An Interview with . . .

Dr Bjorn Thylefors
Director
Disability/Injury Prevention and Rehabilitation
World Health Organization
Geneva
Switzerland

Q: Why does China appear to have a greater incidence of treatable blindness than many other Asian countries?

Dr Thylefors: China has a relatively large and more rapidly ageing population compared with other countries, which is linked with a weak eye care delivery system. The number and productivity of ophthalmologists is fairly low, and there is a need both for further training in ophthalmic surgery and for updated equipment. In addition, the uptake of cataract surgery by the population is low due to the comparatively high cost of medical attention. The World Health Organization (WHO) is working on these issues with many non-governmental organisations (NGOs) and the Chinese Government's Ministry of Health.

Q: Which other countries in the region are you targeting for treatable blindness?

Dr Thylefors: We are currently working together with NGOs in Laos and Vietnam. We also have a very active programme in The Philippines. However, some countries such as Japan, Australia, and New Zealand are actively supporting programmes within this region. If the WHO is asked by the government to participate in a programme in any country, then we will take part.

Q: How do you obtain the epidemiological data required to determine the best strategy?

Dr Thylefors: The WHO is continually compiling data from various countries in an attempt to keep our knowledge up to date. We currently have data on treatable blindness for approximately 100 countries worldwide, but data is still required for many countries. China made a large effort to compile data in the 1980s, but new data is now needed as changes occur. For example, one of the common problems in the 1980s was trachoma, which is now reported in only a few provinces. The social problems in China have changed during the past decade or so, with an increase in the incidence of diabetes and an increasing ageing population. Therefore, regular epidemiological studies are required. The WHO is willing to assist in the organisation of these studies by providing study guidelines, comprehensive instruction manuals and forms for data collection. In addition, the WHO may send a consultant to coordinate the study if a country requests this approach. Many countries do have good data available. For example, Thailand has a very good record for both data collection and reduction of treatable blindness.

Q: What is Vision 2020: the Right to Sight and what is the WHO's role in this initiative?

Dr Thylefors: Vision 2020: the Right to Sight has been established to eliminate avoidable blindness. It is intended as a coherent effort at eliminating treatable blindness with a long-term perspective a 'global master plan' for the elimination of blindness. The WHO is not working alone, but with several NGOs and other groups with similar aims. The idea is to pool resources and make a concerted effort for the common good. If successful, Vision 2020 will become a formula for making possible the treatment of preventable blindness throughout the world. The WHO's role is to establish a task force for sponsorship and to coordinate with the NGOs as to how best to utilise the available resources. For example, there are many large-scale projects planned which range from fundraising for newer instruments and technology to setting up training schools. The WHO will also make staff available to help train local ophthalmologists and update their skills. Coordinating the work of the many initiatives in China into 1 concerted effort brings greater strength to the group as a whole.

Q: From where does the funding for this initiative come?

Dr Thylefors: Funding comes from sponsorship of these programmes by NGOs and other groups. We hope, in the future, to involve other agencies, such as the United Nations Children's Fund (UNICEF) and the World Bank. The NGOs organise their own fundraising activities.