Q&A: Poor vision as the world's largest unaddressed disability

Primary vision care provider in Ivory Coast. Photo by: Essilor

Poor vision affects 4.2 billion people and while for many it can be corrected with lenses, glasses, or surgery, 2.5 billion people continue to live with uncorrected poor vision. This has a detrimental effect on the individual and society as a whole as it can affect their ability to learn, earn, and participate in their community.

“People who wear glasses know how difficult everyday life can be without them. Glasses change lives for billions of people affected by the disability that is poor vision,” said Jayanth Bhuvaraghan, chief mission officer of Essilor International — one of the world's leading ophthalmic optics companies working to achieve its ambition of eradicating poor vision by 2050.

With such a simple solution so readily available, why is it that so many people living in developing countries don’t have access to adequate visual care? Bhuvaraghan believes it is a question of priorities, with many other issues on government health agendas leaving vision far from the top. He insists “uncorrected poor vision isn’t life threatening, but it is the world’s biggest unaddressed disability,” and this needs to change. More awareness around uncorrected poor vision and its social and economic impact is needed to make this happen, he added.

“It’s time the world acknowledged this disability, recognized the hugely positive social and economic benefits of taking action to address it, and how governments, the private sector, and communities can collaborate to resolve it. Only by working together can we eradicate this disability from the world within a generation.”

In a conversation with Devex, Bhuvaraghan explained how this can be done and what lessons the organization has learned on its journey to improving vision worldwide.

This conversation has been edited for length and clarity.

When it comes to developing countries, do you think there is enough awareness of visual health?

Vision is generally not top of the agenda for many countries, whether developed or developing. There’s an acute lack of awareness about poor vision and its consequences to the individual and society.

Today, approximately one-third of the population suffers from poor vision that can be corrected with a very simple intervention. Countries and societies can reap huge social and economic dividends as a consequence. When you see all this together, it’s a no-brainer. It should have been addressed many years back. The fact that it has not been done shows that there isn’t enough awareness about the solution, perceived costs, and the consequences of not taking action.

I'm from the vision care sector — of course I want the issue of uncorrected poor vision to get more attention from governments around the world. I also recognize there are other pressing needs and life-threatening causes that demand that attention. It’s not surprising that vision, despite its socioeconomic importance, does not always get the focus it deserves.  

I also think we as an industry haven’t always done a good job of adequately highlighting the scale and impact of the problem.

We haven’t had the data or evidence needed to enable countries to make informed decisions on the most effective ways to address the problem. Looking forward, I am really very optimistic and hopeful that vision is starting to get the right kind of attention and this will help us to achieve our ambition to eradicate poor vision in one generation.

School children in India. Photo by: Essilor

What successful solutions have you seen that tackle poor vision and with it any social or economic implications?

The problem of uncorrected poor vision is somewhat different to many other global challenges. I believe there are three key elements needed to create a solution.

First, we need to create infrastructure to actually deliver and administer primary vision care. It’s not an over-the-counter sale: You can’t just drop off a pair of spectacles in a village and hope the problem will be solved. We need qualified technicians to conduct simple refraction checks and give the appropriate solution, product, to people. That means you need to create thousands of access points. There is also a need to upskill and train people, to empower people to create access points that can be scalable and sustainable in the long run.

“In a nutshell, when you’re serving a developing market, the need for creating revolutionary, pioneering solutions is much greater than anywhere else.”

— Jayanth Bhuvaraghan, chief mission officer, Essilor International

We have developed inclusive business models that focus on empowering young people to become primary vision care providers and to provide those crucial access points. By 2020 we will have created over 25,000 access points in Asia, Latin America, and Africa, but we need a lot more than that.

The second solution is impact-driven philanthropy, or strategic giving as it is sometimes called. There are more and more people interested in the cause simply because the impact is huge. Inclusive business and philanthropy go hand in hand. In order to reach billions of people, we not only need to create impactful models and put a lot of technology and delivery solutions in place, we also need to build partnerships with governments, with large NGOs, and with local leaders who understand the local terrain.

Thirdly, financing is very important, so what we're also looking at is innovative financing models, which have actually been tried and tested in other sectors but not at the scale we need. We need to adapt or refine those innovations to help us access funds and scale.

This is a formulation I strongly believe in and we have most of the pieces in place. Now it’s a question of actually getting all of them together and taking it to scale.

What lessons have you learned in implementing some of these solutions?

The primary lesson I learned very early is that the aspirations of a consumer living in a rural market in a low-income country are not very different to a consumer living in the city in a developing country.

You really can’t approach them differently. All of them have their own expectations and aspirations so ‘hand-me-down’ products or something where people simply ‘make do’ will not solve the problem. You need to understand every consumer’s needs and wants regardless of their income level and develop affordable and quality products through innovative design and technologies.

I talked about product, but there’s also a need for innovation around supply chains. You see the cost of the product itself is a fraction of the total cost. The cost to serve is actually a huge part of the overall cost, so we try to minimize it substantially through innovation, technology, and digital means. Innovation in business models is also required, and understanding ways of reaching out to and engaging with the consumer.

In a nutshell, when you’re serving a developing market, the need for creating revolutionary, pioneering solutions is much greater than anywhere else.

The other learning is on partnerships. They are key for us. Not one company, government, NGO or aid agency can solve the world’s problems alone. Vision is a common problem and all of us must align toward solving it. That’s why we are creating global collations and cross-sector partnerships with corporates, NGOs, governments, startups etc., and welcome all efforts to work together.

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.

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