Global Lack of Access to Eye Care Exacts a Great Cost. But This Organization Is Stepping Up

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Sight is arguably one of the body’s most important functions, yet even in wealthy countries like the U.S., eye care is treated as an outsider. Those seeking care often hit a financial roadblock, as healthcare insurers hold vision apart from mainstream coverage.

The problem is even more acute in less affluent parts of the world. Globally, 9 in 10 people with vision loss live in low- and middle-income countries (LMICs) where quality eye care is difficult to access at any cost, even as 90% of vision loss cases are completely avoidable.

The price of ignoring preventative and treatable needs is universally steep. The World Health Organization puts the global financial burden of productivity loss from vision impairment at roughly $410 billion — a number that towers over its $25  billion estimate of how much it would cost to address unmet needs.

MacKenzie Scott took a step toward a solution last year, with a $15 million gift to VisionSpring to help vision-impaired artisans and agricultural workers in the coffee, tea and cocoa industries in LMICs like Ghana and Kenya — a gift the organization said will help unlock $1 billion in economic potential. 

Overall, however, philanthropy has been slow to recognize the ways vision affects all aspects of global life, from independent living to education and employment. 

Orbis International

That being said, one locus for philanthropic support for eye care is the organization Orbis International, which has spent five decades bringing eye care to hard-to-reach people and places around the globe, and works to address the economic fallout caused by a lack of access to vision care.

Teaching is an essential part of Orbis International’s delivery model, and training sits “at the heart” of everything it does. Its paid and volunteer faculty trains healthcare workers at all levels — doctors, nurses, regional hospital staff, district leaders and teachers — then delivers the knowledge gained through partnerships with local hospitals, public health agencies and governments. In 2021, Orbis reported roughly $360 million in grants and contributions and net assets of roughly $63 million.

Orbis specifically works to address avoidable blindness, which, as Hunter Cherwek, Orbis International’s vice president of clinical services, explained, is vision loss that stems from a preventable or treatable cause. That includes people who can be saved from vision loss by interventions like simple antibiotics, and those who can regain sight through “10-minute cataract surgery” performed by trained practitioners.

Mobile, virtual and on-the-ground programming

Several delivery models support Orbis International’s work. Since 1982, Orbis has operated a Flying Eye Hospital. Its current iteration is a MD-10 airplane donated by FedEx. Beyond transporting medical experts, the plane features a mobile teaching classroom as well as operating and recovery rooms. Cherwek said it has touched down in 90 countries, raising on-the-ground awareness of Orbis’ goals with the general public, donors, governments and other stakeholders.

Orbis International’s telemedicine platform, Cybersight, is currently celebrating 20 years of connecting experts with local practitioners at all skill levels around the world. Cybersight extends the organization’s ability to deliver mentoring to places otherwise ruled out by cost, logistics or security. According to Orbis, it has been welcomed in every nation besides North Korea and Western Sahara, collecting more than 11 million video views and 80,000 registered users. The platform’s more advanced features include an artificial intelligence diagnostic tool, remote surgical mentorship and teleconsultations on complex patient cases. 

Orbis also recently launched an app that puts all of Cybersight’s capabilities in the hands of medical professionals, providing immediate access to training and education tools, long-distance mentoring and online courses. Data transmits in real time. Users can create, view or work on cases from anywhere in the world — the app autosyncs when the next user connects. Content is also available offline for delivery in places the internet doesn’t reach.

The organization also works on the ground. Cherwek said Orbis has the most full-time employees, 70, in Ethiopia, where it recently crossed the milestone of administering 100 million doses of a common antibiotic, azithromycin, toward the goal of eliminating trachoma. An infectious disease that’s responsible for the irreversible blindness or vision impairment of nearly 2 million people in 42 countries, trachoma alone creates an economic burden of between $3 billion and $5 billion a year in lost productivity.

Who’s backing Orbis International’s projects?

In 2022, Orbis International’s backers contributed toward a total of $140 million in support of projects around the world. Its philanthropic supporters include the Alcon Foundation and the David and Molly Pyott Foundation.

The Alcon Foundation, the philanthropic arm of Alcon, Inc., a Geneva-based developer and manufacturer of surgical and vision care products, primarily focuses on programs that advance eye health education, training and skills transfer. In 2022, it made a $1.8 million grant to Orbis over three years in 2022 to strengthen eye care globally.

Meanwhile, the David and Molly Pyott Foundation donated $4 million over three years to boost eye health across Zambia, with a focus on capacity-building and quality-of-care delivery. That follows the successful $2 million first phase of funding from the pharma executive’s foundation, which rolled out between 2019 and 2021 and focused on a residency training program with one of Orbis’ partners, the University Teaching Hospitals Eye Hospital in Zambia’s capital, Lusaka.

Signs of progress

Broadly, some progress has been made toward recognizing the critical nature of global vision and eye care. In 2021, the U.N. issued its first resolution to include eye health by making Vision for Everyone part of the 2030 agenda for achieving its Sustainable Development Goals (SDGs). 

And a number of other philanthropic funders are turning their attention to the problem. Hong Kong-based philanthropist (and IP guest author) James Chen created Vision For a Nation (VFAN), which partnered with the Rwandan Ministry of Health to provide affordable vision screening to 2 million Rwandans, and also founded a second NGO, Clearly, to raise this issue’s profile and build scalability. Other notable philanthropic support includes Arcadia’s $1 million investment in U.K.-based Sightsavers programs in Asia.

As more funders recognize that eye care is healthcare, the hope is that philanthropy can become a bigger part of the solution to global vision-driven economic disparities, and move eye care into the mainstream in more places.