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The $1 Billion Answer to Universal Vision Care

By

Dr Astrid Bonfield

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8 min read

Summary Points

  • The Vision Catalyst Fund (VCF) has been launched with the aim of delivering vision care to 1 billion people by raising an initial $1 billion in catalytic finance by 2050.
  • AVPN Members including Essilor, Standard Chartered Bank, UBS Optimus Foundation, and philanthropist James Chen have come together as founding partners of the fund.
  • VCF is launching a $9 million development impact bond to tackle vision care coverage in India while addressing the unemployment crisis.

A Problem in Plain Sight

I’ve spent my working life in international development, starting by running a local NGO working in squatter camps in Zimbabwe, through policy jobs in the Foundation sector, and in the latter 15 years, running both The Diana, Princess of Wales Memorial Fund and then ​The​ Queen Elizabeth Diamond Jubilee Trust.

In considering the most impactful way to ‘spend out’ the Trust in honour of Her Majesty The Queen, I became aware of an extraordinary fact: today, more than 1 billion people live with a visual impairment where the causes are preventable. I could not help but be struck by the consequences of widespread vision impairment on peoples’ ability to participate in education and employment, as well as the cumulative impact on national economies.

Aside from the unfairness of losing your sight, the real injustice was that, in most cases, the problem is easily solvable. In fact, the 700-year-old invention of a pair of glasses would largely tackle this problem, while simple and low-cost cataract surgery would tackle much of the rest.

According to the World Report on Vision, the cost of closing the gap for those without access to eye care is more than US$14 billion. It is estimated the global economy could make US$19trn in productivity gains over the next three decades. Even with those bountiful returns, with all the will in the world, it is highly unlikely any such sums would be available without a seismic shift in the current reality.

And so, the Trust, alongside a broad coalition of partners, set its sights on improving the status of the persistently underfunded area of vision care across the Commonwealth. Significant headway was made especially in eliminating blinding trachoma as a public health​  problem.

Same Vision, New Catalytic Outlook

What if there was a way we could close this gap and eliminate all preventable blindness within a generation? Essilor, the world’s largest lens manufacturer,​ Standard Chartered Bank, UBS Optimus Foundation, The International Agency for the Prevention of Blindness, and philanthropist, James Chen, believe we can with a big, bold vision to tackle the vision care crisis.​

Together these founding partners established The Vision Catalyst Fund (VCF), which aims to deliver vision care to 1 billion people by raising an initial $1 billion in catalytic finance by 2050.

“Most people with vision impairment just need a simple pair of glasses which were invented 700 years ago. We worked with the Ministry of Health in Rwanda to train nurses to perform vision screening in every one of the fifteen-thousand villages in Rwanda. All 12.5 million people now have access to vision correction. I know what is possible. My goal is that when NASA sends the first person to Mars, everyone can see that incredible event. The VCF provides the platform for this to be possible with catalytic finance.”
James Chen, Founder of Vision for a Nation, Clearly and Adlens
James is a founding partner of The VCF and has pledged $10m USD to the fund.

In collaboration with the government, investors and partners, VCF will deliver results-based financing and national programmes in lower and middle-income countries. This will strengthen both markets (e.g. for glasses) and health systems to establish self-sustaining universal eye health coverage.

Alongside leading banking and social finance teams, VCF will be producing a range of financial products that will fund best-in-class solutions to the vision care crisis, while yielding financial return for investors.

Blindness Does Not Stop in Pandemics

When people think about eye care, they tend to think of it only as a health issue. Poor vision, however, impacts education, productivity, employability, road safety, equality and quality of life. With women making up two in three people who are blind, while being half as likely to receive eye care, eye health is closely linked to gender equity. For these reasons, vision is recognised as a critical part of the 2030 Agenda for Sustainable Development.

COVID-19 is having devastating effects globally, especially where health care systems and social safety nets are weaker. There are, of course, many pressing challenges on governments’ time and precious resources, but there are few issues as cross-cutting as vision. Just consider all of the challenges COVID-19 has brought into your life, in terms of your children’s education, access to specialist healthcare, and job security. Now, imagine you are living in a lower or middle-income country and are unable to see clearly.

We could not have imagined what the world had in store when the VCF began to work fully at the start of 2020. With all the adjustments of driving forward such a complex project from our bedrooms via Zoom, we are still determined to push forward with our innovative finance vision revolution and for very good reason.

We do not give up, we get innovative. From the devastation of systems, we can take the opportunity to build private-public partnerships that encourage reconstruction in more efficient ways.

