Action plan for integrated people-centred eye care in South-East Asia 2022–2030

Vision is the most dominant of human senses. Eye conditions affect all stages of life, with young children and older people being most vulnerable. Women, rural populations and ethnic minority groups are more likely to have vision impairment and less likely to access care. Impairment of vision impacts the achievement of Sustainable Development Goals and universal health coverage.

Globally, at least 2.2 billion people have vision impairment or blindness. This includes those with near vision impairment due to presbyopia (1.8 billion, including both addressed and unaddressed presbyopia), and moderate-to-severe distance vision impairment or blindness due to unaddressed refractive error (123.7 million, e.g. myopia or hypermetropia), cataract (65.2 million), age-related macular degeneration (10.4 million), glaucoma (6.9 million), corneal opacities (4.2 million), diabetic retinopathy (3 million), trachoma (2 million), and other causes (37.1 million) and 188.5 million people with mild vision impairment of unknown causes.

Further, the estimated economic cost of blindness and moderate-to[1]severe vision loss was US$ 411 billion in 2020, which is equivalent to 0.3% of the world’s GDP. At least 1 billion cases of vision impairment could have been prevented or are yet to be addressed. The number with presbyopia is projected to increase from 1.8 billion in 2015 to 2.1 billion in 2030.

Nearly 30% of the world’s blind and vision-impaired population live in the WHO South-East Asia Region. While trachoma continues as a public health problem in 43 countries globally, as of March 2022, 14 countries had achieved elimination goals. Within the South-East Asia Region, Myanmar (2020) and Nepal (2018) were verified for elimination. With the current drive, the region can achieve trachoma elimination by 2025.

To address eye health problems, the Seventy-fourth Session of the WHO Regional Committee for South-East Asia mandated in 2021 the development of a regional action plan for integrated people-centred eye care (SEA/RC74(2)), taking into consideration the 2030 global targets for effective coverage of treatment for cataract and refractive error that were endorsed by the Seventy-fourth World Health Assembly (WHA74/2021/REC/1). Further, the Seventy-fifth Session of the United Nations General Assembly in the same year adopted the resolution

Vision for everyone: accelerating action to achieve the Sustainable Development Goals (A/RES75/310), and called upon Member States to ensure access to eye care services for their populations and to mobilize the resources and support necessary to achieve the global targets by 2030.

To address the eye health needs within the region and also to achieve the global targets, the Regional Office for South-East Asia developed the Action plan for integrated people-centred eye care in South-East Asia 2022–2030, which was endorsed by the Seventy-fifth Session of the Regional Committee in 2022 (SEA/RC75/R2).

The action plan envisions that all people in the South-East Asia Region have equitable access to high-quality, comprehensive eye health services to achieve universal eye health by 2030 with the following targets:

• a 40-percentage point increase in effective coverage of refractive error;
• a 30-percentage point increase in effective coverage of cataract surgery; and
• at least 80% of people with diabetes screened regularly for retinopathy, and 80% of those identified with sight-threatening diabetic retinopathy receiving treatment.

In addition, there is the target to eliminate trachoma in the region by 2025. The targets will be achieved through the implementation of five broad, integrated, people-centred eye health strategies, namely:

1. engaging and empowering people and communities;
2. reorienting the model of care to prioritize primary care and community-based services with functional referral linkages;
3. coordinating services within and across sectors;
4. strengthening and reorienting the eye health workforce; and
5. creating an enabling environment.

Priority strategic approaches and actions are listed for Member States to adopt and implement. An eye care indicator menu has also been developed to facilitate monitoring of progress by Member States. With the implementation of the actions by Member States, the region can achieve its set targets by 2030.