WHO Can Change Things?

Researchers from the Vision Loss Expert Group, led by Rupert Bourne of Anglia Ruskin University and Cambridge University Hospitals, have analyzed data from 169 different studies worldwide to determine treatment coverage figures for refractive error in several regions. Perhaps unsurprisingly, coverage varies dramatically worldwide; though the treatment rate is 79 percent in high-income countries, it drops to just 5.7 percent in sub-Saharan Africa (1). Alongside geographical differences, the study also highlights lower levels of coverage for women in all defined world regions. Other than longer life expectancy among women, there is little evidence that biological sex-based differences contribute to this; rather, differences in healthcare access explain the observed gender inequity.

In response to the discouraging statistics, Bourne said, “There are multiple social and cultural reasons that influence coverage of treatment for refractive error [...]. The lower coverage among women is most striking. We believe that differences in access to healthcare and take-up of services are likely to be the main reasons for this gender inequality” (2). These finds echo a recent article by Syeda Asma Rashida on unequal access to healthcare in Bangladesh and highlight the urgency of addressing discrimination in healthcare settings.

To combat the issue, the WHO aims to increase treatment coverage for distance refractive error by 40 percent by 2030. To meet this target, countries must consider interventions to improve access to quality healthcare services. These will include better government oversight, more clinical regulation, and the standardization of training programs for refraction. Increasing the number of access points in low- and middle-income countries at the community and primary care level will increase the quantity (and therefore availability) of these services and pave the way for universal access to eyecare.