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Federal Labor's plan to eliminate avoidable blindness in our region.



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Labor’s plan to Eliminate Avoidable Blindness in Our Region Page 1 of 7

Federal Labor’s plan to Eliminate Avoidable Blindness in our Region

“It’s such a small organ, the eye…and what a big role it plays.

Close your own eyes and see how big!”

(Dr Sanduk Ruit - Medical Director Tilganga Eye Centre, Nepal)

Blindness in our region

There are 153 million poor people who are blind or vision impaired due to uncorrected refractive error. This can be corrected with an eye examination and the right pair of glasses.

Globally, 161 million people are blind or vision impaired due to eye disease such as cataract, diabetic retinopathy, glaucoma, trachoma and macular degeneration and around half a million children become blind every year.

Up to 75% of blindness is treatable or preventable, and more than half of the world’s vision impaired live on Australia’s doorstep in Asia and the Pacific.

A Rudd Labor government will lead efforts to give sight to the poorest of the poor in our region, and will provide $45 million over two years to:

Ñ Address eye health and vision care needs in our neighbouring countries in the Pacific

using existing health system infrastructure.

Ñ Identify and plan to expand into selected priority countries in South-East Asia.

By drawing on the skills and expertise of Australian organisations, Federal Labor will develop partnerships with regional countries to eliminate avoidable blindness and vision impairment in our region.

This plan is part of the broader policy on disability in development. Disability affects 20% of people living in poverty. Labor will develop a disability policy to mainstream disability considerations into the aid program.

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Causes of Blindness in South-East Asia and Pacific Region

Source: State of the World’s Sight VISION 2020: the Right to Sight 1999-2005, 2005 (Adapted from Foster

A. VISION 2020: from epidemiology to program)

Poverty and blindness

There are clear links between poverty, blindness and disability in the developing world and in many poor communities, people who are blind and living with a disability are among the poorest of the poor.

Poverty underlies not only the causes of, but also ongoing ill health, including eye health. Blindness and vision impairedness remain key barriers to development.

Ñ Potentially blinding eye conditions such as age-related macular degeneration (AMD),

diabetic retinopathy and glaucoma are increasing as the number of people affected grows. These are non-communicable chronic eye diseases to which the principles of long-term care including issues of cost of treatment and compliance (adherence) apply. Additionally, more programmes for those with low vision will need to be made available.

Ñ The global disparity and inequity in the availability of eye health care services still fails to

prevent and control an overwhelmingly increasing magnitude of avoidable blindness in the highly populated poorest parts of the world1.

Health is a cornerstone of development and poverty alleviation. An ever-increasing number of people are at risk of visual impairment as populations grow and demographic shifts move towards the predominance of older age groups.

It is not only the right thing to do, it is critical that the Australia works to eliminate avoidable blindness among the poorest of the poor.

Australia can make a substantial impact on the lives of people living in South-East Asia and the Pacific, and assist the economic development of countries in the region.

1 World Health Organization (WHO) Factsheet No. 282

Cataract

Refractive Error

60%

Treatable

Trachoma

Vitamin A Deficiency

Glaucoma

Diabetic Retinopathy

Age-related Macular Degeneration Retinal Disease

15% 15% 10%

Preventable Manageable Requires

research

Regional Blindness

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What Labor will do

Federal Labor will support Vision 2020 to eliminate avoidable blindness by controlling major blinding conditions, conducting eye examinations, developing infrastructure and building the capacity of eye care workers.

According to Vision 2020, based on a population of 450 million, avoidable blindness and vision impairment could be eliminated in the region at a cost of $600 million over 10 years.

A Rudd Labor government will provide $45 million over two years to:

Ñ Address eye health and vision care needs in our neighbouring countries in the Pacific

using existing health system infrastructure.

Ñ Identify and plan to expand into selected priority countries in South-East Asia.

As part of this plan, a Rudd Labor government will undertake a pilot program in the South Pacific, establishing 10 Vision Centres and one Service Centre as well as providing support to the Pacific Eye Institute.

Vision Centres

Vision Centres deliver Primary Eye Care to 50,000 people. This includes screening refraction, dispensing of glasses, disease detection, appropriate referral, community activities such as Vitamin A campaigns and non-medical aspects of trachoma control. These centres cover 25% of major blinding diseases and 70% of overall vision needs.

Service Centres

Service Centres deliver Secondary Eye Care to 500,000 people. They provide both primary and secondary eye services, including optical prescribing, dispensing of glasses and cataract surgery. These centres cover 75% of blinding disease and 90% of vision needs.

A second stage of this program is to identify other priority areas of need. For example, in countries such as Indonesia, estimates suggest vision impairment is the leading cause of disability. More than 2 million people in Indonesia need cataract surgery and 88.5 million people or 36% of the population are affected by refractive error.

