Building back better: Why integrated people centred eye care is needed to achieve vision for all
Throughout 2020, the COVID-19 pandemic has caused widespread disruption to many health programs, highlighting the vulnerability of health systems and the need for improved coordination across sectors to deliver essential services to populations. This is particularly true for communities at risk of trachoma and onchocerciasis, two neglected tropical diseases (NTDs) that can lead to avoidable blindness and which affect some of the world’s most vulnerable and marginalized communities.
When the WHO launched its first World Report on Vision in October 2019, few would have foreseen how soon the issues of cross-sectoral collaboration and people-centered care would have been driven to the forefront of the global health agenda. Specifically, the COVID-19 pandemic has demonstrated the importance of these approaches, as a broad spectrum of stakeholders work together to promote public health measures such as handwashing, wearing masks in public and maintaining social distancing.
As countries strive to resume eye health activities that have been disrupted as a result of COVID-19, there is an opportunity to build back better by drawing on these cross-sectoral lessons. In that regard, it was very encouraging to see the World Health Assembly adopt a new Resolution on Vision in August 2020 urging Member States to implement recommendations included in the World Report on Vision.
This World Sight Day, we recognise the political, economic, policy and programmatic shifts taking place across NTDs, eye health and the broader health sector to ensure universal health coverage and vision for all.
The resolution calls for Member States to adopt an integrated people-centered eye care approach that provides a continuum of promotive, preventive, treatment and rehabilitative interventions against the spectrum of eye conditions while simultaneously strengthening health systems. Additionally, the resolution notes that achieving global targets for NTDs that cause preventable blindness, specifically trachoma and onchocerciasis, requires that health systems have the capacity, including adequate resources, to document, identify, screen for, treat and manage these conditions, using defined strategies, and, after verification or validation of elimination, to continue to retain people in eye care in order to manage these conditions and their complications.
The World Health Assembly Resolution on Vision highlights several themes that also underlie the draft WHO road map for neglected tropical diseases 2021-2030, which will guide NTD programs over the next decade. In particular, the road map emphasizes the importance of country-owned integrated programs to sustain progress made towards NTDs and provides clear entry points to promote and implement people-centered approaches.
To support health ministries and partners to effectively integrate programs, the International Coalition for Trachoma Control developed a series of transition toolkits to manage the integration of trachoma interventions into routine public services including closer coordination and collaboration with the national eye health sector. Furthermore, the NTD community has re-emphasized its commitment to people-centered care through a new statement of commitment to the participation of persons affected by NTDs at the 11th annual Neglected Tropical Disease NGO Network conference, held in September 2020.
This World Sight Day, we recognize the political, economic, policy and programmatic shifts taking place across NTDs, eye health and the broader health sector to ensure universal health coverage and vision for all. As countries resume NTD programs in line with WHO interim guidance published in July 2020, it is important to recognize COVID-19 will have short, medium- and long-term impacts on the way we all live and change the environment for how we deliver and ensure access to health services.
Although COVID-19 is a new challenge, it may well be a challenge that stays with us for the long term and must be a factor we include alongside our work to overcome other existing challenges, such as conflict and insecure environments, and limited human and financial resources. However, within this challenge, there are unique opportunities to improve the way we work by improving hygiene through better cross-sectoral collaboration to increase access to water and sanitation as well as behavior change interventions. The eye health sector must be proactive as we build back better; the cost of inaction risks losing significant gains. Although significant progress has been made against trachoma, including a 91% reduction since 2002, 136.9 million people live in areas that are known to require interventions across 44 countries. The job is not complete and we cannot be complacent or lose momentum.