1. International Council of Ophthalmology Coordinating Advocacy In sub-Saharan Africa Daniel Etya’ale ICO Council Member ICO World Ophthalmology Roundtable World Ophthalmology Congress, Hong Kong 27 th June 2008

2. International Council of Ophthalmology Context & Environment of Eye Care Delivery & Blindness Prevention in Africa

3. International Council of Ophthalmology Pop by Region (% Total Pop) Blind by Region (% Total Blind) AFRICA: A DISPROPORTIONNALLY HIGHER NUMBER OF BLIND

4. International Council of Ophthalmology AFRICA: THE HIGHEST CONCENTRATION OF THE POOREST PEOPLE

5. International Council of Ophthalmology AFRICA: THE REGION WITH THE HIGHEST “OUT OF POCKET” EXPENDITURE FOR HEALTH

6. International Council of Ophthalmology INEQUALITY IN HEALTH SPENDING – BY REGION (WHO, 2000)

7. International Council of Ophthalmology EXTERNAL AID AS PERCENTAGE OF TOTAL HEALTH SPENDING (2000)

8. International Council of Ophthalmology AFRICA: A REGION WHERE DONOR COMMITMENT FOR HEALTH CARE IS QUITE VOLATILE & UNPREDICTABLE

9. International Council of Ophthalmology VISION 2020 ???

10. International Council of Ophthalmology Africa Challenges in Coordination & Advocacy

11. COUNTRY POLITICAL AND FINANCIAL COMMITMENT A Clear and Coherent National Eye Care Policy A fully developed, V2020 compliant National Plan A non fictitious budget line for Vision 2020 Activities A COMPLETE & FULLY FUNCTIONAL EYE CARE SYSTEM (Community, Primary, Secondary & Tertiary) Eye care Teams O’Gists Opht. Nurse Optometr. L.V. Techn. Comm. Wkr Managers Essential Eye Medic. & Equipmt Nation. List A Procurmt & Distribut. System that Works! MOH Partners NGDOs Missions FoundationsUN Prof. Assoc. Training Centr. A good Monitoring System Data Collect. Transmiss. & Feedback Activities Reports Infrastruct. Fully functional Eye Care Units Offering Cat. Surg. + Other Essential Surgeries Minim. Function al Equipmt. CENTRAL AND REGIONAL COORDINATION NATIONAL COMMITTEE FOR VISION 2020 ACTIVITIES Ultimate Goal

12. International Council of Ophthalmology VISION 2020 Many Partners in AFRICA VISION 2020 Many Partners in AFRICA 46 COUNTRIES IAPB, WHO NGDOs : Al Noor Foundation, Christoffel-Blindenmission (Christian Blind Mission International), Helen Keller Worldwide Organisation pour la Prévention de la Cécité, Operation Eyesight Universal, ORBIS International, Sight Savers International, The Carter Center, The Fred Hollows Foundation Dark & Light, Seva Foundation, International Centre for Eyecare Education, Lions Clubs International Foundation, The International Eye Foundation, Operation Eyesight Universal, International Trachoma Initiative. Foundations & Others :, International Council of Ophthalmology, The American Academy of Ophthalmology, etc VISION 2020 Many Partners in AFRICA VISION 2020 Many Partners in AFRICA 46 COUNTRIES IAPB, WHO NGDOs : Al Noor Foundation, Christoffel-Blindenmission (Christian Blind Mission International), Helen Keller Worldwide Organisation pour la Prévention de la Cécité, Operation Eyesight Universal, ORBIS International, Sight Savers International, The Carter Center, The Fred Hollows Foundation Dark & Light, Seva Foundation, International Centre for Eyecare Education, Lions Clubs International Foundation, The International Eye Foundation, Operation Eyesight Universal, International Trachoma Initiative. Foundations & Others :, International Council of Ophthalmology, The American Academy of Ophthalmology, etc

13. International Council of Ophthalmology GlobalGlobal Regional/Sub-RegionalRegional/Sub-Regional CountryCountry 13 Three Levels of Operation OKOK Work in ProgressWork in Progress OKOK Work in ProgressWork in Progress Africa Challenges in Coordination & Advocacy

14. International Council of Ophthalmology Achievements so far Addis Ababa, 2006 & Accra, 2007: Two coordination/consultation/advocacy meetings with all NGDOs Accra, April 2008: All stakeholders coordination/advocacy meeting: WHO, IAPB, NGDOs, Countries, ICO, Training Institutions, Other sub- regional health organisations involved in Eye care Addis Ababa, 2006 & Accra, 2007: Two coordination/consultation/advocacy meetings with all NGDOs Accra, April 2008: All stakeholders coordination/advocacy meeting: WHO, IAPB, NGDOs, Countries, ICO, Training Institutions, Other sub- regional health organisations involved in Eye care

15. International Council of Ophthalmology Achievements so far The Addis Ababa & Accra meetings: Main outcomes: A consensus on work together among NGDOs An agreement on building NGDOs coalitions at sub-regional and country to support eye care and blindness prevention To date, 2 sub-regional coalition groups (West & Southern Africa) are already working well Joint funding of projects also started The Addis Ababa & Accra meetings: Main outcomes: A consensus on work together among NGDOs An agreement on building NGDOs coalitions at sub-regional and country to support eye care and blindness prevention To date, 2 sub-regional coalition groups (West & Southern Africa) are already working well Joint funding of projects also started

16. International Council of Ophthalmology Achievements so far The Accra “All stakeholders meetings”: Main outcomes: A consensus on ways to accelerate VISION 2020 activities throughout the region, in a more equitable way (support to “neglected countries”) A proposed new structure for IAPB mandate & Coordination in Africa The development of the new SS African Strategic and Business Plan The Accra “All stakeholders meetings”: Main outcomes: A consensus on ways to accelerate VISION 2020 activities throughout the region, in a more equitable way (support to “neglected countries”) A proposed new structure for IAPB mandate & Coordination in Africa The development of the new SS African Strategic and Business Plan

17. MINISTRY of HEALTH Chairman, Nat’nal Coord, Secretariat LOCAL NGDOS + Mission Eye Care Services INTERNATIONAL NGDOs & OTHER AGENCIES THE PROPOSED COORDINATION STRUCTURE AT COUNTRY LEVEL PROFESSIONAL GROUPS O’gists, OCOs/AMOs, Optometrists, Nurses TRAINING INSTITUTIONS DISTRICT PROGRAMS Regional Ophthalmologists District Eye Workers (+NGO/Mission Eye Workers) WHO & OTHER UN AGENCIES PRIVATE SECTOR SCHOOL EYE HEALTH

18. International Council of Ophthalmology Resources for Advocacy The importance of Country Data & Policies More & More data on HRD, Eye Care Structures & Infrastructure Disease Control Activities are now available The new V2020 Strategic Document ICEH Journal: Advocacy E.g., MDG Contact WHO/PBD Contact IAPB or WHO www.cehjournal.org