“Between 2003 and 2020, Standard Chartered raised over USD100 million for Seeing is Believing (SiB), the Bank’s global initiative to tackle avoidable blindness. SiB reached more than 250 million people through medical interventions, eye examinations, and eye health education and training. Standard Chartered is building on SiB’s legacy by mobilising support for the VCF. We believe that through partnership and collaboration, the VCF can help people access vision care and alleviate some of the consequences of the global pandemic.”
David Fein, General Counsel of Standard Chartered Bank and Chair Seeing is Believing
Standard Chartered is a founding partner of VCF.

India’s Silver Bullet Bond

In India, it is estimated that nearly 114 million jobs have been lost to COVID-19 with a disproportionate impact on daily wage earners and low-income households. Alongside this, there is unmet consumer demand. 550 million people in India suffer from uncorrected poor vision. 95% of districts have less than 1 optical shop that caters to 50,000 citizens.

We are therefore accelerating the launch of a new $9 million development impact bond focused on India, The Vision Entrepreneurs (VE) Bond. The bond will be structured by Societe Generale delivered with local skilling partner B-Able.​

Using Essilor’s model, Eye Mitra (Hindi for friend of the eye) the Vision Entrepreneurs programme will train 3,500 unemployed and underemployed people – especially women and young people –  to become primary vision care entrepreneurs in their communities. Like other development impact bonds, outcome investors only invest in the programme if agreed outcomes are met – paying for results. Risk investors put up the initial capital receiving the full principal plus interest if the project is successful.

The impact of this programme will be profound: increased earnings for the entrepreneur increased income through improved productivity of wearers as well as revenues for rural suppliers and other small businesses who benefit locally. Plus, returns for investors.

A recent study in the Lancet showed that tea pickers in rural India had, in some cases, over 30% rise in productivity by simply giving a pair of glasses and an eye test. Imagine if we could scale this in all of rural India.

Essilor will be providing specialist knowledge to the programme including supply chain and technical support to help ensure better sustainability for the entrepreneurs.

“The effects of the pandemic will be felt for the foreseeable future. Besides addressing the growing problem of inadequate vision care coverage, we need to accelerate actions to get glasses into the hands of workers and students and scale inclusive business to reduce COVID-19 related unemployment. This is not something we can do alone. The development impact bond represents a promising vehicle to increase multi-stakeholder collaboration and deliver timely action for underserved communities in India.”
Hubert Sagnières, Vice-Chairman, EssilorLuxottica​
Essilor is a founding partner of VCF and has committed 200 million pairs of ophthalmic lenses by 2030.

Eyes on the Future

The VE bond is the first of a set of financial products that the VCF will be releasing.

Originating in the UK, we are laying roots in Asia by setting up an office in Singapore later in 2021, with the support of the Singapore Economic Development Board.

We hope to close funding for the DIB at the end of April to launch at the World Economic Forum in Singapore in May.

The VCF exists to build collaboration between governments, civil society and the private sector. Our role as a catalytic funder for vision care will extend to supporting the mission of AVPN by working with the network to create a better understanding of innovative social finance.

We are actively seeking outcome funders and investors to be part of the Vision Entrepreneur programme and the wider VCF mission[AK3]. We are fortunate in being able to build on so much great work that has already been carried out in working towards our mission of bringing vision to everyone, everywhere.

For more information on how to get involved email [email protected].

 

References

A. Environmental Stewardship
To protect the environment, we organize programmes like mangrove nursery and Reforestation, Coastal and River Clean-Up, Community Based Environmental Solid Waste Management, Environmental IEC Campaign and Eco-Academy

B. Food Security and Sustainable Livelihood
To ensure a sustainable livelihood for the community, eco-tourism include Buhatan River Cruise Visitor Center Buhatan River Mangrove Boardwalk are run by the community. Others include Organic Vegetable and Root crops Farming, Vegetable and Root crops Chips and by-products Processing and establishing a Zero waste store.

C. Empowered Communities
To empower the community, we provide product and Agri-Enterprise Development Training, Immersion and Learnings Exchange Program, Earth Warrior Training and Community Based Social Entrepreneurship Training

Author

Dr Astrid Bonfield

Dr Astrid Bonfield has almost twenty years’ experience of leading high-profile charitable foundations. As Chief Executive of The Queen Elizabeth Diamond Jubilee Trust, Astrid raised over £100m and successfully implemented eye health programmes in 32 countries throughout the Commonwealth. Under Astrid’s leadership of The Diana, Princess of Wales Memorial Fund became the first investor into the Cluster Munition Coalition which, over an eighteen-month period, successfully secured an international treaty banning cluster bombs (The Convention on Cluster Munitions). Prior to this, Astrid developed a policy unit for the Aga Khan Foundation and represented the Aga Khan Development Network (AKDN) in Brussels. She was a Programme Development Specialist for the Bernard van Leer Foundation and started her career as the Director of Inter-Country Peoples’ Aid, a local Zimbabwean NGO working in squatter camps around Harare. She was awarded a CBE in 2014 for her services to charity in the UK and abroad.

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