Diabetic Retinopathy and the UN Decade of Healthy Ageing

Central to building an environment that enables people of all ages to do what they  value is the need to recognise that the growing ageing population consists of individuals with varying competencies and skills.  Ageing is a demographic driver with medical, social, and economic consequences, and projections indicate that by 2050, there will be more people aged 60 years or over than those younger.[i]

Longer life expectancy does not automatically equate to an enhanced quality of life.  Countries are generally ill-equipped to deal with both the opportunities and challenges posed by an ageing population, and people are spending more years in poor health and/or disability.

These far-reaching generational consequences have not gone unnoticed, leading the United Nations General Assembly to proclaim 2021-2030 as the Decade of Healthy Ageing.  Healthy ageing must be approached as part of the life course being influenced by the social determinants of health and the environment in which the individual and society are embedded.  In practice, functional ability must be brought to its highest capacity early in life, not only through interventions such as physical activity and nutrition, but also through the wider determinants of health such as the built environment.

The Decade aims to drive policy change to improve the lives of older people everywhere, by promoting global to local action to combat ageism, create more age-friendly cities and communities, foster people-centered care, and ensure quality long-term care.

Eye health is an integral part of functional ability and must be viewed through the lens of both the Decade as well as the World Report on Vision, which emphasises an integrated people-centered eye care (IPEC) approach.  Reorienting the current models of care to strengthen primary and community care services by coordinating services across sectors ensures continuity of eye care services across the life course.

Approximately 463 million adults are living with diabetes, of which about 93 million have diabetic retinopathy.[ii]  As a devastating vision-related complication of diabetes that can lead to preventable vision loss, the necessity for robust screening programmes at-country, as well as the integration of eye care services into national health strategies is critical.  Eye care organisations have a significant role to play in promoting strategic investment into accessible DR screening programmes and proactive treatments.

With one in five of those with diabetes being above the age of 65 years, and the majority living in low- and middle-income countries (LMIC)[iii], it is crucial that civil society focuses on reframing vision needs as a development issue that contributes directly to the Sustainable Development Goals.  To prevent avoidable vision impairment and/or loss, especially in LMICs, governments must view eye health as a major public health and sustainable development issue that requires urgent advocacy and political action.

[i] World Population Aging 1950-2050. United Nations Population Division. (2017) https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2017_Highlights.pdf

[ii] International Diabetes Federation. (2019). IDF Diabetes Atlas. Retrieved from https://www.diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdf

[iii] International Diabetes Federation. (2019). Diabetes facts and figures. Retrieved from https://idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html

Photo Credit: IFA