Glaucoma Challenges in Africa

For World Glaucoma Week, Amel Meddeb-Ouertani on why we need to come together to tackle glaucoma especially in Africa…

Africa is the poorest region in the world: ½ of the population live on less than 1 $/ day. Millions of people don’t have access to health care in general and less than 25% currently have regular access to eye care services. In such a context and abject poverty, the prime concern for many is survival and seeking health care is a decision of last resort.

Ophthalmic health care can’t be dissociated from health care in general or from economic growth. Healthy people are more productive, contribute more to the society and are more concerned about their well-being.

Challenges

Glaucoma is the commonest cause of irreversible blindness worldwide and in Africa in particular.
In Africa, almost 6 million people are affected by glaucoma while 0.5 million are already blind. The top priority for most Ministries of health are HIV/AIDS, Tuberculosis and malaria so eye care is relatively tiny, with limited resources.

The experts assembled at the Kampala meeting on Public health Control of Vision loss for Glaucoma held on April 2012, stated that “Glaucoma is the emergent priority for all eye health interventions”.

There are 5 main Challenges related to early detection, diagnosis and management of glaucoma in the Middle East-Africa region:

1. Adequate Infrastructure: Need to ensure that training institutions, tertiary eye units and all high-volume eye units are accordingly equipped
2. Affordability & availability of Anti-Glaucoma Drugs: Need to set a national strategy for their procurement and distribution
3. Availability of skilled personnel: Need to Identify, support, re-train and recruit personnel. Identify & support training institutions and the deployment of eye care teams from primary to tertiary levels
4. Patients continuous education Need to develop a culturally sensitive IEC strategy -Target patients at risk
5. The need for National Glaucoma Guidelines/Policies

This would require at least 2 actions:

1. update the glaucoma strategy section in existing national plans
2. set up an HRD sub-group to oversee their development and implementation

This strategy needs a Political commitment at the national and international level.

Professional organizations, ophthalmological societies, advocacy organizations , civil societies, and NGO’S must use all means to influence the Ministries of health. They need to advocate to the technology and pharmaceutical companies to develop and distribute affordable equipment and drugs especially for African populations. Africa can’t afford the high price of medicine. (WTO) TRIPS agreement contains important flexibilities that can be used to access medicines (like compulsory license allowing local production of patent protected medicines). Pharmaceutical companies can support by developing differential pricing offers for drugs, whereby medicines are sold close to the cost of manufacture. Donors should develop incentives for research and development in health that meet Africa’s need. In the long-term viable markets must developed.

The cost of Ophthalmic health care is a big issue that requires much effort for poor countries. It can’t be resolved without worldwide human solidarity.

A Global Initiative involving all partners can make a real difference.