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National Framework Implementation Plan

IMPLEMENTATION PLAN

under the

National Framework for Action

to Promote Eye Health

and Prevent

Avoidable Blindness and Vision Loss

September 2014

Contents

Introduction1Background1Sector Consultation3Objectives4Scope of the Implementation Plan4Key Priority Areas5Aboriginal and Torres Strait Islander eye health5Preventing eye disease associated with chronic conditions (particularly diabetes)6Improving the evidence base7Indicators and other progress measures8Integration and coordination of Australian Government eye health activities10Potential future investment11Strengthening the evidence National Eye Health Survey11Care integration11Timeframes12Reporting12References13

Implementation Plan - National Framework

Introduction

This is the first Australian Government Implementation Plan under the National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss (the National Framework).

The National Framework was developed as Australias response to the World Health Assembly (resolution WHA56.26) call for member nations to develop a national Vision 2020 plan.

The National Framework is a blueprint for coordinated action by governments, health professionals, non-government organisations and industry to work in partnership to focus activity on the prevention and avoidance of vision loss and disease.

This Implementation Plan (the Plan) has been developed by the Department of Health (the Department) to support the National Framework. It is intended to complement the core responsibilities of the Health portfolio (such as Medicare, Pharmaceutical Benefits Scheme, the Private Health Insurance Rebate, and funding to support access to health care in public hospitals nationally) which ensure that all Australians have access to high quality health care and medicines. The purpose of the Plan is to build on existing eye health care services and programmes, support coordination of effort, provide guidance on the mechanisms to address key priorities, identify indicators and other measures of progress, and guide investment and future activity and action across the Department.

This Plan will cover the period 2014-2016.

Development of the Plan has focussed on targeted action on eye health and avoidable vision loss within the Health portfolio, however the Department acknowledges the key role of the states, territories and the broader non-government sector in addressing eye health. Consultation with Vision 2020 Australia, which represents over 60 eye health organisations (involved in local and global eye care, health promotion, low vision support, vision rehabilitation, eye research, professional assistance and community support), has been central to the preparation of this Plan.

The Plan will be provided to the Community Care and Population Health Principal Committee (CCPHPC), which reports to the Australian Health Ministers Advisory Council, to inform any discussions with states and territories on initiatives relating to the National Framework and Australias international eye health obligations under the Global Action Plan, which was endorsed by the World Health Assembly in 2013.

Background

In May 2003 the 56th World Health Assembly passed resolution WHA56.26 on the elimination of avoidable blindness. The resolution urged all member states to develop a national Vision 2020 plan in collaboration with non-government organisations and the private sector to prevent avoidable blindness[footnoteRef:2]. [2: WorldHealthAssembly 2003, Elimination of avoidable blindness, 56thWorldHealthAssembly, Geneva, 28 May2003,ResolutionWHA56.26: Available at 56th World Health Assembly Resolution WHA56.26 Elimination of Avoidable Blindness]

In response, the National Framework was developed by the Australian Government Department of Health and Ageing and the Victorian Department of Human Services in conjunction with all states and territories and in consultation with the non-government sector.

The National Framework was endorsed by the Australian Health Ministers Conference in November 2005[footnoteRef:3]. In accordance with the World Health Assembly resolution, its focus is on the elimination of avoidable blindness and vision loss in Australia. [3: National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss: Available at: Eye Health Publications web page]

Avoidable blindness and vision loss refer to visual impairment due to conditions that are potentially preventable through the modification of known risk factors, or for which effective treatments exist to restore sight or prevent further vision loss.

The Framework does not focus on any one specific eye condition, but rather seeks to cover the underlying issues that are common to the prevention and treatment of eye disease and vision loss in general. It outlines five key action areas that have the potential to lead to the prevention of avoidable blindness and low vision, including:

Reducing the risk of eye disease and injury;

Increasing early detection;

Improving access to eye health care services;

Improving the systems and quality of care; and

Improving the underlying evidence base.

The National Framework requires that all jurisdictions report every three years to Health Ministers on progress against these key action areas.

On 24 May 2013, the 66th World Health Assembly meeting in Geneva endorsed Universal Eye Health: A Global Action Plan 2014-19 (the Global Action Plan) (Resolution EB132.R1) [footnoteRef:4]. [4: World Health Organization 2013, Universal Eye Health: A Global Action Plan 2014-19: Available at Universal Eye Health: A Global Action Plan 2014-19 web page]

The 130th session of the WHO Executive Board agreed to the development of a new action plan to guide activities over the period 2014- 2019. The new Global Action Plan was developed in consultation with Member States and International Partners and presented to the WHO Executive Board and World Health Assembly in 2013.

The Global Action Plan 20142019 is intended to serve as a roadmap to consolidate joint efforts aimed at working towards universal eye health in the world.

The vision of the Global Action Plan is a world in which nobody is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential, and where there is universal access to comprehensive eye care services.

The Global Action Plan includes three objectives with identified activities for Member States, the WHO Secretariat and international partners.

The three objectives are:

(i) Address the need for generating evidence on the magnitude and causes of visual impairment and eye care services and use the evidence to advocate greater political and financial commitment by Member States to eye health;

(ii) Encourage the development and implementation of integrated national eye health policies, plans and programmes to enhance universal eye health with activities in line with WHOs framework for action for strengthening health systems to improve health outcomes; and

(iii) Address multisectoral engagement and effective partnerships to strengthen eye health.

The Global Action Plan includes three proposed indicators to monitor:

(i) The prevalence and causes of visual impairment, through the establishment of a global target of 25 per cent reduction in the prevalence of avoidable visual impairment by 2019 (from the baseline of 2010);

(ii) The number of eye care personnel, broken down by cadre; and

(iii) Cataract surgery rate (number of cataract surgeries performed per year, per million population) and coverage (number of individuals with bilateral cataract causing visual impairment, who have received cataract surgery on one or both eyes), provided the coverage indicator is voluntary.

Sector Consultation

The Department in conjunction with Vision 2020 Australia conducted a consultation workshop in March 2013 to commence the development of the Implementation Plan. The workshop achieved broad support for the four key priority areas for action:

Improving the evidence base;

Support for people with low vision;

Aboriginal and Torres Strait Islander eye health and vision care; and

Awareness raising.

In October 2013, Vision 2020 responded to the workshop outcomes in the Eye Health and Vision Care Sector Response[footnoteRef:5], which included a broad range of views from the sector. Key areas of vision loss identified by the sector for focus, which account for the majority of avoidable blindness and vision impairment, included: [5: Vision 2020 Eye Health and Vision Care Sector Response. Available at Eye Health and Vision Sector Response to the Department of Health web page]

Age-related macular degeneration;

Cataract;

Diabetic Retinopathy;

Glaucoma;

Refractive error; and

Trachoma.

In particular, the sector emphasised the importance of a national eye health survey to provide nationally representative data on the prevalence of the above conditions. In June 2014, the Australian Government provided $1.126 million towards the development of the survey.

The development of the Plan has taken into account the issues identified by the sector and has recognised the main causes of avoidable blindness and vision impairment.

Objectives

This Plan is designed to guide, promote and draw together Australian Government activity within the Health portfolio to implement the National Framework and to acknowledge Australias obligations under the Global Action Plan.