Last month, we highlighted the opportunities and challenges of our work in The Americas. This month, I sat down with Eva Lazuka-Nicoulaud, Director, Europe and Africa, to bring you a glimpse into our advocacy efforts in this vast region as we work to prioritize good vision.
How many countries, languages, and people are in the region? What is the biggest vision issue?
Together, Europe and Africa comprise 135 countries, 2.7 billion people that represent 37% of the world’s population, and 2,000 official and spoken languages.
When it comes to countries in Africa, the largest avoidable vision issue is uncorrected refractive error (URE). The unmet need is tremendous, especially with school-aged children in underserved areas. Several studies report that up to 100% of children have never had eye exams or even eye screenings, which consequently results in a very low rate of vision correction.
In Western Europe, URE among school-aged children is also a big issue. A recent awareness and screening campaign in France uncovered that 1 in 5 children live with poor vision due to lack of proper correction. The URE numbers will continue to look even more critical in light of the fact that myopia is reaching epidemic proportions. Without intervention, it will reach 56 % in Western Europe by 2050; but it will also accelerate in Africa, especially in North Africa and the Middle East, due to urbanization and environmental factors.
With so many countries and cultures comprising this region, what is similar and unique from the one area to the other?
In both regions, the main cause of poor visual acuity is URE, which can affect people from childhood to old age. Myopia acceleration, its earlier onset and growing prevalence in school-aged children on a global scale, is also a commonality.
However, uniquely in Africa, the population is young, and 60% live on less than $2 a day. Awareness, access, and affordability are key issues. In Europe, as the population ages, the prevalence of uncorrected vision is on the rise and puts pressure on health care budgets.
While Africa and Europe face very diverse economic and legislative challenges around vision care, the need for vision correction and protection remains paramount.
How do you set priorities?
Aligned with the global strategy of the Vision Impact Institute, I focus regionally on topics and countries where intervention is plausible. The responsiveness and engagement of local stakeholders is the key to success. We are stronger when acting together to make change.
Are there key research studies you have identified that empower your work or create a basis for the advocacy work you are doing in Europe/Africa?
It’s important to note that all my work starts with evidence-based advocacy. One of our strategic pillars is children’s vision, because we know it has an impact on their future and the socio-economic development of our societies. Working from that perspective, each scientific study providing evidence about the size of the problem in a country (the prevalence of URE) or knowledge about the positive impact of vision correction and protection in children (impact study), is extremely precious.
When it comes to Myopia, I refer very often to the Holden et al. study that shows 1 in 2 people will be myopic in 2050 and the recently published assessment of cost associated with uncorrected myopia. Additionally, I rely on reports on vision and road safety from international leading organizations.
What topic in research would help to create the most change in your region?
We must continue to close the research gaps in children’s vision whenever we identify a need. We are doing so with the help of local partners and research experts. As we highlight the size of the problem and the benefits of vision correction and protection in children, we can contribute to creating change. This research is the foundation of our working plans with local authorities to build a better socio-economic future across the region.
What is one thing that you are most proud of in the region?
I’m extremely proud of a Kenyan initiative called Macho Bora Elimu Bora (better vision for better education), which started as a school screening program in Nakuru county in 2018, with partners from Essilor. For the first time, this program has been included in the 2019-2020 Annual Working Plan of the Ministry of Health. The project incorporates screenings by trained teachers, refractions by skilled optometrists and comprehensive eye exams for those referred for further examinations in eye clinics. Spectacles are delivered to schools, and payment is made through M-Pesa, a mobile phone-based financing service.
In keeping with our mission, this initiative builds awareness among communities (children, parents, teachers) in underserved areas and creates access to eye care services, while saving costs to travel to the eye health centers, as the interventions occur in schools.
Together with our partners, we are building the case jointly with authorities and stakeholders from private, public and social sectors. I believe these collective efforts may change the ecosystem and legislative landscape, thereby helping to ensure regular, quality eye screenings for 12 million school-aged children in Kenya. This simple shift may change not only the status of eye health, but ultimately accelerate the sustainable development of the country.