October revolution

Following my outlining of the role of Vision 2020 UK, (September 26), I thought it might be helpful to focus more specifically in this article on the global vision initiative to eradicate worldwide avoidable blindness by the year 2020.
Every year the second Thursday in October is designated as World Sight Day. This year, on October 9, a number of events were planned all over the world (including the UK) designed to focus attention on international impaired vision issues.
The focus of this year's World Sight Day was the launch of an interactive CD-Rom designed to ensure that every government in the world has all the information necessary to prepare and develop a national blindness prevention plan.

escalating numbers
In 2000, the World Health Organization (WHO) conservatively estimated that the number of blind people throughout the world was between 44 and 50 million. In addition, the figures for those with significant impaired vision (largely as a result of refractive error) are even more staggering. A conservative estimate puts this group at a further 135 million people.
It is estimated that the cost of world-wide blindness in terms of loss of earning power as well as the provision of direct services to those who are blind in the year 2000 was estimated to be in excess of $19bn dollars. For those who have significant impaired vision the figure in 2000 was put at $23bn.
Unless something happens to redress this appalling situation, the figures, again conservatively estimated, are set to soar dramatically by 2020.
Estimates of those who will go blind (many needlessly, and with currently available cures and treatments) is put at 100 million people over a 20-year period, with a cumulative economic loss in productivity of over $150bn.
The estimate for those with significant impaired vision rises from 135 million in the year 2000 to an estimated 250 million in 2020, with the consequent costs exceeding a further $150bn over that period up to 2020.
The estimates of the impact of a successful vision 2020 prevention and treatment programme by the year 2020 put the number of blind people at 24 million and could see the cost almost halved. The figure for those with significant impaired vision also drops massively with the cost reducing by over 50 per cent.

CAUSES OF BLINDNESS
While virtually all conditions leading to blindness and impaired vision are found across the world, there are five main causes of avoidable sight loss which cover 80 per cent of the causes of blindness in the world. These causes all have effective treatments or preventive medicines/ measures already available. They are:

Cataract
Trachoma
Onchocerciasis
Child blindness (vitamin A deficiency)
Refractive error/low vision.
(See the figure above). WHO now includes uncorrected ametropia in its figures.

Millions of people are needlessly going blind but for the simple want of effective harnessing of global partnerships, which bring together those with money, clinical knowledge, knowledge of effective eye care infrastructures, and in some cases, those supplying essential, effective drugs and equipment.
Vision 2020 Ð The Right To Sight Ð is a WHO-sponsored initiative delivered through the International Agency for the Prevention of Blindness, (IAPB). To be effective it needs to be considered as more than just a health initiative. Blindness is both a consequence and cause of poverty in the poorer parts of the world and should be seen as a part of any country's strategy for achieving the Millennium Development Goals (MDGs) set by the World Bank.

key players
A number of key international players based in the UK, such as Sightsavers International, Christian Blind Mission, ORBIS, Vision Aid Overseas, Impact Foundation, together with clinicians from the Institute of Eye Health, the London School of Hygiene and Tropical Medicine and others meet regularly as an international group within vision 2020 UK. They collaborate and share information on the various programmes that each organisation is operating to combat this tragic waste of sight and human potential.
Countries throughout the world are being encouraged to form Vision 2020 organisations on the lines of those that have already proved successful in, for example, the UK, Australia and Switzerland. Regional structures are in place in Europe, Western Pacific, the Americas, Africa and Eastern Mediterranean and South East Asia. These regions all assist the process of better collaboration.
Key sponsors are beginning to sign up to the global initiative and other major players, such as the World Council of Optometry, are joining the International Agency for the Prevention of Blindness to lend their considerable weight to the initiative.
Watch out for ways in which you as a reader can assist this magnificent cause.

Mike Brace is chief executive of Vision 2020 UK