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Vision 2020

I join others in congratulating my noble friend Lord Crisp on initiating this debate, and I, too, declare an interest, as chair of the medical aid charity Merlin, which I am glad to say works closely with Sightsavers in some of the poorest countries in the world, including Liberia, which I recently visited. The key point that struck me in my noble friend’s opening remarks was that 80 per cent of the world’s blindness is avoidable and can either be treated or prevented by known, cost-effective means. Some progress has been made, of course, but nothing like enough, and there is a real risk that without major and effective intervention, the number of avoidably blind people worldwide will increase rather than decrease as we approach 2020. That is why the Vision 2020 programme is so important. I want to stress three or four points which put the issue of blindness into a broader context than just its treatment. First, avoidable blindness is best eliminated when eye health programmes are embedded in health systems and underpinned by effective government policy. Efforts to tackle blindness and visual impairment must be made within an approach that supports and strengthens national health systems. It is particularly important, as my noble friend Lord Crisp said, that that should be done at the primary healthcare level because it provides the best means of reaching the greatest number of people. My second point was also made by my noble friend Lord Joffe: the importance of adequately trained eye care personnel and the lack of those staff, which is a sub-sector of the broader issue of the chronic lack of effective health workers in developing countries. My noble friend Lord Crisp has done a terrific amount himself on that, on which I congratulate him, but it is a crucial element in treating blindness. Thirdly, disabled people, including blind people, are among those most affected by natural disasters and conflicts. Refugees with disabilities are among the most isolated, socially excluded and marginalised of all displaced populations, which means that efforts to respond to emergencies both acute and chronic must address the issue of people with disabilities. Finally, but most important, is the fact that eye disease is no respecter of national boundaries. Initiatives such as onchocerciasis control are dependent on cross-border collaboration in political and health terms among countries. I stress that this is as much a political issue as it is a health issue, which allows me to draw attention to a point that I have made in other contexts in your Lordships’ House. There is a need in our own country for DfID, the Foreign Office and even the Ministry of Defence to work closely together to ensure that the right political context in which social measures such as health can be taken and thus the incidence of blindness reduced.