DRIVE for sustainable development

The Lancet’s Global Eye Health Report, published in 2021, explained why eye care needs to be reframed as a worldwide development issue: integral to achieving the United Nations Sustainable Development Goals (SDGs).

The eye-opening research calculated that vision impairment costs the world economy over $400 billion because of productivity losses. At the same time, high provision of eye care services was found to accelerate the achievement of various SDGs, such as poverty reduction, food security, and decent work.

Further to the economic benefits, the Lancet highlighted the positive impact on educational outcomes, gender equity and equality in general. Moreover, the report found that eye care could make cities and communities safer by reducing the number of road accidents.

The report urged that eye health be given greater prominence within global development and health agendas. A call that was heard: The United Nations General Assembly has since adopted the resolution ‘Vision for Everyone; accelerating action to achieve the Sustainable Development Goals‘. It committed to reaching the 1.1 billion people with vision impairment who cannot access eye care services by 2030.

Despite this progress, the global eye care coverage overview released by the World Health Organisation in late 2022 shows that vision correction is still unavailable for far too many. While in Europe, North America and South-East Asia, around 80% of those in need of eye care can get it, in Africa, this proportion hardly reaches 20%.

Myopia has been described as a growing epidemic. More than one billion people who currently require vision correction are projected to become 1.8 billion by 2050 if we do not act swiftly. So, how do we bring the importance of eye health into sharp focus again?

To demonstrate to leaders worldwide that vision correction is a powerful engine for challenging global problems, DRIVE (Development and Research for International Vision Correction and Equity), a program of nine research trials, is underway looking at the role of vision correction in powering not only better health outcomes for individuals but in delivering sustainable development for countries around the world. The Chen Yet-Sen Family Foundation initiated DRIVE with co-funding raised from Wellcome Trust, USAid, The MOH Foundation and Medical Research Council (UK).

These studies explore the various impacts of uncorrected poor vision on people worldwide, aiming to deliver the proof that will activate developing countries to invest in solutions, such as the procurement of glasses and increased vision screening.

The first group of three research trials, PROSPER, focuses on productivity.

In 2018, the results of PROSPER 1 were released: the first randomised controlled trial exploring the impact of vision on productivity. The study was conducted in Assam, India, and focused on 750 mostly female tea leaf pickers with poor eyesight. The results showed more than a 20% average increase in overall productivity from the group that had their vision corrected versus the one that had not. This is the largest productivity increase reported for a health intervention in low-income and middle-income countries.

PROSPER 2 will build on these findings, measuring the impact of glasses on the productivity of manual workers within the textile industry in India. The study aims to demonstrate consistent findings in different sectors.

Meanwhile, PROSPER 3 will look more closely at workplace retention, examining whether improving the near vision of textile workers in their 40s and 50s allows them to remain engaged in the workforce for longer.

A further group of trials under the DRIVE umbrella will look into the importance of clear vision in education.

BRIGHT CLASSROOMS will examine the potential benefits of natural lighting in classrooms in abating the development of short-sightedness. SWISH will investigate the impact of access to glasses on the academic choices of secondary school students in China. And finally, ZEAL will prepare for a randomised trial of farsightedness (hyperopia) correction in the improvement of children’s educational outcomes in Zimbabwe.

A final set of three trials will investigate how vision correction can improve well-being and safety in the developing world.

CLEVER will assess the impact and cost-effectiveness of glasses on cognitive decline and quality of life among the elderly in India. STABLE will evaluate the impact of vision correction on road safety in Vietnam. And THRIFT will determine whether providing the recipients of Bangladesh’s Old Age Allowance and Widow Allowance with glasses and digital financial training can improve the use of mobile banking, thus enhancing their financial independence.

Focused on a range of demographics, from students to factory workers and the elderly, the trials under the DRIVE umbrella will show that improving eyecare is both urgent and important for sustainable development. Their ultimate aim is not to deliver an invention but to demonstrate that low-cost interventions exist and can be simply applied by policymakers to populations.

The funders and researchers involved in DRIVE want to unveil a roadmap towards the Sustainable Development Goals that starts a vital conversation about the economic and ethical opportunity glasses can provide. The knowledge obtained will offer a tool for governments to give their people what they need to thrive and a blueprint for a more equitable world to come.