WORLD SIGHT DAY CELEBRATION October 13, 2011

THEME: EYE HEALTH AND DEVELOPMENT "A GOOD SIGHT FOR ALL TOWARDS ATTAINING THE MILLENNIUM DEVELOPMENT GOALS"

Coordination of vision 2020/WAHO 1

World Sight Day has been celebrated on the second Thursday of October every year since the WHO in collaboration with the International Agency for the Prevention of Blindness (IAPB), launched the "VISION 2020-The Right to Sight" Initiative in 1999. This years celebration will take place on the 13th of October 2011. A global theme has always been proposed to all the stakeholders involved in eye health. However, for the 2011 World Sight Day celebration, the Executive Board of Vision 2020 has decided not to provide any theme As a result, in collaboration with the Co-chairs of IAPB for West Africa, the West African Health Organisation (WAHO) has proposed the theme: "EYE HEALTH AND DEVELOPMENT" and the slogan "A GOOD SIGHT FOR ALL TOWARDS ATTAINING THE MILLENNIUM DEVELOPMENT GOALS" for the 2011 World Sight Day. The proposed theme is a continuation of the communication, awareness raising and advocacy activities already undertaken to mark the 2011 WAHO Day, which had the theme "Attaining the Millennium Goals : The Challenge of Multi-Sectoral Approach". Promotiing Eye Health can contribute significantly to attaining the Millennium Development Goals (MDG), specifically MDGS, I-IV as evidenced by the following: MDG 1: Eradicate extreme poverty and hunger

Blindness and poor vision are one of the causes of low production and productivity in heavilyaffected communities. They are both causes and consequences of poverty. MDG 2: Achieve universal primary education.

Over 90% of children with visual impairment do not have access to any form of education. Visual impairment is a major cause of school attrition. MDG3: Promote gender equality and empower women.

Blindness affects more women than men; this is related to inequality of opportunity of access to specialized care, and also the disproportionate exposure of women to certain blinding diseases compared to men. For example in the case of trachoma, the prevalence rate of blindness is one man to two women MDG 4: Reduce child mortality:

Blindness is a factor of high child mortality in general. Over 50% of children, who become blind before the age of five may not live to celebrate their sixth birthday. Improving eye health for the people in the region is among WAHOs priorities, as it has since its inception in 2000 being part of the "VISION 2020: THE RIGHT TO SIGHT" Initiative. Owing to WAHOs commitment to supporting Member States to achieve the Initiatives set objectives,

the promotion of Eye Health of the population featured prominently in both the first (20032007) and second (2009-2013) Strategic Plans of the Organisation. Interventions were therefore aimed at the three pillars of Vision 2020, which are: Development of human resources, Disease control Development of infrastructure and equipment, supplies of medicines and other Eye Health consumables

These interventions were shared between two main strategic orientations thus: Coordination Advocacy and Resource Mobilisation.

Developing national plans for eye health: WAHO, initially, provided financial and technical support to all the Member States for the development of National Plans to prevent and control blindness in the region. This was in response to Resolution 56-26 of the World Health Assembly, which requested all countries to have such a plan before the end of 2005.
STRATEGIC PLAN
NECP
HEAD OFFICE P.O. BOX MINISTRY OF HEALTH & SOCIAL WELFARE

Support

NATIONAL EYE CARE PROGRAM

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LIBERIA 2007 - 2012

The adoption of a resolution in 2005 by the Assembly of Health Ministers of ECOWAS to accelerate the implementation of Vision 2020 in West Africa was a key element in achieving this objective. All countries in the region now have a National Plan on blindness control and most of the plans that were developed between 2005 and 2007 have already or almost come to an end. The big challenge remains their revision, taking into account the new directions offered by the concept that has evolved from blindness prevention and control to the promotion of eye health. Development of human resources: WAHO, in collaboration with its Eye Health partners, has organized several training workshops and capacity building sessions of the key eye health stakeholders in the region. Notable among these capacity building interventions are:

Training in Management, Leadership, Advocacy and Resource Mobilisation Training in Monitoring / Evaluation of Health Programmes Training in new Techniques using new Technologies for Cataract Surgery Training in the use of Geographic Information System (GIS) and other management software and graphical representations of data

