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In many countries, you might pop into a pharmacy to buy a cheap pair of reading glasses. In low-income countries, however, it’s often more complicated.
“Glasses are not common in pharmacies in Bangladesh, and sometimes even optical shops do not offer reading glasses upfront to customers,” says Ella Gudwin, CEO of VisionSpring, a social enterprise that helps people in low-income countries access affordable eyecare.
That means many people simply don’t use them. When VisionSpring screened 300,000 garment workers in Bangladesh, it found that one third of them needed but did not have glasses.
Glasses coverage is six times lower in poor countries than in rich ones, according to the World Health Organization. Globally, one billion people still need glasses – 800 million of whom have near vision impairment, which could be fixed with a simple pair of reading spectacles. Those numbers are set to rise in the coming decade due to ageing populations and lifestyle changes.
But unlike many of the world’s problems, this one is solvable, says Gudwin. Last year her organisation screened 2.6 million people, and corrected the vision of nearly 1.9 million people with what it calls “radically affordable” glasses.
VisionSpring has long argued that better vision means more earning power, and new data backs this up. In April, a first-of-its-kind randomised control trial in Bangladesh found that reading glasses dispensed by community health workers boosted recipients’ monthly income by 33%. Importantly, the study showed what could be achieved by relying on trained but non-medical personnel.
Consensus
VisionSpring has found that customers will pay the equivalent of around one to two days’ wages for a pair of glasses (costs are subsidised by philanthropic funding). But price is not the only issue. Sometimes people assume glasses are too expensive or that they don’t work; or they associate them with looking old or even pretentious. VisionSpring and its partners are working on various campaigns to address this.
Education and awareness are also among the focus areas of an ambitious global initiative launched last month. The World Health Organization’s SPECS 2030 programme sets out a pathway to help countries achieve a global target, agreed in 2021, of increasing the proportion of people with access to appropriate spectacles in each country by 40 percentage points. Since coverage is as low as 20% in some countries, it’s a “really bold” target, says Gudwin.
Global consensus and WHO guidance on the issue will make VisionSpring’s work easier – for example in advocating for reduced import duties on glasses, or in reaching agreements with professional optometrist associations.
“This is a real watershed moment for this sector,” she says. “We’ve been banging on about it for 20 years. What’s really exciting is now there’s lots of other people in the orchestra. And we’re louder and more organised and have more consensus than we’ve ever had before.”
