07 September 2022
System readiness is not just about ensuring health systems can integrate new components of care appropriately – it’s also about ensuring health systems keep pace with societal changes, such as the ageing of the population and enhanced prevalence of a given condition. A perfect illustration of this is the need to address the growing prevalence of vision loss and promote healthy eye health.
Vision loss: the scale of the problem
Of all our senses, vision is probably the most integral to all aspects of life for most people. Yet globally, over 2.2 billion people live with vision loss, 1.1 billion of these as a result of inadequate access to basic eye care services.
The ageing of the population is increasing the number of people affected by vision loss, and this problem is only going to worsen with time: 73% of people with vision loss are over 50. By 2050, 4.8 billion people – nearly half of the global population – are expected to have some form of visual impairment. Ageing is not the only contributing factor, of course. Higher levels of screen use and spending less time outside – along with the rise of conditions like diabetes, which can lead to diabetic retinopathy – also contribute to the growing prevalence of vision loss.
An impact that goes far beyond health
The magnitude of the issue has led the World Health Organization to propose a specific resolution 73.4, which was adopted at the 73rd World Health Assembly in late 2020. It committed to integrated, person-centred eye care, including preventable vision impairment and blindness. The resolution recognises the intersection between healthy vision and the attainment of many of the Sustainable Development Goals, such as:
- education – glasses can reduce the odds of failing a class by 44%
- employment – vision loss costs the global economy $41 billion per year in productivity losses
- poverty reduction – free, high-quality cataract surgery can increase household income
- universal healthcare coverage – globally, 91 million children do not have access to eye care services, and 90% of all vision loss is preventable or treatable.
What readiness for healthy vision should look like
Investment in appropriate eye care services is an essential first step to ensure health systems have sufficient capacity to cope with vision loss and provide appropriate eye care to their population.
Beyond this, systems thinking is needed to ensure the vision of integrated, person-centred eye care – including preventable vision impairment and blindness – is fully embedded within each health system context.
From a governance and leadership perspective, eye health must be built into health system planning and subsequent public health goals. Countries need to have the appropriate workforce and service delivery models to ensure eye health services are accessible to all and fully built into primary care. Efforts are needed to improve health literacy about eye health, particularly among disadvantaged populations, raising awareness of the importance of protecting one’s eye health and services available. Financial barriers to proper eye care need to be addressed: eye care services should be treated as an essential part of the bundle of services covered by universal health coverage. Data and digital health solutions should be explored to improve accessibility, quality and reach of eye health services – such as through digital reminders to attend eye health checks.
Finally, there is also a need to better integrate goals for healthy vision into the healthy ageing agenda. As suggested by a recent Lancet article, eye care and ageing advocacy efforts and communities need to work together to recognise that ‘our world will only be truly ageing friendly once it is vision friendly.’
This post is part of a series about health system readiness – read the first instalment here.
Suzanne Wait, Managing Director of The Health Policy Partnership
