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Special Education

Notes Country cooperation strategies reflect the agreed joint agenda between health ministries and WHO.
So far, the inclusion of blindness prevention in such documents has been minimal, despite seven
resolutions of the Health Assembly relating to prevention of avoidable blindness and visual
impairment, the existence of WHO’s major, long-standing international partnerships on prevention
of blindness, and major successes in reducing avoidable blindness, such as WHO’s Onchocerciasis
Control Programme. Lack of adequate resources for preventing blindness at the country level is a
major impediment. Additionally, faced with increasingly limited resources, donor and recipient
countries often give higher priority to mortality related disease control programmes than to those
dealing with problems of disability. Also, experienced staff to coordinate blindness-prevention
activities at the regional and country levels are in short supply.
Greater priority should be given to preventing blindness in health development plans and country
cooperation strategies. Action is also needed to strengthen technical support and enhance the provision
of expert advice to Member States where blindness and visual impairment are a major health problem.
(i) National eye health and prevention of blindness committees: It is important to establish
national committees and programmes for eye health and blindness prevention. Their role is to
liaise with all key domestic and international partners, to share information and to coordinate
such activities as implementing the national eye health and blindness-prevention plan. A
functional national committee is a prerequisite for developing the national blindness prevention
plan and its implementation, monitoring and periodic assessment. Some countries, particularly
those with decentralized or federated management structures, have similar committees at
subnational level.
However, not all national committees are functional and, unfortunately, in many cases such
committees have not successfully initiated effective action. In some instances, selected
individuals, often dedicated eye-care professionals, are relied on to provide leadership and
serve as the driving force for blindness-prevention plans and programmes. The committees’
membership is often not uniform, ranging from the ideal scenario, in which all key partners are
represented (including the national health-care authorities), to a minimal group of dedicated
eye-care professionals.
(ii) National eye health and prevention of blindness plans: Experience has shown that, in low-
and middle-income countries, a comprehensive national plan containing targets and indicators
that are clearly specified, time-linked and measurable leads to substantially improved provision
of eye health-care services.
Most low- and middle-income countries (104 Member States by October 2008) have reported
the development of national eye health and blindness-prevention plans, but reporting on and
assessment of their implementation and impact have been insufficient. Some national plans do
not include measurable targets, an implementation timeline and adequate tools for monitoring
and evaluation. In some countries, the plans have only been partially implemented. In addition,
because of lack of resources and leadership, some countries have made only slow or fragmented
progress and their plans for eye health and national prevention of blindness have not yielded
tangible improvements in the provision of eye-care services. It is necessary to ensure that the
implementation phase of national plans is well managed, and a standardized approach to
monitoring and evaluation of national and subnational eye health and blindness-prevention
plans must be taken.
(iii) WHO’s strategies for prevention of blindness and visual impairment and provision of
technical support: WHO’s strategy for the prevention of avoidable blindness and visual
impairment is based on three core elements: disease control, human resource development,
and infrastructure and technology. This approach has been promoted since 1999 by the global
initiative “VISION 2020: the Right to Sight”, which was established as a partnership between
WHO and the International Agency for the Prevention of Blindness. The past decade has seen
major progress in the development and implementation of WHO’s approaches to controlling
communicable causes of blindness and visual impairment. Achievements in controlling
onchocerciasis and trachoma were based on implementation of WHO’s strategies of community-

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