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Valedictory Address:By Dr. Uton
Muchtar Rafei
Regional Director, WHO/SEARO
Mr Chairman, Prof Madan Mohan,
Distinguished Participants,
Ladies and Gentlemen:
I am pleased to be invited to the
valedictory session of this workshop on corneal blindness. The World Health
Organization appreciates the efforts of the Madan Mohan Cornea Society in
reducing blindness in the South-East Asia Region.
You will recall that the Region has a very
high burden of blindness. While the Region is home to only a quarter of the
world’s population, one-third of the world’s 45 million blind people live in
this Region. Our Region also has the highest number of cataract backlog among
all six WHO regions.
Cataract remains the most frequent cause of
blindness in our Region. Encouraging progress has, however, been made to reduce
the cataract backlog in Member countries of the Region, thanks to the
sustained efforts of the governments of these countries and the support of
national and international nongovernmental organizations.
Indeed, so much emphasis has been placed on
managing backlog of cataract surgery in many of our countries that programmes
dealing with other causes of blindness have, in some cases, been neglected.
Corneal disease, as a major cause of
blindness in the world as well as our Region, remains second only to
cataract. We also know that the prevalence of corneal disease varies widely
from country to country and from one population to another in the same
country.
Cataract is responsible for nearly 20
million of the 45 million blind people in the world. Trachoma related
blindness as a result of corneal scarring is about 9.5 million people.
Significant progress has been made in our Region for control of blindness due
to trachoma. Trachoma is now a focal disease in selected geographical areas
of India, Myanmar and Nepal. We must give a last push
to eliminate one of the oldest recorded diseases of humankind. We will work
with the Member countries to eliminate trachoma from the remaining parts of
the Region in order to declare it trachoma-free.
Almost half of the world’s 1.5 million blind
children live in our Region. Corneal diseases are also responsible for a
large proportion of this number. The brunt of childhood corneal blindness is
caused by vitamin-A deficiency, ophthalmia neonatorum and
traditional eye medication.
I am also pleased to share the information
that our Region has done very well in reducing blindness, particularly due to
vitamin-A deficiency. National programmes for vitamin-A distribution in many
countries still exist and are now contributing significantly in preventing
blindness.
While these have been our successes, we are
confronted with new challenges. A study conducted in our Region
estimates that up to 12 million people are at risk of developing corneal
ulcers every year. Most of these ulcers follow minor agricultural injuries.
Recognizing the public health importance of corneal ulcer, WHO is currently
engaged in evaluating the effectiveness of antibiotic prophylaxis distributed
through grassroot workers. The three countries where we are supporting this
project are Bhutan, India and Nepal. If the outcome of this
study is favourable, it will encourage us to launch large-scale prevention
programmes in all countries of our Region which have this problem.
While new technology has greatly improved
the quality of life of patients with cataract, the uncontrolled use of
technology has jeopardized corneal health. Corneal complications due to
intraocular lens implantation, phaco-emulsification and excimer laser,
currently constitute the bulk of indication for corneal grafts in many
centres. Preferred practice guidelines together with appropriate training
should be carried out in preventing this avoidable loss of vision.
An estimated three million people who lost
their vision due to corneal opacity are in need of corneal graft. Yet, no
more than 30,000 corneal grafts are performed every year in our Region. This
is largely because of lack of donor eyes, but to some extent, also due to
lack of trained ophthalmic personnel. I am aware that you have extensively discussed
the subject of eye banking. WHO will be happy to collaborate with Member
countries in this area. We will do everything we can to improve this
situation.
I am also aware of the shortage of
ophthalmic personnel to deal with corneal diseases. WHO will also be happy to
collaborate with Member countries in the area of human resources development.
In conclusion, let me reiterate that WHO is
delighted at this opportunity of working together with the Madan Mohan Cornea
Society. We look forward to further collaboration in future.
Thank you
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