The ICO Advocacy Network William C. Felch, Jr. Chief Executive Officer, International Council of Ophthalmology International Agenda for the Prevention of Blindness, 9 th General Assembly September 18, 2012 | Hyderabad, India

Mission of the ICO The International Council of Ophthalmology works with ophthalmologic societies and others to enhance ophthalmic education and improve access to the highest quality eye care in order to preserve, restore and enhance vision for the people of the world.

Evolution of ICO Commitments Improve Access to Quality Eye Care Prevent Avoidable Blindness and Vision Loss Education International Council of Ophthalmology

Evolution of ICO Commitments Improve Access to Quality Eye Care Prevent Avoidable Blindness and Vision Loss Education Eye Care Delivery International Council of Ophthalmology

Evolution of ICO Commitments Improve Access to Quality Eye Care Prevent Avoidable Blindness and Vision Loss Education Eye Care Delivery International Council of Ophthalmology Society and Leadership Development

Evolution of ICO Commitments Improve Access to Quality Eye Care Prevent Avoidable Blindness and Vision Loss Education Eye Care Delivery International Council of Ophthalmology Society and Leadership Development Teaching the Teachers

ICO Strategic Plan Four Mission-Related Goals: I.EducationNeed Photo II.Eye Care Delivery III.Society and Leadership Development IV.ICO Organizational Development

Strategies: Eye Care Delivery A.Develop a system for collection and analysis of data about ophthalmology and eye care. B.Advocate for increased support for eye care by helping national societies become effective advocates within their countries. C.Develop stronger relationships between ophthalmology and NGOs. D.Foster community ophthalmology with a focus on public health and populations (not only individuals).

ICO Advocacy Purpose and Goals The purpose of the Advocacy Committee is to lead and coordinate the efforts of the ICO and international ophthalmology to increase governmental and non- government support for eye care and prevention of vision loss worldwide. Long-term Goal: To make sure that comprehensive eye care is part of public health policy in each country and is financed as part of the national health system. Serge Resnikoff, MD, PhD, Director for Advocacy, Switzerland Abdulaziz AlRajhi, MD, Saudi Arabia Rubens Belfort, MD, Brazil Bruce Spivey, MD, USA Hugh Taylor, AC, MD, Australia Staff: Lindsey Washburn

ICO Advocacy: Past International: Official relation with WHO Participation in advocacy efforts of IAPB, support for resolutions, action plans, etc. National: 2006: Asked national societies of ophthalmology to name Advocates to work with ICO, and 1.Form a relationship with national prevention of blindness or VISION 2020 committees and coordinators 2.Ask governments to support WHA resolution in Ask governments to support the WHO Action Plan in – 2011: Workshops for advocates at WOC 2008 Hong Kong, 2010 Berlin and 2011 with IAPB, Pan-American Association of Ophthalmology in Buenos Aires

ICO Advocacy: Future International: Participation in advocacy of IAPB: support for WHO Action Plan, etc. Establish mechanism to collect data useful for advocacy on an ongoing basis National: 2012: Renew Advocacy Network: Support adoption of WHO Action Plan at EB and WHA in 2013 Work with IAPB regions and national committees and coordinators to generate support for implementation of the Action Plan implemented at the national level Additional workshops and online resources for Advocates, possibly a toolkit

International: The Public Need for Eye Care Global Causes of Visual Impairment—2010 BCVA<6/18 Pascolini D, Mariotti SP. Br J Ophthalmol 2011; Epub Dec 1. Slide from Serge Resnikoff.

What Can Ophthalmologists Do? Study designed and conducted by ICO Aim: To capture the dynamics of the global ophthalmologic population, including residents Standardized survey ed to 213 global ophthalmic societies or individuals (March 2010) Missing data gathered from direct correspondence with ophthalmologist contacts (August 2010) Number of Ophthalmologists in Practice and Training Worldwide

What Can Ophthalmologists Do?

Number of ophthalmologists in practice and training worldwide Of the 193 countries surveyed, 192 responded (represents 99.99% of the global population) Total number of ophthalmologists in the world Ranging from 28,338 in China to 0 in some Small Pacific Islands, with 131 countries representing less than 5% of the total 204,909 Slide from Serge Resnikoff. Number of Ophthalmologists in Practice and Training Worldwide

What Can Ophthalmologists Do? Two-Thirds of Ophthalmologists in 15 Countries Slide from Serge Resnikoff.

What Can Ophthalmologists Do? 0 to to to to Ophthalmologists per Million Population Slide from Serge Resnikoff.

Africa: What Can Ophthalmologists Do? 0 to to to to Ophthalmologists per Million Population Slide from Serge Resnikoff.

Ophthalmic Growth Rate vs. 60+ Population Growth Rate All Ages60+ Ophthalmologists growth rate+ 1.2% Population growth rate+ 0.77% + 2.9% Actual growth rate+ 0.43% - 1.7% On average, the population aged 60+ is growing more than twice as fast as the number of ophthalmologists Slide from Serge Resnikoff.

What Can Ophthalmologists Do? Very broad picture System being set up to improve data collection The gap between need and supply is widening in both developing and developed countries Needs to be urgently addressed in training eye care teams now, led by ophthalmologists, focused on meeting community needs Slide from Serge Resnikoff. Conclusions

Need for Training: Principles Training in ophthalmology should focus on meeting needs of communities and populations, not just individuals Philippine Academy of Ophthalmology: “My Community, My Problem” Dr. Para: “If ophthalmology is your profession, prevention of blindness is your business” Needs are best met by eye care teams, trained together to work as teams Comprehensive eye care should be an integral part of the health care system Question: Do you agree with these principles? Hugh Taylor, February 2012

ICO Advocacy: Data Collection Three options for the future: 1. Obtain better data on cataract surgical rate 2. Provide a tool for calculating the economic cost of eye disease and visual loss, for use in advocacy at the national level 3. Provide a tool based on the PWC methodology for calculating the potential cost benefit of eye care at the national level

ICO Advocacy: Summary The ICO is working at the international and national level to make sure that comprehensive eye care is part of public health policy in each country and is financed as part of the national health system. We have formed a network of Advocates from national ophthalmologic societies to: Work with national VISION 2020 Committees and Coordinators Support adoption of WHO Resolutions and Action Plans Support implementation of the next Action Plan We plan to organize workshops and online resources to help Advocates learn to be effective We are establishing an ongoing system to collect data that may be helpful for advocacy

IAPB Course 13: Effective Advocacy Discussion: 1.Any questions for/comments on speakers? 2.Please describe: a. Any positive advocacy outcomes and how you achieved them. b. Any negative experiences you had and what you learned. If there is time: 3. What do you consider to be best practices for advocacy at the national level? What really works?

ICO Advocacy: Data Collection Three options for the future: 1. Obtain better data on cataract surgical rate 2. Provide a tool for calculating the economic cost of eye disease and visual loss, for use in advocacy at the national level 3. Provide a tool based on the PWC methodology for calculating the potential cost benefit of eye care at the national level