Academic journal article Bulletin of the World Health Organization

Blindness Prevention Programmes: Past, Present, and Future

Academic journal article Bulletin of the World Health Organization

Blindness Prevention Programmes: Past, Present, and Future

Article excerpt

Voir page 225 le resume en francais. En la pagina 225 figura un resumen en espanol.

Introduction

This article summarizes WHO's activities in blindness prevention, from the early years to the present day, and outlines the current and future global challenges in blindness prevention as well as the plans to address them.

Past and present

WHO's early efforts on blindness prevention, starting in the 1950s and predating the formal establishment of a programme for the prevention of blindness (1), were devoted to the prevention and possible eradication of trachoma. These efforts involved not only providing assistance to Member States to assess the magnitude of the problem and institute control activities, but also several research initiatives on treatment options. The research activities included laboratory and field studies (2, 3) and, based on the results, strategies were evolved for the prevention and control of trachoma. These strategies, which were delivered in national trachoma control programmes, primarily in a number of countries in the Eastern Mediterranean, South-East Asia and Western Pacific Regions where trachoma was hyperendemic, consisted largely of antibiotic treatment using 1% tetracycline eye ointment. These national activities were, however, single-purpose vertical programmes and, although they succeeded in reducing endemicity and preventing blindness from trachoma, were generally not sustainable. As a result the control of blinding trachoma became an unfinished agenda (4).

Just prior to and particularly after the establishment of the WHO Programme for the Prevention of Blindness (PBL) in 1978, the scope of the organization's blindness prevention activities became more broadly based when onchocerciasis, xerophthalmia and cataract were identified, in addition to trachoma, as preventable causes of blindness. PBL's mandate was to assist Member States to organize programmes and activities aimed at the prevention and control of these four major causes of blindness and visual impairment identified at that time. Consistent with the declaration of the International Conference on Primary Health Care held in Almaty, 6-12 September 1978, the strategy adopted by PBL was the delivery of eye care as an integral part of primary health care, and the concept of "primary eye care" was developed. This strategy remains in place even today (5).

The data on blindness compiled at the request of the Twenty-fifth World Health Assembly (6) in 1972 provided the earliest epidemiological information on the magnitude and pattern of blindness globally. The methods used to collect these data in population surveys in many countries differed, however, and in 1978 WHO therefore produced standardized guidelines and protocols for this purpose (7). Subsequently, WHO also prepared a standardized protocol for collecting data for use in a simplified grading system for community-based trachoma surveys and childhood blindness. (8, 9).

In 1975, largely as a result of the pivotal role played by WHO, the International Agency for the Prevention of Blindness (IAPB) was set up. Several initiatives followed as a result; for example, the theme of World Health Day on 7 April 1976 was "Foresight Prevents Blindness". The founder members of IAPB included the International Council of Ophthalmology (representing the International Federation of Ophthalmological Societies), the World Council for the Welfare of the Blind (later renamed the World Blind Union) and two international nongovernmental organizations -- the American Foundation for the Blind (later renamed Helen Keller International) and the Royal Commonwealth Society for the Blind (later renamed Sight Savers International).

National programmes for the prevention of blindness

Working together with IAPB, an early initiative of WHO/PBL was to establish national programmes for the prevention of blindness in a number of Member States. …

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