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rivate and entrepreneurial sectors can play a key role in addressing the lack of access to spectacles for over a billion people, according to a new report commissioned by the International Agency for the Prevention of Blindness (IAPB).
Improving vision for the bottom billion P
A new IAPB report explains the issues that inhibit eye care on a global scale. Emma White reports
Glasses for All: Improving Supply to the Poorest by Frontier Economics reported that a billion people, 90% from low and middle-income countries (LMICs), were living with vision impairment, mainly from untreated refractive error and presbyopia. With an abundant supply of existing research into ‘demandside’ issues, including lack of diagnosis, affordability and lack of awareness, the study instead addressed ‘supply-side’ issues and whether firms and supply chains were functioning well enough to ensure an efficient, cost-effective supply of frames.
SUPPLY CHAIN BARRIERS Often-overlooked supply side barriers, including inefficient supply chains and outdated regulations, were highlighted in the report due to preventing many people in LMICs from obtaining affordable, quality frames. While the study focused on LMICs in general, it conducted three country ‘deep dives’ in India, Nigeria and Mexico in order to illustrate how market characteristics vary from country to country.
Peter Holland, chief executive of IAPB, said: ‘While much attention in recent years has been paid to raising awareness and providing eye exams, this report argues that, as well as continuing this important work, the private and entrepreneurial sectors can play a critical role in reaching the billion people who don’t have access to glasses.
‘But to do so we need to address
Nearly a billion people in low and middle-income countries are living with vision impairment systemic issues within the supply chain of glasses as a crucial step to reaching those in greatest need.’
The report recommended exploring alternative models to address the strict regulations surrounding who can prescribe and sell frames leading to inflated costs and limited access.
It suggested gathering relevant medical and related evidence to understand whether the role of optometrists and ophthalmologists could be changed to allow more flexible retail models to be developed.
For example, it suggested that trained technicians could be allowed to sell mass-produced spectacles for simple refractive errors, under the guidance of medical professionals, which could benefit ‘up to 80% of the underserved population’.
INEFFICIENT DISTRIBUTION Fragmented supply chains, including lack of competition, inefficient distribution and high import tariffs could be addressed by ‘leveraging the entrepreneurial spirit of the informal sector,’ optimising distribution networks and reducing import barriers to drive down prices, it said. Many small businesses in LMICs also lack the support and financing to develop and invest in inventory and expand their reach, the report stated. It encouraged governments and non-governmental organisations (NGOs) to work together to support the development of entrepreneurial providers, including developing accessible financing options.
Sumrana Yasmin, deputy technical director – Eye health and URE at Sightsavers, said that while the report highlighted a broken vision system in developing countries, it also provided ‘hope’.
‘This new report reveals a broken vision system, where outdated regulations, a fragmented supply chain and limited access to finance keep affordable glasses out of reach for millions. But there’s hope.
‘By empowering trained technicians, streamlining distribution, and fostering local enterprise, we can unlock 80% of the market, ensuring clear sight for all,’ she said.
IAPB and others in the eye health sector had a crucial role in implementing the report’s recommendations, according to the authors. Namely, they should advocate for regulatory reform by lobbying for changes to regulations governing the sale of frames, including expanding the scope of qualified personnel and simplifying prescription requirements.
Supporting new business models could be achieved by developing innovative approaches to supply and distribution through regional hubs and partnerships with the informal sector. Also, by collaborating with governments and financial institutions to provide funding opportunities and technical assistance to entrepreneurs in the eyewear industry.
IAPB and the wider eye health sector were also urged to work to reduce import tariffs and customs frictions to reduce the costs on imports.
The report concluded that fulfilling these recommendations would help to create an efficient, consumer-orientated market.
‘There is no doubt that demandside measures continue to be important. The evidence presented here suggests that more focus on supply-side changes would help in meeting the needs of those on lower incomes impaired by poor vision,’ it said.
James Chen, philanthropist and IAPB global ambassador, welcomed the findings: ‘By addressing these supply-side challenges, we can unlock the potential for a more efficient, consumer-oriented market for glasses, ensuring that everyone, regardless of income, has access to the vision care they need to lead a productive and fulfilling life,’ he said. •
opticianonline.net
9 Februar y 2024 OPTICIAN 7
