need clear and concise presentations - key messages - targeted for audience • Need to speak in one voice • Talk often with policy leaders • Make sure policy implementers are kept informed • Use media contacts

“Because I cannot do everything, I will not refuse to do something I can “Because I cannot do everything, I will not refuse to do something I can do”. Helen Keller The elimination of avoidable blindness is an achievable goal; it is something we can do.