Research focuses on need for universal eye health coverage

Issue: November/December 2014

ByIvo Kocur, MD MA MSc MBA

“Universal eye health: a global action plan 2014-2019,” endorsed by the member states of the World Health Organization during the 2013 World Health Assembly in Geneva, Switzerland, sets a global road map for the development of eye care services. The need for further research was repeatedly highlighted in various sections of the eye health action plan specifically because of the recognized need to focus available resources toward the most cost-effective interventions and develop innovative approaches to prevent and cure eye diseases.

The action plan addresses two areas of research: biomedical research, which is important in developing new and more cost-effective interventions, especially those that are applicable in low- and middle-income countries, and operational research, which provides evidence on ways to overcome barriers in service provision and uptake and improvements in appropriate cost-effective strategies and approaches for meeting ever-growing public health needs for improving and preserving eye health in communities.

The Sight Loss and Vision Priority Setting Partnership, discussed in this issue of Ocular Surgery News Europe Edition, is the result of a remarkable effort to identify eye health research priorities through engaging a large number of stakeholders, jointly working in a transparent and consultative way. The methodology used, which is thoroughly described in the project report, allowed first for agreeing upon the key questions. Those with missing or incomplete answers were identified by the participating organizations and individuals as a major impediment, limiting further progress in the area of preventing vision loss. The focus was on specific eye conditions relevant to a specific population segment, such as childhood-onset eye conditions. The report then presented, under each respective category, a subset of issues recommended for further research. Those cover various aspects of prevention, diagnostics and treatment of the major causes of blindness, specifically in the context of the United Kingdom, where this project was conducted. One of the ultimate objectives of this project was to publicly present the identified research priorities in order to guide current and new eye health researchers and to support their efforts in seeking resources for their research activities.

Similar efforts addressing research needs in other geographic and socioeconomic settings would certainly contribute to the global understanding of the eye care research agenda. Additionally, it is encouraging that some eye conditions have already been included among research options by authors examining the whole range of other health conditions. Cataract, for instance, has been listed among the options for future research in a report entitled “Medical devices: managing the mismatch,” published by the WHO.

While clinically oriented research is a prerequisite for better outcomes in the management of eye conditions, increasing access to eye care services is an equally important step. This need has been particularly recognized in low- and middle-income settings, underserved communities and vulnerable groups. In its last World Health Report entitled “Research for universal health coverage,” the WHO brought experiences from its member states and research concerned with how to reach the goal of universal health coverage. As the WHO formulated, the goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.

For a community or country to achieve universal health coverage, several factors must be in place. They include a strong, efficient, well-run health system that meets priority health needs through people-centered integrated care, provision of affordable health services, and access to essential medicines and technologies to diagnose and treat medical problems, in addition to a sufficient capacity of well-trained, motivated health workers able to provide the services to meet patients’ needs based on the best available evidence. The same applies to the efforts to make comprehensive eye care, already integrated in national health systems, universally available.

“Universal eye health: a global action plan 2014-2019” is structured by the health system approach. Regarding the research needs, this approach should help to identify general as well as locally specific areas for operational research so that the results of clinical research are made accessible to all.

References:
Medical devices: managing the mismatch. World Health Organization. whqlibdoc.who.int/publications/2010/9789241564045_eng.pdf?ua=1. Published 2010.
Universal eye health: a global action plan 2014-2019. World Health Organization. www.who.int/blindness/AP2014_19_English.pdf?ua=1. Published 2013.
What is universal health coverage? World Health Organization. www.who.int/features/qa/universal_health_coverage/en/. Published October 2012.
The world health report 2013: Research for universal health coverage. World Health Organization. apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng.pdf?ua=1. Published 2013.

For more information:
Ivo Kocur, MD, MA, MSc, MBA, OSN Europe Edition Board Member, can be reached at World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland; email: kocuri@who.int.

Disclosure: Kocur is Medical Officer for Prevention of Blindness and Deafness at the World Health Organization.