Launch of Global Research Programme devoted to vision and SDGs

• The Wellcome Trust and Chen Yet-Sen Family Foundation announce £3.5 million support for the five-year ENGINE research project, exploring vision care as a driver of development across the life course.
• ENGINE comprises a four-country suite of trials examining the impact of glasses on promoting better living from childhood through to old age.

2 June: A new research programme has launched today, with £3.5 million in funding from the Wellcome Trust and Chen Yet-Sen Family Foundation. Poor vision, the world’s largest unmet disability, affects 2.2 billion people. ENGINE examines how an affordable, effective and widely-available treatment, glasses, can help achieve the United Nation’s Sustainable Development Goals across the life course in the following ways:

• Reduce road traffic injuries, the world’s leading cause of death in children and young people.
• Enhance learning among the millions of African children with long-sightedness, present at higher rates in Africa than any other global region.
• Slow the onset of cognitive decline and dementia among elderly persons struggling with poor sight. Proven preventive strategies for cognitive decline and dementia are desperately needed, and could reduce incidence by an estimated 41%.
• Improve economic independence by helping older people use online banking on smartphones, as currently two thirds of adults in Bangladesh are excluded from financial services.

Previous trials by this research team in China and India have highlighted the positive impact of vision correction on school performance and workplace productivity.

Led by Professor Nathan Congdon of Queen’s University Belfast (QUB) in the UK and Professor Rohit Khanna of the LV Prasad Eye Institute (LVPEI) in India, the multi-disciplinary ENGINE team draws from 29 collaborating institutions in six countries, ranging from schools of public health to government ministries, patient groups, companies and NGOs.

ENGINE (Eyecare Nurtures Good-health, Innovation, driviNg-safety and Education) is designed to leverage high-quality research results from four component studies to drive lasting policy change and achieve improved quality of life for people in low and middle-income countries.

The four research projects are:

• STABLE (Slashing Two-wheeled Accidents By Leveraging Eyecare) will assist local partners, including the Vietnamese Ministry of Transport, to combat Vietnam’s twin epidemics of uncorrected short-sightedness and motorcycle crashes in the young.
• ZEAL (Zimbabwe Eyecare and Learning) will work with local partners who currently implement the Zimbabwe government’s national school vision project to explore how targeting long-sighted children with novel, low-cost screening can add to the academic impact of the programme.
• CLEVER (Cognitive Level Enhancement through Vision Exams and Refraction) supports the Indian government’s strategy of finding scalable, low-cost means of preventing dementia, the management of which currently consumes 1.5% of national GDP.
• THRIFT (Transforming Households with Refraction and Innovative Financial Technology) will capitalise on the Bangladesh government’s novel and forward-looking plan to digitise all social safety net payments to the elderly by providing free glasses and training to help them better cope with unfamiliar smartphones, thus improving financial independence.

CLEVER and STABLE are the first trials of their kind, examining how low-cost vision care can slow the pace of cognitive decline with aging and deliver safe roads in low-resource settings.  Potential benefits of ENGINE extend far beyond the borders of participating countries:

• Traffic injuries are the leading cause of death globally between ages 5 and 29. While only 60% of vehicles are found in low and middle-income countries, 90% of traffic deaths occur there.
• The World Bank and others suggest Bangladesh’s novel strategy of delivering safety net payments through e-banking to the elderly provides a model for many other countries, especially during COVID, if visual challenges for users are successfully met.

James Chen, Chairman of the Chen Yet Sen Family Foundation, said: “700 years on from the invention of glasses, poor vision is still the largest unaddressed disability in the world, and getting worse. We will never be able to complete the Sustainable Development Goals unless this hurdle is faced. This research programme represents a watershed moment in proving the importance of addressing vision correction throughout the life course and development agenda.”

Professor Nathan Congdon of Queen’s University Belfast and Director of Research at Orbis International, the study’s principal investigator under a Wellcome Trust Investigator Award, said: “Decision-makers need high-quality evidence. Our previous trials showing glasses enhance school performance in China (“Seeing is Learning”) and workplace productivity in India (“PROSPER”) have spurred government and industry-led vision programmes around the world. ENGINE’s local partners in academia, civil society and government are well-placed to ensure this project drives similar policy action, changing lives and helping achieve the SDGs in these four countries and beyond.”