Grand Challenges in global eye health: a global prioritisation process using Delphi method
Jacqueline Ramke, Jennifer Evans, Esmael Habtamu, Nyawira Mwangi, Juan Carlos Silva, Bonnielin K. Swenor, Nathan Congdon, Hannah Faal, Allen Foster, David S. Friedman, Stephen Gichuhi, Jost B. Jonas, Peng T. Khaw, Fatima Kyari, G. V. S. Murthy, Ningli Wang, Tien Yin Wong, Richard Wormald, Mayinuer Yusufu, Hugh R. Taylor, Serge Resnikoff, Sheila K. West, Matthew J. Burton, AE Aghaji, Adeyemi Timothy Adewole, Adrienne Csutak, Ahmad Shah Salam, Ala Paduca, A. Bron, Alastair K. Denniston, Alberto Lazo Legua, Aldiana Halim, Alemayehu Woldeyes Tefera, Alice Mwangi, Alicia J. Jenkins, Amanda Davis, A. Meddeb-Ouertani, Amina H. Wali, Ana Gabriela Palis, Ana Bastos de Carvalho, Anagha Joshi, Andreas Kreis, Andreas M. Müller, Andrew Bastawrous, Andrew Cooper, Andrew F. Smith, Andrzej Grzybowski, Anitha Arvind, Anne M Karanu, Anne O Orlina, Anthea Burnett, Aryati Yashadhana, Asela Abeydeera, Aselia Abdurakhmanova, Ashik Mohamed, Ashish Bacchav, Ashlie Bernhisel, Aubrey Webson, Augusto Azuara‐Blanco, Ava Hossain, Bayazıt İlhan, Bella Assumpta Lucienne, Benoît Tousignant, B R Shamanna, Boateng Wiafe, Brigitte Mueller, Çağatay Çağlar, Caleb Mpyet, Carl Halladay Abraham, Carol Y. Cheung, Cassandra L. Thiel, Catherine L Jan, Chike Emedike, Chimgee Chuluunkhuu, Chinomso Chinyere, Christin Henein, Clare Gilbert, Covadonga Bascarán, Cristina Elena Nitulescu, Daksha Patel, Damodar Bachani, Daniel Kiage, Daniel Etya’ale, David N. Dahdal, Dawn Woo Lawson, Denise Godin, Dennis Nkanga, Dennis M Ondeyo, Donna O’Brien, Dorothy M Mutie, Ebtisam S K Alalawi, Eduardo Mayorga, Effendy Bin Hashim, Elham Ashrafi, Elizabeth Andrew Kishiki, Elizabeth Kurian, Fabrizio D’Esposito, Faith Masila, Fernando Yaacov Peña, Fortunat Büsch
Abstract
BACKGROUND: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. METHODS: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. FINDINGS: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. INTERPRETATION: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. FUNDING: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. TRANSLATIONS: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section.