19 April 2000
GLOBAL INITIATIVE FOR THE ELIMINATION OF AVOIDABLE BLINDNESS
VISION 2020 LAUNCHED IN ENGLISH SPEAKING AFRICA,SOUTH AFRICA SET TO ELIMINATE CATARACT BLINDNESS WITHIN THE NEXT FIVE YEARS
Johannesburg, South Africa. In English-speaking Africa, an estimated 3-4 million blind and 10-12 million visually impaired people will benefit from "VISION 2020: the Right to Sight"—a worldwide initiative to eliminate avoidable blindness by the year 2020. More than 60% of them suffer from cataracts.
Major efforts, coordinated nationally, regionally and internationally, will be made to restore eyesight in these people while preventing many others from becoming blind, said today the World Health Organization (WHO) and a group of international nongovernmental development organizations (NDGOs) at the VISION 2020 sub-regional launch in Johannesburg, hosted by the South African Broadcasting Corporation (SABC).
To achieve these objectives, the VISION 2020 group, in close cooperation with African health authorities, will work to increase the number of adequately trained national eye-care personnel; ease access to ophthalmologic services for populations in low income brackets, particularly in rural areas; facilitate the transfer of appropriate sight-saving technologies to African countries; as well as develop and implement cost-effective national strategies for blindness prevention. In its initial stage, the emphasis in VISION 2020 will be placed on awareness-raising and resource mobilization.
Sub-Sahara Africa accounts for an estimated 5-6 million blind and 16-18 million visually disabled people. Around 60% of them live in 20 English-speaking countries, including Botswana, Eritrea, Ethiopia, Gambia, Ghana, Kenya, Lesotho, Liberia, Malawi, Mauritius, Namibia, Nigeria, Seychelles, Sierra Leone, South Africa, Swaziland, Uganda, The United Republic of Tanzania, Zambia and Zimbabwe.
"Everywhere, blind people live difficult lives. But in Africa, where social support services are non-existent, blindness and extremely low vision, first and foremost, spell humiliation. Begging becomes the only way for those affected to survive," stated Dr Ebrahim Malick Samba, WHO's Regional Director for Africa, addressing some 150 journalists, African ophthalmologists, Western and African diplomats accredited in South Africa, as well as RSA's government officials present at the launch.
"To give a ray of hope to the blind and visually disabled Africans, I am ready to beg on their behalf too. And I am begging the more fortunate and affluent -- populations and governments in donor countries, various foundations, nongovernmental organizations and the private sector – to help VISION 2020 reach its noble objectives. Together we could restore sight to millions of people and prevent many more from going blind," WHO's Regional Director for Africa said.
Dr Samba's involvement in blindness prevention in Africa dates back to 1981—1994, when he worked for WHO as head of the very successfulOnchocerciasis Control Programme (OCP). Over the past 25 years, OCP has protected an estimated 11 million children against onchocerciasis and have saved around 500 000 people from blindness in most of West Africa.
WHO's Regional Director for Africa praised the work of NDGOs active in blindness prevention on the continent. Among those mentioned were (in alphabetical order): Christoffel-Blindenmission (Christian Blind Mission International–CBM); Helen Keller Worldwide; International Federation of Ophthalmological Societies; Lions Clubs International Foundation; Operation Eyesight Universal; Orbis International; Organisation pour la Prévention de la Cécité (OPC); Sight Savers International (SSI); The Carter Center and The Fred Hollows Foundation.
Like in the rest of sub-Saharan Africa, the major causes of blindness in English-speaking African countries are cataracts, trachoma, glaucoma, onchocerciasis (river blindness) and childhood blinding disorders. In absolute terms, these countries are the home to an estimated 3-4 million blind and 10-12 million visually disabled people. The VISION 2020 group said that up to 80% of this blindness and visual disability was preventable and treatable.
According to WHO, some 2.4 million people in the sub-region are blind from cataracts, with an estimated 600 000 new cases of blinding cataracts occurring each year. "Today, only less than 10% of these cases receive surgical treatment. In fact, the provision of, and access to, good cataract services vary widely within the sub-region and even within countries," emphasised Dr Serge Resnikoff, Coordinator of the Blindness and Deafness Prevention Programme at WHO in Geneva.
"The cataract surgery rate (CSR) in the sub-region ranges from 200 to 1000 per 1 million of the general population per year. As a result, the backlog of unoperated cataracts is steadily on the increase. Within the next five years, the VISION 2020 group plans to increase the CSR in the sub-region to 2500 per one million population," he said.
English-speaking Africa also has an estimated 200 000 blind children (aged 0–15). About half of them die within two years of becoming blind. The main cause of childhood blindness is corneal scarring (around 70% of all cases) from measles, vitamin A deficiency, conjunctivitis of the newborn and harmful traditional medicines. All these conditions are amenable to simple and cost-effective measures. Other causes of childhood blindness include congenital cataract and hereditary disorders.
