Vision for Development: Why Eye Health Needs a Seat in National Budgets

Clear vision drives growth, inclusion, and public health. No country
can achieve universal health coverage without universal access to eye
care services.

For millions of children, the difference between passing or failing in
school is a $10 pair of glasses. For many adults, cataract surgery
costing under $100 means the ability to work and live independently
again.

Clear vision drives growth, inclusion, and public health. No country
can achieve universal health coverage without universal access to eye
care services.

Each year, the world loses an estimated USD 411 billion in
productivity because of vision impairment and blindness (IAPB, 2021).

Behind that figure are children unable to see the board, drivers
navigating roads they can barely read, and older adults whose
independence fades with every blurred line.

On World Sight Day 2025, the main message is simple: a strong vision
sector is necessary. It is key to education, safety, and sustainable
growth.

The Cost of Invisibility

Good eyesight affects how children learn and how adults work. Studies
show that people with untreated vision problems have a 30% lower
chance of getting a job and earn less money (IAPB, 2023).

Simple actions can make a significant difference. Cataract surgery
that costs less than $100 can help someone work again for their entire
life. Glasses that cost under $10 can boost a student’s test scores by
up to 20% in one school term.

The Value of Vision Report 2025 states that spending USD 7.1 billion
on basic eye-care services in low- and middle-income countries over
five years could bring USD 199 billion in economic benefits. This
means a return of USD 28 for every dollar spent. Some studies suggest
that the return could be as high as USD 36 per dollar. Few public
health investments offer such reliable returns.

However, the numbers alone cannot close this gap. To translate
economic potential into real change, we must examine where services
are lacking and who is being left behind.

Africa’s Persistent Gap

Sub-Saharan Africa has the largest shortage of eye-care professionals
in the world. The International Agency for the Prevention of Blindness
(IAPB) states that there are approximately 2.3 ophthalmologists for
every million people in this region. In rich countries, there are more
than 70 ophthalmologists per million population. In some impoverished
areas, there are fewer than one ophthalmologist per million people.
This means that many places do not have access to eye surgery (IAPB,
2020; WHO, World Report on Vision, 2019).

There is a shortage of optometrists and other related professionals.
The IAPB Global Optometry Survey (2023) found that many African
countries have fewer than 10 optometrists per million people. Rural
areas often have no such facilities.

In national health budgets, eye care often receives less than 0.5
percent of the funding. In some cases, it is not even listed
separately. Most eye care services are in cities; therefore, many
people in rural areas do not receive basic eye checks or glasses.

Women and girls are especially disadvantaged. Studies show that they
face higher rates of uncorrected vision problems yet have lower access
to care, particularly in rural communities. Social and cultural
barriers, along with economic constraints, exacerbate this gap. Any
serious eye health strategy must account for these inequities if it
aims to achieve universal access to eye care.

However, examples of progress show what is possible.

In 2012, Rwanda integrated eye care into primary health services,
creating community-level screening and referral systems.

Ghana’s cataract strategy reduced surgical backlog within five years.

Nigeria’s school eye health programs have improved academic
performance and attendance, sparking momentum for a national policy
framework.

These successes show what can be achieved with the right policies,
funding, and training for eye health workers.

Integrating Vision into Health Systems

Real progress must include eye care in national health systems. This means:

1.      Financing and insurance: Eye care services, such as check-ups,
vision tests, and cataract surgery, should be included in public
insurance and universal health coverage plans.

2.      Workforce Expansion: Train and deploy more optometrists,
ophthalmic nurses, and vision technicians, especially in underserved
regions.

3.      Data and Accountability: Develop national eye health
information systems to inform planning and budgeting.

4.      Partnerships and Innovation: Leverage private and nonprofit
partners to lower costs, expand mobile clinics, and adopt
tele-optometry and portable diagnostic tools.

The World Health Organization urges countries to integrate eye care
into general health systems and ensure access without financial
hardship (World Report on Vision 2019). The IAPB 2030 In Sight
Strategy reinforces this call, linking vision directly to the
Sustainable Development Goals.

A Clear Case for Investment

Every dollar spent on eye health yields multiple returns in terms of
improved education, productivity, and quality of life.

Therefore, prioritising vision care is a development strategy, not a
cost centre. It strengthens human capital, promotes equity, and
reduces preventable disabilities.

The cost of inaction is higher: lost GDP, dependency, and millions
left unseen in policy and practice.

“There is no universal health coverage without universal eye health.”

The Vision We Need

Governments must act. Eye health should no longer be hidden in the
generic health budget. Policymakers should commit to the following:

i.                 Allocate at least 1 % of the national health budget
to eye care services (promotion, screening, surgery, and
rehabilitation).

ii.                Embed eye health indicators in UHC scorecards, for
example, child screening rates, spectacle coverage, and cataract
surgical rates.

iii.               Mandate school eye health programs nationwide, with
annual screening and corrective treatment.

iv.               Gender-disaggregated reporting of eye health data is
required to expose inequities and track gains for women and girls.

v.                Fully implement the National Eye Health Policy and
School Eye Health Guidelines with clear accountability and state-level
funding.

vi.               Track national targets already underway, such as 5
million spectacles and 25,000 cataract surgeries by 2027 and ensure
that these commitments are met.

By prioritising vision, a nation invests in its citizens, fosters
economic growth, and secures its future. Good eyesight should be a
fundamental policy, not a luxury for the few.

– Dr Ugonna Nwigwe, OD, MPH, PMP, is an Optometrist, Health Systems
Expert, and Healthcare Transformation Leader. She is the Founder of
The Eye Place Nigeria and a Mandela Washington Fellow. A WIMBoard
Fellow, she drives innovation in eye care, strengthens health systems,
and advances community impact.