Preventing avoidable sight loss from blinding trachoma and cataract.

Eliminating Blinding Trachoma

Trachoma starts as a painful inflammation of the upper eyelid that, through repeated infections, results in irritation and scarring. In the advanced stages of the disease, known as trichiasis, the scarring contracts the eyelid, causing the eyelashes to turn inwards. The eyelashes repeatedly irritate the cornea with every blink, ultimately causing blindness.

Trachoma is a neglected tropical disease that continues to affect the most vulnerable and underserved. The burden of trachoma on affected individuals and communities is enormous. The economic cost in terms of lost productivity from blindness and visual impairment is estimated at $2.9-$5.3 billion annually, increasing to $8 billion when trichiasis is included. As the world gets closer to the end of blinding trachoma, the Foundation remains committed in supporting the national elimination programs in Mali, Niger and Tanzania. An In Practice paper titled “Eliminating Blindness from Trachoma Infection” details the Foundation’s approach to the elimination of blinding trachoma using the SAFE strategy — Surgery, Antibiotics, Facial cleanliness, and Environmental improvement — as recommended by the World Health Organization. The Foundation’s current funding strategy focuses on filling strategic gaps in this space, primarily through funding trichiasis surgeries. It has played a critical role in the fight against the disease, contributing directly to the programs in several target countries that have achieved elimination targets, including Morocco, Ghana and, most recently, Cambodia.

Improving Access to Cataract Surgeries

A cataract is a clouding of the lens of the eye which impairs vision. While not preventable, the blindness it causes is treatable with a simple, relatively painless procedure. Globally cataract is responsible for 51 percent of all blindness – representing about 20 million people – who are unable to access surgery. The Foundation seeks to improve access to cataract surgery through supporting two intervention models: community ophthalmology and social enterprise. Current funding is focused on sub-Saharan Africa, specifically in Cameroon, Ethiopia, Kenya, Nigeria, Tanzania and Zambia.

Typically, cataract interventions were delivered through the community ophthalmology model, which is rooted in primary health care. An alternate “social enterprise” approach uses commercial strategies and a flexible fee structure that attempts to recoup revenues from clinical services to provide subsidized health care to for those unable to pay. The focus of this model is expanding access and improving quality while maintaining affordability. Given the growing forecasted need for cataract surgical services as a result of an aging global population, the aim of the Foundation is to help develop solutions that may scalable in the future.

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