Onchocerciasis, or river blindness, is endemic in 8 English-speaking African countries:Ethiopia, Ghana (southern part), Liberia, Sierra Leone, Malawi, Nigeria, Tanzania and Uganda. Nearly one-third of all known cases today in Africa are found in Nigeria alone. In these countries, with the exception of Ghana, the disease still constitutes a serious obstacle to socio-economic development.
Beyond 2002, efforts to eliminate avoidable blindness due to onchocerciasis will be pursued mainly through the African Programme for Onchocerciasis Control (APOC) -- a global partnership between affected communities, participating governments, a consortium of international NGDOs and bilateral agencies. Provided present efforts in endemic areas continue, WHO hopes control of river blindness throughout Africa may be achieved by the year 2010.
In the sub-region, an estimated 800 000 people are either blind or severely visually impaired by trachoma – a disease bred by poor housing, hygienic, water and sanitation conditions. To fight the disease, a strategy referred to as "SAFE" (Surgery, Antibiotic, Facial Cleanliness & Environmental Improvement) has been developed. The VISION 2020 group said the use of the SAFE strategy in affected areas should lead to the elimination of trachoma as a blinding disease by the year 2020.
"Despite [these] frightening statistics, the elimination of avoidable blindness by 2020 in Africa, as well as worldwide, is quite feasible, provided adequate resources are available," stated Christian Garms, Chairman of the VISION 2020 Task Force and Executive Director of Christoffel-Blindenmission (CBM) -- a major international charity that raises funds in the West and operates successfully in many developing countries. "Today, the international community spends worldwide around US$100 million a year on blindness prevention and treatment. To reach the objectives of Vision 2020, we need to at least double this level of spending," Mr Garms said.
To demonstrate the Government's backing of the Vision 2020 objectives in South Africa,Dr Manto Tshabalala-Msimang, the RSA's Minister of Health, signed at the launch the VISION 2020 Global Declaration of Support issued last year in Geneva by WHO's Director-General Gro Harlem Brundtland.
"VISION 2020 has our full support, both in terms of public health and political commitment. The country has already done a lot in blindness prevention. For example, we have developed effective models for trachoma control andfor the last two years no confirmed active cases in children have been found. However, much more has to be done to facilitate access to quality cataract surgery, particularly in rural areas. We will certainly welcome any assistance that the international community can give us in this respect," Dr Tshabalala-Msimang said.
According to the Minister, cataract and glaucoma, responsible for 66% and 14% of South Africa's blind respectively, are the two leading causes of blindness in the country. Dr Tshabalala-Msimang stressed that the major challenge forSouth Africa in the elimination of avoidable blindness was to overcome the disparity, inherited from the past, in access to and provision of cataract surgery for the country's more than 160 000 indigent cataract blind. "Without any doubt, South Africa has the very best in cataract surgery. However, this expertise is unevenly distributed throughout the country, as well as between the public and private sectors," she said.
"For instance, there are 275 ophthalmologists in the whole of South Africa: 250 of them work in the private sector catering for the needs of 8 million people, whilst only 25 work in the government practice that services 32 million people. The CSR for the indigent population is 850 per million of the general population per year. In order to eliminate blindness due to cataract, it should be 3000 for South Africa," Dr Tshabalala-Msimang explained.
At the VISION 2020 launch in Johannesburg, DrTshabalala-Msimang and Dr William Rowland, Executive Director of the South Africa National Council for the Blind (SANCB), jointly kicked off the national Right to Sight campaign to restore eyesight in the country's more than 200 000 cataract blind over the next five years.
Inspired by VISION 2020, this campaign will be run as a partnership between the Bureau for the Prevention of Blindness (SANCB's operational branch) and the national and provincial departments of health. The Right to Sight will cost an estimated R120 million (approximately US$20 million) to be raised by the organizers both within and outside South Africa.
"The SABC welcomes the opportunity to support Vision 2020 in Africa and the Right to Sight campaign in South Africa. As part of its social responsibility efforts and in the interests of nation building and community development, the SABC is hosting this media launch and will be using its broadcasting capabilities to assist in eliminating avoidable blindness in Africa," said SABC's Acting Senior General Manager for Corporate Affairs, Tango Lamani.
For further information, please contact Mr Igor Rozov, WHO, Geneva on (4122) 791 2532, mobile phone in Geneva (4179) 217.34.93, Fax (41 22) 791 4858. Email: email@example.com. All WHO Press Releases, Fact Sheets and Features as well as other information on this subject can be obtained on Internet on the WHO home page http://www.who.int