In addition, WAHO, with the support of its partners, established and equipped the Training Centre for Post Graduate Diploma in ophthalmology (DESSO) at the Faculty of Medicine, Pharmacy and Dentistry of Conakry in Guinea for middle cadre officers of Eye Health in the Francophone Bloc of ECOWAS. The Centre opened in May 2004 and has since trained about twenty officers, who are providing quality specialized eye care to people in the region Poorly or non treated refractive errors and poor vision are the second leading cause of preventable blindness. Previously, West Africa did not have a training centre for personnel, such as optometrists, specializing in the management of these cases. But in November 2008, WAHO, with the support of these partners, opened a training centre in optometry at the Institute of Tropical Ophthalmology in Africa (IOTA) in Bamako, Mali; the first set will be graduating in November 2011. To facilitate recognition of qualifications and free movement of human resources, WAHO coordinated and facilitated the development and harmonisation of curricula for training in Eye Health in the region. Control of vision 2020 target diseases 1. Cataract Control

WAHO, in collaboration with the University of Marseille in France, has trained more than fifty trainer Surgeons in sutureless Cataract Surgery with posterior arches implant or Phaco alternative, or phaco A; a new technique using new technologies that has significantly improved the quantity and quality of cataract surgery in the region.

The average Cataract Surgical Rate which is the number of cases of intervention per year per million populations increased from less than 500 in 2005 to 600 in 2010. Two countries, The Gambia and Senegal have higher Cataract Surgical Rates well above the regional average, with respectively 2,210 and 924 in 2010. Strategies that enabled them achieve these feats have been identified and documented as Best practices, which have been validated and shared with all countries in the region to improve their Cataract Surgical Rate. 2. Trachoma Control An inventory compiled during the in implementation of the SAFE Strategy in the region shows that the disease is experiencing a sharp decline in the affected countries. A mapping of the infection and the blinding aftereffect of the disease was done and made available to countries for regular updating and monitoring of progress achieved. Ongoing efforts must be sustained and strengthened to achieve the goal of eliminating trachoma as a cause of avoidable blindness by the year 2020. 5

3. Onchocerciasis Control: In this area, WAHO has based its interventions mainly on coordination, in collaboration with APOC and the other partners involved in Onchocerciasis control. For two years, WAHO has been co-organizing and co-financing with APOC the regular annual meeting of Coordinators of Onchocerciasis Control in ex-OCP countries, which incidentally are all member countries of ECOWAS. A resolution was adopted by the Health Ministers of ECOWAS at their General Assembly in 2006 in Abuja, Nigeria on securing the gains and sustaining onchocerciasis control activities. It was primarily intended to maintain onchocerciasis control on the list of national health priorities of countries. 4. Childhood Blindness Control:

A child goes blind every minute. There are about one million five hundred thousand under 16 blind children in the world, with about five hundred thousand new cases per year. Blindness among children is a priority not because of the number of children who are blind but because of the number of years of visual impairment.

Childhood blindness control is one of the weakest links of the implementation of Vision 2020. WAHO has organized several regional meetings to consider and propose solutions and develop action plans to improve the situation. These plans have not been implemented up to the desired level because of insufficient human and material resources. Most of the measures are preventive and are handled by non-specialized personnel in Eye Health: e.g. the fight against vitamin A deficiency and immunization against measles or other diseases that impact eye health. Vitamin A could have significant impact on the control of blindness among children and infant mortality rate. Many efforts have been made and progress is notable. WAHO and all the partners are now working for the institutionalization of vitamin A supplementation to reach 10 to 20% of children and women who still lack access to it. For the past two years, WAHO has been trying to establish Pediatric Ophthalmology units in member countries to improve the management of avoidable blindness cases such as cataracts and congenital glaucoma. This programme has been facing some difficulties due to the lack of qualified human resources in Pediatric Ophthalmology, mainly because of lack of Centres for the training of staff in the region. Efforts are underway to develop two training Centres for Eye 6

