Expanding Access to Low-Cost Eyeglasses and Assistive Technology

Globally, at least 2.2 billion people have a vision impairment or blindness, and at least one billion of these individuals have an impairment that could have been prevented or has not yet been addressed.[1] Refractive error is the most common cause of visual impairment – and at least 826 million people living with visual impairment due to uncorrected refractive error would benefit from eyeglasses. Some estimates, including milder vision loss, place this number at more than 2 billion.

As vision plays a crucial role in so many aspects of our lives, the uncorrected refractive error can have a negative impact on the health, education, productivity, quality of life, and general wellbeing of individuals. Yet, correcting refractive errors with eyeglasses is a highly effective intervention. Eyeglasses are considered functioning interventions, which means they provide compensation for refractive errors, rather than eliminating them by treating their causes, to improve the functioning and independence of an individual to facilitate participation and enhance general well-being.

The primary focus of this work will be on eyeglasses that are prescribed, though it is envisioned that positively strengthening systems that support the provision of prescription eyeglasses could positively impact other assistive technology systems as well. As per WHO, assistive technology is an umbrella term covering the systems and services related to the delivery of assistive products.

Many factors contribute to the low uptake of eyeglasses, particularly in low- and middle-income countries (LMICs), where the unmet need is concentrated. These are multi-fold and require a series of targeted, coordinated interventions to overcome them both in the private and public sectors. The World Health Organization’s 2019 World Report on Vision, Eye Care in Health Systems 2022, Package of Eye Care Interventions 2022, and the World Health Organization’s 2022 Global Report on Assistive Technology articulates the current global situation, as well as overarching recommendations to support countries, including integrating eye care into national health plans and health service delivery to support the integration of eye care into fundamental health system planning and included across all appropriate service delivery platforms. Addressing eye care can help achieve the Sustainable Development Goals (SDG), particularly SDG 3, in addition to addressing Universal Health Coverage targets. Further, beyond healthcare, the WHO highlights integrating eye care with other sectors such as education is also key to delivering high-quality, cost-effective interventions such as school eye health programs. [1]

Improving access to appropriate, affordable eyeglasses and related services will require innovative and ambitious efforts from multiple perspectives to achieve national scale. The current market landscape and relevant strategic objectives are described in the Product Narrative: Eyeglasses, published in 2020 by ATscale, the Global Partnership for Assistive Technology, together with the AT2030 Programme. This document provides a foundation for ATscale’s investment to improve access to eyeglasses globally.

In addition, the Case for Investing in Assistive Technology, published in 2021 by ATscale, lays out a compelling argument that access to assistive products provides a 9:1 return on investment, with eyeglasses comprising a large percentage of that gain. Economic, health, and social benefits for individuals and their families contribute to this return on investment. The recently published Global Report on Assistive Technology (GReAT) estimates that more than 2.5 billion people would benefit from one or more assistive products. The unmet needs are significantly higher in low-income and middle-income countries.

Supporting Partners

USAID, through the Inclusive Development Hub in the Bureau for Development, Democracy and Innovation, has been investing in improving access to assistive technology and rehabilitation services for over 30 years. Congress now mandates specific funds to improve access to low-cost eyeglasses. USAID is investing these funds in partnership with ATscale and its partners to implement the strategy outlined within the Product Narrative: Eyeglasses with the ambitious goal to develop national programs that meet the needs of all of its citizens.

ATscale, the Global Partnership for Assistive Technology, is a cross-sector partnership with the goal of reaching 500 million additional people with life-changing assistive technology by 2030.

ATscale has two primary strategic objectives driving its initial work including (1) developing an enabling ecosystem for increased access to assistive technology by galvanising political will, mobilising investment, driving policy reform, and strengthening targeted, cross-product systems, particularly at the country level; and, (2) building and shaping markets for priority products and their related services by identifying and investing in interventions to overcome specific supply and demand-side market barriers. This market-shaping work is initially focused on five priority products: wheelchairs, hearing aids, prostheses, eyeglasses, and assistive digital devices and software.

The United Nations Office for Project Services (UNOPS) is an operational arm of the United Nations, supporting the successful implementation of its partners' peacebuilding, humanitarian, and development projects around the world. Mandated as a central resource of the United Nations, UNOPS provides sustainable project management, procurement, and infrastructure services to a wide range of governments, donors, and United Nations organisations. In light of this, the United States Agency for International Development (USAID) has entered into an agreement with UNOPS to support the management of awards aimed at improving access to assistive technology worldwide.