1. UNIVERSAL EYE HEALTH Ha Noi – Viet Nam 27 June 2014

2. Why eye health? Better eye health improves quality of life, and participation in work and the community Cost-effective interventions exist for cataract and refractive error Every dollar spent on eye health generates a four-fold return on investment Most vision loss is avoidable. Four out of five people who are blind don't need to be.

3. Globally, prevalence of blindness and visual impairment over the past 20 years is declining In 2010 there were nearly 100 million fewer people who were blind or with severe or moderate visual impairment than would have been expected VISION 2020 is making a big difference

4. The number of blind people in the world Those with moderate and severe visual impairment Total 32 million 191 million 223 million Bourne R, Price H, Stevens G. Global Burden of Visual Impairment and Blindness. Arch Ophthalmol. 2012;130(5):645-647

6. Links to poverty: rates of blindness in low income countries are considerably greater than in high income countries Women are disproportionately affected Cataract and refractive error remain the major causes of vision loss The data confirmed

7. Universal Eye Health: A Global Action Plan 2014- 2019 Adopted by all health ministers at the World Health Assembly in May 2013 Emphasis on: Universal access National plans Evidence Funding Integration and partnership

9. Global Action Plan: Towards Universal Eye Health Western Pacific Regional Action Plan National initiatives NGO initiatives and programs National Plan for Viet Nam 2014-2019 Provincial plans and initiatives

10. IAPB and international partners in Viet Nam are willing to support implementation and monitoring National Plan for Viet Nam 2014-2019

11. CSR has increased rapidly Expanding health insurance Good numbers of ophthalmologists Trachoma close to elimination Strong public health and education system Committed partners, National PBL Committee Guidelines for district level eye care, National Plan drafted Advanced training curriculum and teaching in basic ophthalmology Good infrastructure for eye care Strengths

12. Lack of access to quality services for refractive error. Improve legal and policy frameworks to ensure a greater quantity and quality of refraction services Clearer policy and registration of spectacle shops in public settings, including financing Formalised training for optometrists Insurance expanded to cover spectacles Gather more evidence Vision screening included in student health checks Refractive error

13. While the CSR has increased, the cost and quality of surgery remains a problem. Ensure affordable services are available to all, especially the poor and those close to the poverty line Options of different services, for example SICS and ECCE /IOL Increase public awareness of the benefits of cataract Health insurance to cover IOL for traditional method (SICS) Clearer guidelines for monitoring of surgical outcomes and standard procedures for follow-up to ensure quality, including CSSS Cataract

14. Vulnerable groups – women and children, the poor, elderly and persons with disability, ethnic minorities – have limited access to quality eye health service Training and awareness of health staff to be sensitive to different patient’s needs Expand outreach to hard-to-reach and vulnerable groups in poor and remote areas Adequate incentives for health staff to work in remote areas, including allowances for outreach Prioritise and focus on primary eye care, cataract and refractive errors in remote areas Promote the public benefits of eye health services Expand access and improve referral for low vision and rehabilitation and disability support Guidelines for district level eye care should include sections to promote inclusion Inclusion and access

15. Diabetic Retinopathy Almost 6 per cent of the adult population of Viet Nam has diabetes, and are at risk of losing their vision. Improve capacity of health staff to diagnose and treat, particularly at the provincial level Strengthen collaboration and referral mechanisms between diabetes sector and eye health Include eye health in guidelines and protocol for managing diabetes Gather evidence on prevalence and future projections Expand health insurance to ensure access to all necessary screenings Improve facilities and equipment to manage diabetic eye disease Increase public awareness to encourage early intervention

16. THANK YOU! For more information please contact IAPB Damian Facciolo E: dfacciolo@iapb.org www.iapbwesternpacific.org