1. Return on Investment of Childhood Blindness Program in Bangladesh Abu Raihan, AM Zakir Hussain, ASM Nurullah Awal IAPB General Assembly, Hyderabad, Sept 2012

2. 2 | ORBIS International Background and Purpose Bangladesh CB Survey - 2002 estimates total number of blind children in the country 40,000 (of them 12,000 cataract blind) and anticipated, at least five times the number of blind children, suffer from refractive errors and low vision. The purpose of this study is to estimate the economic return of CB program in order to make recommendations to the policy makers for allocation of resources to address the problem of CB in the country.

3. 3 | ORBIS International Method The study adopted the standard “Cost-of-illness” methodology to measure the economic burden of CB. In 2007, ORBIS conducted a performance and expenditure survey of pediatric eye care service among the 23 major eye hospitals in Bangladesh. The findings were sued to estimate the cost of treating all CB. Although indicators of effect and impact of blindness are not known for Bangladeshi population, extrapolations were used as far as suited to the Bangladesh context upon some assumptions.

4. 4 | ORBIS International Key Assumptions The average age of blind children is 8 years, and all of them would have become productive members of the community after 7 years, at age 15. The life expectancy of a blind child is assumed to be 47 years, resulting in a loss of 32 working years. GNP lost due to CB = direct loss + indirect loss Net loss of GNP = {(Direct loss+ Indirect loss)- Economic productivity} Cumulative GNP lost over lifespan of the blind child Cumulative GNP loss due to preventable or curable blindness assuming 50% of CB is either preventable or curable.

5. 5 | ORBIS International Results In 2006, total 7,661 pediatric cataract surgeries were done at the cost of US$ 1.2 million. The cost of treating all childhood cataract cases in 2006 would be US$ 4.5 million Annual gain of GNP if all CB cases were operated would be US$ 32 million. The lifelong gain of the prevention and treatment of CB in Bangladesh would be US$ 1.1 billion.

6. 6 | ORBIS International Conclusions From this study, the economic return on investment (RoI) of CB is estimated to be aprox. 8 times gain annually and on a life cycle approach a dollar returns 250 dollar gain. This could be potentially a significant contribution to the national growth of GNP. Those blinded during childhood or at birth incur a higher economic cost to their family members and society over their lifetime than adults blinded later in life. Economic valuation helps the policy makers in appraising the problem extent and investing in children eye care.

7. 7 | ORBIS International Thank You