The global crisis of visual impairment: an emerging global health priority requiring urgent action

Figures & data

Figure 1. Adopted from WHO, how to use ICF? VI involves bidirectional cause and effect relations between Activity, Body Function and Structure and Participation.

Table 1. Global concerted action. A few examples of legislation that have been carried out by government leaders, healthcare policymakers, and healthcare professionals.

Scope	Legislation	Aim
International	WHO: Vision 2020	VISION 2020 is a global initiative that aims to eliminate avoidable blindness by the year 2020
	UN: Convention on the Rights of Persons with Disabilities (CRPD)	The Convention is intended as a human rights instrument with an explicit, social development dimension. It adopts a broad categorization of persons with disabilities and reaffirms that all persons with all types of disabilities must enjoy all human rights and fundamental freedoms.
	UN: Article 26, Habilitation and Rehabilitation	States parties shall take effective and appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life.
Europe	European accessibility act	The act establishes the common requirements for member countries and companies operating within the EU to provide essential services and products to disability persons.
U.S. federal law	The Rehabilitation Act Section 501	Requires affirmative action and non-discrimination in employment by Federal agencies of the executive branch.
	The Rehabilitation Act Section 503	Requires affirmative action and prohibits employment discrimination by Federal government contractors and subcontractors.
	The Rehabilitation Act Section 504	States that “no qualified individual with a disability in the United States shall be excluded from, denied the benefits of, or be subjected to discrimination under” any program or activity that either receives Federal financial assistance or is conducted by any Executive agency or the United States Postal Service.
	The Rehabilitation Act Section 508	Section 508 establishes requirements for electronic and information technology developed, maintained, procured, or used by the Federal government→ Web Content Accessibility Guidelines (WCAG) WCAG 2.0: 2008 WCAG 2.1: 2018
	Americans with Disabilities Acts 1990	Signed a law to provide civil rights protection to people with disabilities, making discrimination on the basis of disability illegal.
	Americans with Disabilities Acts Title 3	Mandates that public accommodation must be provided to disabled persons to allow for the “full and equal enjoyment” of the related privileges, goods, services, advantages and accommodations as those provided to able-bodied persons.
	Javits-Wagner-O’Day Act	The federal government is required to “purchase certain goods and services from non-profit agencies that employ the blind or visually impaired”.
	Assistive Technology Act of 2004	The goal of the act is to provide AT to persons with disabilities, so they can more fully participate in education, employment, and daily activities on a level playing field with other members of their communities. Under the law, each U.S. state and territory receives a grant to fund an Assistive Technology Act Project (ATAP).
China	Law on the protection of disabled persons (China)	The China law provides political and civil rights, remove barriers and provide rehabilitation services.
England	The Equality Act 2010 in England, Wales and Scotland	The Equality Act protects you from different kinds of discrimination. These apply in a range of different situations and include: Direct discrimination Failure to make a reasonable adjustment Victimizations
Philippines	RA 3562 – An act to promote the education of the blind in the Philippines	Under the supervision and control of the Director of Public Schools a Teacher-Training Centre to train teachers for the blind. The Philippine Normal College shall provide room and other facilities for the said Centre.

Table 2. Moving forward.

Barriers	Intervention	Future
Eco-systemic and pragmatic
Inadequate policies and standards	Vision 2020 Article 26 CRPD WHO Global Strategy for Health for all	Review and revise legislation and policies
The low priority accorded to rehabilitation
Lack of provision: deficiencies in services such as health care and rehabilitation
Rehabilitation at personal/environmental levels
Lack of accessibility	WCAG Assistive technologies	Adopt national accessibility standards and ensure compliance in new buildings, in transport, and in information and communication Infrastructure-based AT Infrastructure-free AT
A lack of enforceable access standards in physical environments