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Vision 2020

My Lords, I join in thanking my noble friend Lord Crisp for introducing this very important and topical debate. I would like to devote my allotted few minutes to addressing the problem of river blindness in Africa, where I have spent most of my life. A number of rather chilling statistics exist and one reads that more than 100 million people are at risk in 30 African countries, with almost 18 million already infected with the disease. In researching for this debate I read the initiatives of Vision 2020 to prevent avoidable blindness. I was encouraged to read that between 75 and 80 per cent of the world’s blindness is avoidable, 60 per cent is treatable and 20 per cent is preventable. I returned last week from a visit to Ghana where the health authorities have been fighting the scourge of river blindness for almost 50 years. West Africa, particularly Nigeria, has been worst affected. Despite treatment with ivermectin, concerns are growing that this crippling disease is endemic and may be developing a resistance to the drug. It is encouraging that its mass administration has been effective in preventing nearly 40,000 cases of river blindness a year, but that figure could be considerably increased with better management. I was pleased to hear that phase three trials have recently been launched in the Democratic Republic of the Congo, Ghana and Liberia to assess the effectiveness of moxidectin in preventing transmission from the worms that cause river blindness. It is also encouraging that scientists in Cameroon and Ghana have identified the first biological agent, a midge, which can be cultivated, that eats the pupae of the blackfly that cause river blindness. Like my noble friend Lord Bilimoria, I also support the work of public-private partnerships in preventing avoidable blindness. I have always been a firm believer in prevention rather than cure. While it is unlikely that the scourge of river blindness will be eradicated, it is encouraging that there are cost-effective solutions to the problem. In a recent article on combating river blindness in Cameroon, my noble friend’s charity, Sightsavers International, has estimated that for an average cost of just 5p, the drug ivermectin can protect an individual against the devastating effects of the disease for a whole year. However, 15 years of such protection would be needed because that is the period during which the river blindness bug stays in the system. Getting the treatment to remote communities and training people to distribute it is a challenging task. As most speakers have already mentioned, river blindness predominantly affects poor people in remote areas. In many cases, children have missed out on education because they are forced to stay at home to act as full-time carers for relatives who have become blind. In some cases, residents have fled areas where the level of infection has hit hard, leaving "ghost" villages behind. These are often situated in arable areas of Africa, near to fast-flowing rivers. It is well known that lack of eye care can have a severe economic impact by perpetuating poverty or pushing a family into poverty. Clearly, effective and low-cost solutions exist to eradicate avoidable blindness. To this end, I wholeheartedly support the aims of the Vision 2020 initiative.