1. Aravind Eye Care System “restoring vision to millions”

2. WHAT DOES IT MEAN TO BE BLIND?

4. Kuppammal is one of the… 45 million blind, worldwide 12 million blind in India

5. 80% of this is preventable or curable Cataract Surgery – a simple procedure – will give sight to 7.5 million A pair of spectacles will make another 2.4 million see

6. 200 million need eye care in India Less than 10% have been reached

7. ARAVIND GENESIS

8. Aravind’s Vision “To eliminate needless blindness by providing high quality, high volume, compassionate eye care to all”

9. Aravind Eye Clinic, 1976 11-bed clinic Post-retirement project of Dr. V

11. Aravind Eye Care System, 2011 Eye Bank Hospitals (7) Aurolab Out Reach Research “Aravind Eye Care System” LAICO IT Training AMECS 2 Hospitals

12. Total Surgeries & Lasers till March 2011: 4,018,295

13. A day at Aravind... 850 – 1000 surgeries 6,000 Outpatients in hospitals 5-6 outreach camps – 1500 examined – 300 transported to base for surgery 500 – 600 Telemedicine Consultations Classes for 100 Residents/Fellows & 300 technicians and administrators Making Aravind the largest provider of eye care services and trainer of eye care personnel in the world

14. Building Blocks of Aravind Value System Delivery System Innovation

15. How Dr. V built the Organization Guiding Philosophy “… Spirituality allows the divine force to work through each of us for a greater good If work is approached from a spiritual perspective, then it becomes divine work. If in your actions, you allow the divine force to flow through you, you will accomplish things far greater than you might have imagined.” - Sri Aurobindo Aravind’s Guiding Values: Compassion/Dignity Equity Transparency Sharing Translated to action: Eye care to all - Equity Standardization - Transparency Affordability Accountability

16. The need to innovate Market conditions at the ‘bottom of the pyramid’: Large underserved population Resource scarcity (Capital and HR) Dispersed population Low affordability Poor logistics (Based on analysis by Prof. C K Prahalad)

17. REACHING THE UNREACHED

18. Breaking the access barriers 2010 Jan - Dec: 2244 screening eye camps – 1384 Comprehensive 316,148 patients examined 58,665 spectacles dispensed 74,764 surgeries performed

19. Effectiveness of screening camps? We reached only 7% of those in need of eye care1 Those with rarer eye conditions were not addressed 1 “Low uptake of eye services in rural India”; Astrid E. Fletcher et al; Archives of Ophthalmology Vol 117, Oct 1999

20. Solution 1: Primary eye care centers 36 centers covering a population of 2 million Approx. 400,000 patients seen so far 40% penetration within the first year Everyone receives telemedicine consultation Online health records 91% of them received full care at the center

21. Solution 2: Taking super-specialty care to villages

22. Impact – reaching the unreached Increased awareness Influencing health-seeking behaviour Creating access Community participation Growing the market (reaching the unreached)

23. ADDRESSING RESOURCE SCARCITY

24. Efficiency - Surgical Productivity

25. Aravind (Wo)manpower 300+ village high school girls selected each year Value fit over skill fit 60% of Aravind’s workforce Perform most of the routine clinical tasks Thus allowing doctors do what they are best at - diagnosis & surgery Results in higher quality, productivity and lowers cost The life of these young women are vastly improved

26. Surgeon Productivity: A comparison

27. Surgical Quality2 Aravind’s complications are less than half of those in UK

28. Making it affordable For the patient & the community For Aravind (to be sustainable) When most can’t pay What we did Gave away a lot of it free Charged market rates for those who can pay Were helped by market inefficiency Had the MINDSET

29. Through a unique fee system & effective management, Aravind provides free eye care to 50% of its patients Surgery mix: 2009 -2010

30. “ELIMINATING NEEDLESS BLINDNESS” REQUIRES GOING BEYOND ARAVIND

31. Creating Competition “to eliminate needless blindness” 6/22/10 270 Eye Hospitals worldwide

32. 6/22/10 Established in 1992 to address the high cost of ophthalmic supplies which had to be imported

33. Making Eye Care Affordable 10 million people see the world through Aurolab’s lenses Used in 120 countries 7% of global market Price of IOL came down from $ 100 to $ 2 – making cataract surgery affordable

34. Dr. G. Venkataswamy Eye Research Institute RCT Epidemiology Operations Research Biostatistics Genetics Proteomics Cell Biology GLP Facilities Pharmacology Microbiology ImmunologyInformation Technology Drug Trials Product Development

35. BROADER RELEVANCE? Is it applicable to developed countries & outside of eye care?

36. NHS*-UK vs. Aravind No. of eye surgeries Ophthalmologists graduating annually 71% 59% (*National Health Service – Main provider of Healthcare in UK)

37. Cost of delivering eye care < 1% of what it costs in UK

38. Why is the cost 100 times more? It is beyond the simplistic “UK isn’t India” Consider: – Efficiency – Clinical process – Cost of supplies – Regulations – Defensive medicine

39. Compassion Owning the Problem Insights  Large population  Cost-effective interventions  Cuts across all economic strata  Equity issues  Cost control  Efficiency  Focus on quality  Patient centered care  Productivity  Achieving scale ConditionsSolutions

40. Enhancing Better Eye Care Service Delivery – Increase from quarter million to one million surgeries and serve 6 million outpatients a year – Increase presence in 100 locations (in areas of need) Clinical and Medical Research – Dr. G.V Institute of Medical Research Through Quality & Affordable Products – Aurolab

41. Pursuing Our Mission Eliminating needless blindness much has been done and much remains to be done...

42. “Intelligence & Capabilities are not enough. There must be the joy of doing something beautiful..” Dr. V Thank You