1. Prof. M. Daud Khan IAPB, 9 th General Assembly; Hyderabad, India,18.9. 2012

2. A Mixture of joys and sorrows. Indo- pak wins freedom but the partition caused death, disease, destruction and displacement of some 20 million people

3. 1947 Specialists 6 Medical Officers 42 (Mainly in Punjab) Paramedics and nurses negligible number Only two medical colleges in the country, with 80% staff migrating to India Health care Heritage at birth

4.  Rising population  Aging population  Poverty  Illiteracy  Extremism  Political instability  Regional conflicts

5.  Few Missionary Hospitals  Sir H. Holland and Sons (Quetta & Shikarpur)  Dr. Novel Christy -Taxilla  Mayo Hospital – Lahore  Civil hospital, Karachi  Few family owned cottage Eye Hospitals

6. O S P 1957 A P A O 1979 1980 W.H.O Consultant ( Prof. Hugh Taylor ) The wake up call A P A O 1960 APAO conceived, 1957, Approved, 11.9 1958, 18 th ICO, Brussels

7.  The initial leadership used Five pillars for initiating and scaling up of eye care. Awareness & Advocacy Situation Analysis & E.B Goal Setting Resource Generation & Management Program Development & Management Partnership & Collaboration DISTRICT BASED EQUITABLE EYE CARE

8. Relevance NCECP NHRDP Access Quality Research based Needs Assessment

9. 1 st National Survey 1987 -1988 1 ST 5yrs Plan 1994-1998 2 nd 5yrs plan 1999-2004 2 nd national Survey 2002-03

10. A major seat of learning, an autonomous institute, governed by an elected council of 20 members  Goals & Objectives  PGME  R&D in biomedics  Equitable Specialist health care  Collaboration HQ: Karachi Regional centers;16, 3 overseas Accredited institutes: 235 Supervisors: 2100 PG students: 13,5oo Number of Subspecialties: 60 Total outputs: 19,000 Impact: > 90% of specialist health care delivery is through CPSP alumni

11. 4 +2 centers for training of OAHP

12. 12 LRBT hospital Al-Shifa Trust hospital ISRA EYE INSTITU TE KARACH I

13. Plan Evaluate Implemen t Monito r District Comprehensive Eye Care Services (DCECP) Primary Eye Care Community Detect TreatRefer Disease Control cataract Simple Glaucoma Horizontal squints Lids & Adnexa Trauma Infections Special programs on: Corneal blindness Trachoma Vitamin A deficiency Refractive Errors Diabetes ARMD

14. WHO OS Professionals P GOP NECPNECP Partnership & Collaboration NGDOS & INGDOS

15. Primary Secondary Health Care Complex Service delivery District Comprehensive Eye Care Programme Primary Eye Care Detect TreatRefer Tertiary Eye Care CENTRE OF EXCELLENCE Community All the three tiers are important for development of National Eye Care Programme HRD, CME, CPD, CED

16. 2.0% 0.9% 0 1 2 1980 2004 Impact National Prevalence of Blindness

17. HRD (Eye care team) 1980 2006 Ophthalmologist 80 2000 Comm. ophthalmologist 0 100 MLECP 0 >500 Infrastructure Centers of Excellence 0 7 3ry eye care centers 10 >80 2ry eye care centers 8/64 118/120 Disease control ( 1115/M 2400 ---4000/ M Special programs for: Corneal blindness Trachoma Vitamin A deficiency Diabetes, ARMD and Glaucoma Refractive errors and low vision (CSR)

18. P. Cartwright, W Van Berkel, J Banzin, Khan, N Jan 2004 Gender wise Service uptake

19.  Afghanistan  Yemen  Iran  Bangladesh  Jordan  Syria  Lebanon  Palestine  Libya  Sri Lanka  Indonesia  China  Nigeria  Kuwait  Egypt  UAE  Iraq  Saudi Arabia

20. Future Priorities HR for Sub specialty development Enhanced focus on AHP including nurses CME, CPD & CED Enhanced focus on R & D Pediatric Eye care Diabetic Eye care ARM Ref. Error & low Vision School H. service CVC  3 rd 5 yr. program  GOP commits 2.8 billion ( 46 M $ )

21. Acknowledgements WHO ICOIAPB ICEHCBMSSIFHF LFW EU Juntedo University ALBASAR LVPEcww AAO Rotary International Dr PARA Prof. Allen Foster Prof. Clare Gilbert Prof. Konyama Prof Prowzeski Dr. Gana IEF Dr Babar Q. Dr. Aman K Dr.Rubina G Dr.Haroon A Mr Hassan M. Prof. Saleh M Prof. Nasim P Pros Asad Aslam Aravind eye care systems Impact EMR

22. Leaders who Inspired us

25. THANK YOU