The authors – a multidisciplinary team of ophthalmologists, health economists, and ethicists – propose a “Global Clinical Care” model that treats prevention and cure as interdependent pillars of health equity. While measles vaccination and vitamin A supplementation have nearly eliminated corneal blindness in children, illustrating how effective preventative and curative measures can be when used in conjunction, other major causes such as cataract and glaucoma still require surgical intervention.
In sub-Saharan Africa, bilateral cataracts remain the leading cause of preventable childhood blindness, with an estimated 200,000 affected children worldwide, and 20,000–40,000 new congenital cases documented every year. A health-economic simulation from the Rostock–Kinshasa partnership demonstrated that cataract surgery in children is not only cost-effective but cost-saving, generating a present-value GDP gain of over US $23,000 per patient and significant quality-of-life improvement.
Two long-term partnerships in sub-Saharan Africa — between Rostock and Kinshasa (DR Congo) and Tübingen and Blantyre (Malawi) — illustrate how institutionalized collaborations can build sustainable ophthalmic capacity.
In Kinshasa, joint efforts between the University Eye Clinic in Rostock, Hôpital Saint-Joseph, and Christoffel Blindenmission (CBM) have enabled thousands of pediatric cataract surgeries, community-based screening through Caritas, and post-surgical reintegration programs – with up to 87% of operated children returning to mainstream schooling.
Meanwhile, the Tübingen–Blantyre partnership has strengthened ophthalmic training at Kamuzu University of Health Sciences in Malawi, producing a new generation of specialists who are improving national coverage across the country, where only 0.85 ophthalmologists per million inhabitants currently practice.
Policy recommendations
The Leopoldina authors urge the German Federal Government and international donors to rebalance health policy by:
Integrating prevention and cure in global and national health strategies;
Expanding institutional partnerships as sustainable, bilateral cooperation models; and
Creating a government framework program to fund infrastructure, medical training, and curative services alongside preventive initiatives.
The report reframes pediatric ophthalmology as a microcosm of global health equity. Preventing blindness through vaccination is a triumph – but restoring sight through surgery can be equally transformative, both socially and economically. As the report concludes, curative ophthalmic care is not a luxury but a moral and developmental imperative, and investing in it yields lifelong dividends for children, communities, and nations alike.
