Advocacy

On World Sight Day in 2006 the World Health Organization (WHO) revealed for the first time to the global community that an estimated 153 million people were either blind or vision impaired due to uncorrected distance refractive error. Prior to this, avoidable blindness and vision impairment, mostly occurring in the developing world had been largely unrecognised.

The advocacy efforts of the WHO, International Agency for the Prevention of Blindness (IAPB), World Council of Optometry and international non-governmental development organisations, including the Brien Holden Institute Vision Public Health Division, were pivotal in raising awareness of this hidden burden amongst the eye care community and wider world. These groups took up the challenge to develop a coordinated global response to address this, resulting in the joint WHO and IAPB initiative VISION 2020: The Right to Sight, a global plan of action to eliminate avoidable blindness.

Globally 285 million people are visually impaired. Of these, 107.8 million have uncorrected distance refractive error. In addition, there are 517 million people with near vision impairment due to uncorrected presbyopia. The prevalence of refractive error, such as myopia, is rapidly increasing, particularly in Asia Pacific where in countries like China around 50% of population has myopia which translates into > 600 million people.  Over 80% are visually impaired due to treatable or curable causes. Over 90% of this demographic resides in lower or middle income countries. The financial burden on economy due to uncorrected distance and near refractive error is ≥ US$227.36 billion while the estimated cost of correction of distance vision is between US$20 billion and US$28 billion.

Governments generally are more attentive to mother and child health issues like vaccination, immunization, family planning etc. under the umbrella of primary health care. These issues are also more likely to see policy reforms if any. However, there is a growing awareness of the need for inclusion of eye health-related optometric services within the primary health care systems. WHO’s Global Action Plan aims for universal eye health with an overall goal to reduce the prevalence of avoidable blindness and visual impairment by 25% by 2019 from the baseline of 2010. This calls for enhanced efforts by countries and regions across the world to achieve the objective. With defined advocacy strategies we can reach out to policy makers around the world to raise their awareness of the need for comprehensive eye care services that are easily accessible and affordable for everyone.

Launch of the Ashanti Vision Centre in Kumasi, Ghana is a great example of advocacy working well to build local eye care capacity for the community. The launch of the vision centre in Ghana was just amazing. At the formal launch after our speeches they conducted a collection and even Chiefs from other areas contributed. Community people gave what little they could. A local businessman drove past, saw the community working on the project and then asked what was happening. He was so moved he came back and donated the first of two computers he is giving the centre. We can preach about true partnerships but this project has got it right: Community, government, the university, with the Institute providing technical expertise and part funding. – Professor Kovin Naidoo, CEO, Brien Holden Vision Institute.

Launch of the Ashanti Vision Centre in Kumasi, Ghana is a great example of advocacy working well to build local eye care capacity for the community. The launch of the vision centre in Ghana was just amazing. At the formal launch after our speeches they conducted a collection and even Chiefs from other areas contributed. Community people gave what little they could. A local businessman drove past, saw the community working on the project and then asked what was happening. He was so moved he came back and donated the first of two computers he is giving the centre. We can preach about true partnerships but this project has got it right: Community, government, the university, with the Institute providing technical expertise and part funding.
– Professor Kovin Naidoo, CEO, Brien Holden Vision Institute.

WCO is developing an advocacy strategy to help lobby governments around the world to ensure optometry is recognised as a key profession in the public health sector. With over two hundred thousand optometrists in the world with varying level of competencies and integration, advocacy towards optometry playing a much more proactive role in the reduction in avoidable blindness, strengthening health systems while effecting systems change and reaching the unreached is imperative.

The World Council of Optometry is in close contact with optometric organizations around the world, and is in a strong position to help the voices of optometrists to be heard.  We have been working on the development of a training package that will develop the advocacy skills of optometric leaders and enable a systematic advocacy campaign with the relevant stakeholders to build the professional profile of optometry and help integrate it into various health systems. The ultimate goal is to effect social change for the benefit of our world.

The Advocacy for Eye Health course in partnership with the Brien Holden Vision Institute, will enable eye health leaders to use advocacy strategies to effect change at the policy and practice levels. The course uses a blended approach in which an online component compliments a face-to-face workshop.  The workshop has been conducted in three countries: Mozambique, Nigeria and Lebanon.

The Advocacy for Eye Health Course has been offered three times by Prof Kovin Naidoo and Mr Hasan Minto of the Institute. The first course was delivered in Maputo, Mozambique for 20 Optometrists from the African region invited by the African Council of Optometry (AFCO). The second course was run in Nigeria for 17 participants invited by the Nigerian Optometry Association. Feedback from the Nigeria course was positive with 94% of the participants rating the workshop as very relevant for them and 100% thought that the workshop reached its objective. The third course was delivered in Lebanon for the Eastern Mediterranean Council of Optometry (EMCO), with 21 participants from 8 countries in the region. The real challenge is occurring now, engagement with key health officials and political leaders to ensure access to eye care services via policy change.

A Master Trainer Programme for the Advocacy for Eye Health course is currently being proposed. The concept of this programme is to select 3 key leaders from each of the WCO regions to complete a comprehensive program that includes both Advocacy for Eye Health and Delivering Short Courses. Assignments will be added to the Advocacy for Eye Health course to ensure the future trainers have the competence and confidence to be able to teach and facilitate future advocacy workshops. Competence will be judged based on co-delivery the Advocacy for Eye Health course with an educator from Brien Holden Vision Institute. Successful Master Trainers will then be able to run the course in their regions for the WCO.

If you or your optometry association is interested in participating in one of the future courses in Advocacy, kindly register your interest here: https://academy.brienholdenvision.org/

Case Study: Advocacy in Brazil
Brazilian optometric professionals are breathing a sigh of relief after hearing the news that their President, Dilma Vana Rousseff, has also vetoed the clause affecting optometry in a new law.

On 19 June 2013 the Brazilian Congress approved Medical Bill No 268/2002268/2002, which would regulate the medical profession.  This piece of legislation had been under discussion for 11 years.

The Brazilian Council of Optometry and Optics (CBOO) has been working tirelessly to get optometry recognised as a health care profession that contributes to comprehensive and multidisciplinary eye health and vision care.  Brazilian optometrists and other non-medical health professionals have been very concerned about the impact that this Bill could have had on their scope of practice and even their ability to practice at all.

Here at the WCO, we demonstrated our full support to Brazilian optometrists and to keep the profession alive in their country. We encouraged our members to write letters to the Brazilian president to show their support. WCO President Susan Cooper also wrote to the Brazilian President raising our views on the vast implications of this legislation for the profession. Our efforts were greatly appreciated by Ariel Scussel, Vice-president of the CBOO.

“WCO was fundamental in this achievement for Brazilian optometry. Thanks to the letters of support sent by several countries we managed to raise awareness among decision makers on the importance of optometry for public health,” he stated.

WCO believes that optometry is an autonomous healthcare profession that is educated and regulated and that restricting it to only acting under the supervision of a medically qualified doctor will severely limit the right of people to easy, immediate and affordable access to health care.

Greater access can ensure that more sight threatening problems can be identified in their early stages enabling the prevention of blindness and visual impairment.We would like to thank all those who showed their support for Brazil during these tough times and admire the dedication of the Brazilians who did not give up.