Poor eyesight is a $227bn-a-year global health crisis. A cheap, 700-year-old solution could solve it.

When a team of eye technicians visited the Al Shohada’a School in Masakin Al Shohada’a, a poverty-stricken area of New Cairo, to distribute free glasses to poor-sighted pupils, they delivered more than just the promise of clearer vision. For the children who’d grown used to straining to see the blackboard, they brought the possibility of a better education and a brighter future.

“Eyeglasses represent one of the most cost-efficient interventions there is in healthcare,” says Dr Mohammed Shalaby, executive director of Magrabi Foundation, the Cairo-based nonprofit behind the initiative. “For less than EP100 [about $6], you can enable a child to see.”

Since the early 2000s, Magrabi Foundation has dispensed more than 90,000 pairs of glasses to Egypt’s poorest communities. At the same time, it works to raise awareness of eye health issues, and quash pervasive social stigmas that can deter people from seeking help.

“A young girl might know she needs a pair of glasses,” says Shalaby, “but not wear them because this is not the norm in her village. People would mock her. There’s no point in distributing glasses to find that in six months she's no longer wearing them.”

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Poor eyesight is a global health burden that affects all ages, and all communities.

"Eyeglasses represent one of the most cost-efficient interventions there is in healthcare." 

Dr Mohammed Shalaby 
Executive director, Magrabi Foundation.

Globally, at least 2.5 billion people need but can’t afford glasses, or pay for the eye exam needed to prescribe them. The burden is at its worst in low and middle-income regions, where people with near and farsightedness are four times less likely to get the help they need.

The impact of uncorrected vision can be felt at every strata of society – from the child whose reading falters in school, to adults whose blurry sight stops them holding down a job. In developing countries where rates of uncorrected vision is high, so too are traffic fatality rates.

This lack of lenses costs the global economy an estimated $227bn a year in lost productivity, according to research cited by the World Health Organisation (WHO). Women are half as likely as men to receive treatment.

“Poor vision is not just a health problem: it has economic, social and educational repercussions too,” says Shalaby, who describes the condition as the largest untreated disability in the world.

For many philanthropists, eye health dwells near the bottom of the public health agenda, passed over in favour of combating higher-profile diseases such as malaria, AIDS and tuberculosis. Yet unlike other preventable diseases, the answer to this health crisis doesn’t require the invention of new drugs or the use of complex and pricey technology. Instead, the solution is 700-years-old and costs around the same as two takeaway coffees.

“Eyeglasses are a simple and cost-effective solution to this problem,” says Elizabeth Smith, co-founder and CEO of EYElliance, a nonprofit group that lobbies to push eye care up the global health agenda, and which counts Magrabi Foundation among its members. The coalition argues that glasses represent a small investment for catalytic change, demonstrated in results ranging from safer roads to fewer families in poverty.

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At least 2.5 billion people around the world need, but can’t afford, glasses.

Essilor, the French lens company that fights for universal access to vision correction, estimates that $2.4bn would be enough to give 90 per cent of those in need access to eyeglasses via designated access points.

“Without good vision, both children and adults are excluded from a world of economic opportunity,” says Smith. “We must make the case to the global development community to prioritise this area.”

There is a growing bank of evidence to back the cause. A study published in The Lancet in 2018, for example, showed that a group of shortsighted female tea pickers in India increased their daily yield by 21.7 per cent after being fitted with glasses. For those aged over 50, the increase was 31.6 per cent.

In China, a study found that providing primary-age students with eyeglasses boosted their academic performance to the same degree as four to six months of extra schooling.

The pressure to invest in improving sight is also increasing. Experts have warned of a creeping epidemic of myopia, or shortsightedness, which could see half the world’s population need corrective eyewear by 2050.

In parallel, the push of urbanisation in the developing world, in which people move indoors to work, and the growth of ageing populations is driving up the need for corrective eyewear.

Smith says NGOs working to deliver eyeglasses to the developing world are collectively tackling just 0.3 per cent of the problem, adding that vision represents an untapped development opportunity for philanthropists and governments alike.

“A problem of this magnitude requires a multi-solution approach,” she says, “and active engagement of the public and private sectors.” – PA