Health personnel in Pediatric Ophthalmology; one in the English-speaking bloc of ECOWAS in Ibadan, Nigeria and the other in IOTA in Bamako, Mali for the French-speaking countries. Both Centres should be operational by October 2012. 5. Management of refractive errors: Like childhood blindness, refractive errors have a very low level of care provision. As a result, WAHO organized a workshop in 2005 to reflect on improving care provision for the treatment of refractive errors in Francophone West Africa. One of the major findings was the lack of qualified human resources and lack of training Centres. One of the key recommendations of the workshop was the establishment of a training Centre in Optometry in the Francophone bloc of West Africa. IOTA in Bamako was identified to host the centre, which has been functioning since November 2008 through collaboration with the World Council of Optometrists,the African Association of Optometrists and the School of Optometry in Bures sur Yvette France

Developing infrastructures/equipment and improving supply of medecines and other eye health commodities As a result of fruitful partnerships, the infrastructure and equipment of some Eye Care Units have been improved. Regional meetings were organized to analyse the situation to identify existing problems and to propose solutions aimed at improving them. These meetings helped to update regularly a list of medicines and other essential commodities of Eye Health and conduct advocacy for their inclusion on countrys list of essential medicines. Most countries moved from zero Eye Health drugs on the national list of essential drugs in 2005 to the inclusion of nearly 80% of the needs on these lists.

Coordination: Since November 2004, WAHO, in collaboration with its partners, has created the position of Coordinator of Vision 2020 among its programmes. Prior to this, an Advocacy Forum for Vision 2020 in West Africa had been established in Abidjan in 2002, under the auspices of WAHO. The Forum consists of all the stakeholders of Eye Health, and has a small group called Forums Action Group, which deals with more technical issues. The Forum meets every two years while the action group meets once a year.

Vision 2020 Forum in Abuja in 2006 The Forum meets every two years while the action group meets once a year.

Vision 2020 Forum in Bissau in 2008

An analysis of the human resources situation was carried out. Participants were able to identify needs on the basis of the available workforce andin 2008projections for the next five years. Vision 2020 Forum in Bissau make

An analysis of the human resources situation was carried out. Participants were able to identify needs on the basis of the available workforce and make projections for the next five years.

Vision 2020 Forum in Ouagadougou in 2010 Participants reviewed the ten years of implementation of the Vision 2020 initiative in the region, drawing lessons and proposing solutions to achieve the goals by 2020. A Coordination Group of Vision 2020 NGO partners in West Africa was also set up in 2003. The group has as its founding members, the top five international NGOs involved in Eye Health in the region: Christofell Blindenmission CBM, Helen Keller International HKI, the Organisation for the Prevention of Blindness OPB and Sightsavers. Subsequently, Swiss Red Cross, Light for the World, Operation Eyesight Universal, ORBIS International, Nadi Al Bassar and Prevention of Blindness Union joined the Group, which now has about ten members.. The Group has been holding a regular annual meeting since its inception. Theme-based meetings are organised at least once a year with the Coordinators of National Eye Health Programmes of all ECOWAS Member States. Advocacy and resource mobilisation

An advocacy visit targeting research, partnership strengthening and resource mobilisation was made to Paris.

Lessons learnt WAHOs Coordination served as a catalyst for improving Eye Health in the region as evidenced by the 2005-2009 review, which was considered positive by all the Secretaries and DirectorGenerals, Permanent Secretaries of Ministries of Health of the ECOWAS Member States during the Vision 2020 Forum in October 2010 in Ouagadougou, Burkina Faso. The Coordination gave better visibility to Eye Health in Health Ministries and in the region as a whole. It afforded us the opportunity to mobilize additional resources for Eye Health from partners, which countries individually could not have done. It allowed regular exchanges and sharing of very enriching experiences between countries, which is a factor of progress.

Proposed solutions to achieve the objectives: Translate into practice the transition from the concept of blindness prevention and control to the concept of Eye Health promotion; Focus on Eye Health staff training, particularly middle level personnel; Build the capacity of countries to mobilize more internal resources for Eye Health; Improve the information management system for Eye Health; Provide policy-makers with further information on resolutions and commitments made at regional and global levels.

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