Q&A: Life after COVID-19 for eye health and development

As development projects move to tackle the current crisis, funding and efforts around other health issues may wane, but COVID-19 could act as a catalyst for positive change, says Jayanth Bhuvaraghan, chief mission officer at Essilor International.

“Every crisis is an opportunity for us to look at ways of working better and I think this crisis will throw open more opportunities than ever,” he said. “We all have to be ready to accept that, adapt to the new situation, and make sure that we stay aligned and focused on what we set out to achieve.”

Currently 2.7 billion people live with uncorrected poor vision and over half of these cases could be prevented or have yet to be addressed. Essilor has called for uncorrected poor vision to be eliminated by 2050 and estimates it will cost $14 billion to make that happen.

While limited and diverted resources may create a hurdle in working toward that goal in the months ahead, Bhuvaraghan believes better use of technology, willingness to collaborate, and increased efficiency will later emerge and make the sector stronger.

Speaking to Devex, he detailed the implications of COVID-19 on eye health and what the development sector can do to ensure vision projects and others continue during this time.

This conversation has been edited for length and clarity.

How do you think COVID-19 will affect public health as well as the development community?

In a way, this pandemic has exposed how inadequately public health and other issues are funded. More than anything else, it has brought awareness of the importance of allocating significant budgets to bring universal health care around the world.

The development community depends on grants and support from governments and various foundations. Right now and rightly so, most efforts and funding are going toward fighting the coronavirus. As a result, many less urgent causes and associated organizations are seeing their grants and funding dwindle. This will affect NGOs, particularly smaller ones. It is unlikely financing will come back as soon as the virus goes away as it’ll take some time for investors to build their confidence. I'm worried this will mean a reduction of activities on the ground.

But this also is an opportunity for the development sector to reinvent the ways they’ve been working. This is the time for people to look at efficiencies, at stretching the dollar, and reducing administrative costs to make themselves leaner and more efficient so they can reach more beneficiaries for a smaller amount.

When we start to experience COVID-19 recovery, I hope we won’t revert back to the old ways of working. We don't know what the new normal will be but definitely in the public health space and the development space, technology will play a big role: telemedicine, telehealth, teleoptometry. People will be more open to accepting technology simply because it gives the scale, reach, and impact without losing quality of service.

Do you think the current pandemic actually has the potential to impact efforts to improve eye health?

The increase in hand-washing and general consciousness towards better hygiene will have an overall positive impact on general health. It could also limit the spread of eye infections — like trachoma — which normally spread due to touch and contact. In fact, people wearing glasses have less tendency to touch their faces than people without glasses, meaning a lesser chance of infection.

But there’ll be other issues because of the time people are spending indoors on screens, whether it’s online learning or working from home. On one hand, this is great because it doesn't compromise the quality of education or the ability of people to continue working. On the other, staring at screens constantly, combined with reduced time outdoors, can cause eye fatigue, dryness, and accelerate the rate of short-sightedness, or myopia.

In the future, there'll be an increased focus on public health, and eye health should be at the top because it is a cross-cutting issue.

International organizations like the World Health Organization will continue to play a leading role. In fact, as WHO continues its leadership in managing the COVID-19 situation, it could be easy to forget the work it does across many other important health issues including vision care, for example, its “World Report on Vision” published last October to galvanize action toward eye health.

And as the world recovers from this crisis, the United Nations Sustainable Development Goals become even more relevant and important, providing common objectives for the world to work toward.

With funds and efforts being diverted elsewhere, what do you think the development sector should do to ensure other health programs, such as those around eye health, continue?

It's about partnerships, collaboration, and working together. For instance, in India, famous Bollywood star, Amitabh Bachchan, is supporting a pro-bono campaign that we run in partnership with The Fred Hollows Foundation, Sightsavers, and other local players.

See Now raises awareness about eye health and directs people to effective and quality eye health services. It’s a combination of awareness creation, service delivery, and where required, hospital referrals for issues like cataracts. It created a huge impact, but not one organization could have done it on its own. We could only have done it in collaborative mode with all the players.

Likewise, there are other collaborations and partnerships on the ground where each one plays to its strengths. For example, there’s work happening around the Vision Catalyst Fund to bring in people from within and outside the sector to drive more funding into the space, and we’re working with all leading eye care players to form a new coalition which will work to build universal eye health.

The game-changer will be telemedicine. Through our innovation lab, we piloted telerefraction in India where we use technology to remotely connect primary vision care providers and the consumer they have with them, to an optometrist sitting miles away who can supervise the prescription and send it through WhatsApp. This was before the coronavirus but it becomes all the more important now. This is the way to go because this will bring high-quality care at the lowest possible cost.

What call to action would you have for other vision-focused organizations and programs during this time?

All of us are focused on solving this problem and working with the authorities to make sure that we come out of this crisis. It's our responsibility as primary health care and public health providers to work with the authorities and help in the best way we can with equipment, volunteering, or whatever is required in each country. That's the primary responsibility today for all vision care providers and all of us in general: private, public, NGOs, everyone.

In parallel, we need to secure the work that we’ve already achieved. A big focus for us at Essilor is protecting the network of primary vision care providers we’ve created in the base-of-pyramid communities of Asia, Africa, and Latin America so they can continue to provide previously unavailable access to vision care. These people are microentrepreneurs — many the only source of income for their families with limited savings. Unable to operate in the current climate they are vulnerable so our local teams are working to see what support we can offer.

When we come out of this crisis, the important thing is to actually make sure that we reinvent the ways we’ve been delivering services. We should look for learnings, bring innovation around efficiency, and embrace technology. We should also work in partnerships to create new ways of working and reduce costs. That way we can stretch our dollar to the maximum to reach more beneficiaries.

One thing we know for sure is that we’re even more committed to our mission of improving lives by improving sight and to our ambition to eliminate poor vision from the entire world by 2050.

Devex, with financial support from our partner Essilor, is exploring challenges, solutions, and innovations in eye care and vision. Visit the Focus on: Vision page for more.