Editorial

John Trevelyan
IAPB’s Fundraising and Partnership Development Manager

Over forty key professionals in eye health met alongside representatives from the Pan American Health Organisation (PAHO) and Pan American Association of Ophthalmology (PAAO) to review the progress towards the goals of VISION 2020 and plan our next steps. The meeting also heard updated reports from national coordinators in Argentina, Brazil, Mexico, Peru, Chile, Paraguay and the Dominican Republic. The meeting was timely, whilst there have been many achievements in eye health over recent years, much more needs to be done to realise our ambitious goals of the elimination of avoidable blindness by 2020. It is heartening that all countries in Latin America have adopted national plans in line with VISION 2020 but it is less clear that the plans have been effectively implemented within the national health systems.

Collaboration will be the key to meet the challenges we have set ourselves to eliminate avoidable blindness. The WHO estimated, in 2010, that there were 3.2 million blind and 26.6m million visually impaired in Latin America. The main cause of blindness is cataract (60% of people bilaterally blind due to cataract, followed by glaucoma (15%), diabetic retinopathy (7%), corneal scarring (6%), age related macular degeneration (6% ) and refractive errors (6%). Looking ahead we can predict an increase in diabetic retinopathy as already suggested in a mass review of recent data in Brazil, Cuba, Chile and Mexico (Furtado, Langsingh and Carter, 2012).

One significant achievement has been an increase in the cataract surgical rate (CSR) across the region. From 2005 – 2011 the rate in Argentina tripled to 5,100 per year. There were similar increases in the CSR in Chile, Costa Rica the Dominican Republic and Venezuela. However Guatemala has shown a decrease from 810 to 800 over the period. Although these improvements are welcome more effort is required. Across the region numbers of ophthalmologists have risen, currently there are 42 ophthalmologists per million people, four times the rate that the WHO calculate as sufficient to meet eye care need. However their productivity across the region is low and primarily focussed in urban centres. Inadequate eye care services amongst rural communities remains one of the most serious challenges to eye health in Latin America.

The outcome of the VISION 2020 Latin American plan is to focus on the key areas where we can effect change. Through collaboration between PAHO, PAAO, INGO’s, national governments and the private sector we will concentrate our efforts where we will have the greatest impact, these were determined to be advocacy, communications and awareness, capacity building and research and data collection.

Effective advocacy is key if we are to influence governments and key stakeholders to enshrine VISION 2020 priorities within national policies and health budgets. We need to improve our communications and awareness of VISION 2020 more widely across the region. We must utilise new media and social networks to raise public awareness of eye health measures. More must be done to integrate eye health within the daily work and general knowledge of health care professionals. We must work to address the imbalance of eye care services, promote Community Eye Health training to promote improvements in the quality and quantity of services and ensure these are extended to the underserved areas. Research and data collection are vital to demonstrate the quality of, and need for, eye care services.

The purpose of the Strategic Plan will take forward these central initiatives and provide a roadmap with measurable milestones to make significant steps towards the objectives of VISION 2020.

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