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TABLE 1: WHAT EXPERTS SAY ABOUT HOW $45 MILLION COULD MAKE A DIFFERENCE TO AVOIDABLE BLINDNESS IN OUR REGION

Initiatives Value

50 doctors could receive training in the Pacific region at the University of Papua New Guinea, Port Moresby, the Pacific Eye Institute, Fiji, or the National Institute of Health Science, Dili, East Timor

$4,500,000

300 nurses could receive training in the Pacific region at University of Papua New Guinea, Port Moresby, the Pacific Eye Institute, Fiji, or the National Institute of Health Science, Dili, East Timor

$8,000,000

As many as 87 Vision Centres could be established across the Pacific Region and link into pre-existing infrastructure where possible $8,500,000

200 doctors could receive training in Cambodia and Vietnam at the Vietnam National Institute of Ophthalmology, Hanoi, or the Ho Chi Minh Centre for Eye Health, Ho Chi Minh $3,500,000

1,500 nurses could receive training in Cambodia and Vietnam at the Vietnam National Institute of Ophthalmology, Hanoi, or the Ho Chi Minh Centre for Eye Health, Ho Chi Minh $500,000

As many as 75 Vision Centres could be established in Cambodia, linking with pre-existing infrastructure where possible. $4,000,000

As many as 250 Vision Centres could be established in Vietnam, linking with pre-existing infrastructure where possible. $10,000,000

Scoping South-East Asia

Opportunities will be explored in Indonesia, Philippines and Sri Lanka in consultation with stakeholders in-country. Officials in relevant health ministries will seek partnerships and joint projects to identify opportunities for the Australian Government

$2,000,000

Monitoring, evaluation and program management costs for Phase 1 $4,000,000

(Source: Vision 2020)

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TABLE 2: DOCTOR TRAINING NEEDS IN THE PACIFIC REGION BY 2013

Country Population

Local Eye Doctors Needed

Local Eye Doctors in Public Sector*

Training Needed 2008-13 PEI

Training Needed 2008-13 UPNG

Training Needed 2008-13 East Timor

Cook Islands 21,750 0 0 0 0 0

Federated States of Micronesia 107,000 2 0 2 0 0

Fiji 900,000 9 2 6 0 0

Kiribati 107,000 2 0 2 0 0

Marshall Islands 62,000 0 0 0 0 0

Nauru 13,000 0 0 0 0 0

Niue 1,500 0 0 0 0 0

Palau 21,000 0 0 0 0 0

Papua New Guinea 5,800,000 58 9 0 49** 0

Samoa 214,000 2 0 2 0 0

Solomon Islands 560,000 5 0 3 0 0

East Timor 1,085,000 10 0.5 0 0 9.5***

Tokelau 1,450 0 0 0 0 0

Tonga 117,000 2 0 2 0 0

Tuvalu 12,000 0 0 0 0 0

Vanuatu 211,000 2 1 1 0 0

Pacific Population Total 9,233,700 92 12.5 18 20 3

(Source: Vision 2020)

* Doctors with one year postgraduate diplomas are considered ‘eye doctor’

** Not possible with present health resourcing. Would be possible to train 20 Doctors so there is one eye doctor per province and three in main referral hospitals

*** National Eye Health Strategy plans to train three Doctors in the next five years

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TABLE 3: EYE NURSE TRAINING NEEDS IN THE PACIFIC REGION BY 2013

(Source: Vision 2020)

Country Population Eye Nurses Needed

Eye Nurses in Public Sector

Training Needed 2008-13 PEI

Training Needed 2008-13 UPNG

Training Needed 2008-13 East Timor

Cook Islands 21,750 2 1 2 0 0

Federated States of Micronesia 107,000 4 0 4 0 0

Fiji 900,000 36 6 28 0 0

Kiribati 107,000 4 0 4 0 0

Marshall Islands 62,000 2 0 2 0 0

Nauru 13,000 2 1 1 0 0

Niue 1,500 1 0 0 0 0

Palau 21,000 2 0 2 0 0

Papua New Guinea 5,800,000 232 25 0 200** 0

Samoa 214,000 9 1 7 0 0

Solomon Islands 560,000 22 14 7 0 0

East Timor 1,085,000 43 5 0 0 32***

Tokelau 1,450 1 0 1 0 0

Tonga 117,000 5 3 2 0 0

Tuvalu 12,000 2 0 2 0 0

Vanuatu 211,000 8 11 0 0 0

Pacific Population Total 9,233,700 371 67 62 100 10

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TABLE 4: INFRASTRUCTURE AND HUMAN RESOURCES NEEDS IN THE PACIFIC REGION

Country Population

Vision Technicians Required (considering existing HR)

Vision Centres Required (considering local services and conditions

Optical Workshops Required (considering existing facilities)

Optical Workshop Technicians (calculated at 2 per workshop)

Cook Islands 21,750 1 0.6 0 0

Federated States of Micronesia 107,000 4 4 0 0

Fiji 900,000 18 18 0 0

Kiribati 107,000 4 4 1 2

Marshall Islands 62,000 2 2 0 0

Nauru 13,000 1 1 0 0

Niue 1,500 0 0.2 0 0

Palau 21,000 1 1 0 0

Papua New Guinea 5,800,000 116 116 2 4

Samoa 214,000 7 7 1 2

Solomon Islands 560,000 10 10 1 2

East Timor 1,085,000 0 0 0 0

Tokelau 1,450 0 0.2 0 0

Tonga 117,000 4 4 0 0

Tuvalu 12,000 1 1 0 0

Vanuatu 211,000 7 7 1 2

Pacific Population Total 9,233,700 371 67 62 100

(Source: Vision 2020)