If you had to name the 15 most destructive diseases or injuries in the world, would poor vision be on the list?
It should be. Nearsightedness and farsightedness aren’t fatal. Yet unaddressed they cause so much disability, especially in the developing world, that they rank No. 14, just below tuberculosis, malaria and chronic obstructive pulmonary disease. Kids who can’t see can’t learn. Adults who can’t see can’t work.
Unlike the other top maladies, however, poor vision can usually be easily, and cheaply, remedied. All the patient needs is an eye exam and a pair of glasses costing as little as $1. Investments in vision correction would pay for themselves many times over, given the increases in productivity they could be expected to bring, according to a recent study by researchers at Australia’s Brien Holden Vision Institute and the Johns Hopkins Bloomberg School of Public Health.
To make economic sense, such efforts must be tailored to local needs. Though popular in the U.S., programs that send used eyeglasses to developing countries fail that test, according to an earlier study by some of the same researchers. Getting spectacles from donation centers to end users costs money. About 93 percent of donated glasses have to be discarded because they are damaged, for instance, or have lenses custom-designed for individual eyes.
Providing a pair of recycled glasses is almost twice as expensive ($20.49) as delivering a new, ready-made pair ($11.28), the researchers concluded. It’s also less effective, given that used spectacles are sometimes unfashionable, gender-inappropriate or mismatched to the person’s face shape. Moreover, supplying donated glasses does nothing to develop a sustainable eye-care industry in the community being served.
Instead, the authors of the most recent report propose training 65,000 new optometrists to boost the ranks of the roughly 167,000 now working worldwide to ensure that every community has at least one such professional per 50,000 people, in keeping with the World Health Organization’s recommended ratio. That would be sufficient, the researchers calculate, to cover the estimated 703 million backlogged cases of near- and farsightedness.
Creating or expanding educational facilities would require an injection of funds. Training centers, however, eventually could become self-sustaining by seeing patients and dispensing glasses.
The researchers also factored in the costs of establishing, equipping and running eye-care shops for the first five years. Their assumption is that, after that, day-to-day costs could be recouped from patients. Once the optometrist’s training and startup costs have been covered, an exam and a pair of ready-made glasses might cost a patient $2.
All in all, these investments would total $20 billion over five years. That’s serious money in any field and certainly in global health. Governments, multilateral groups and nonprofit organizations spent an estimated $16.8 billion last year combating HIV, the biggest draw on global health dollars. They invested $1.5 billion addressing malaria.
Yet not tackling vision problems among the world’s poor is an even costlier proposition. The value of the productivity lost to distance-vision impairment is $91 billion a year, a 2009 analysis found. That figure suggests how much global gross domestic product could increase if eyeglasses were made available to all. Rarely does investment in foreign assistance come with that kind of return.
Expanding economies could enable developing countries to address other health needs with their own resources. Thus, a strike against the 14th most harmful disease is also a blow to the other miseries on that list.
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