Bangladesh can become a global hub for eye health research: Prof Nathan Congdon
He highlights opportunities to link poverty alleviation with vision care
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Bangladesh has the potential to emerge as a global leader in eye health research, combining its strong public health network with innovative partnerships that link poverty alleviation to vision care, says Prof Nathan Congdon, Research Director at Orbis International.
Speaking to The Financial Express, Dr Congdon, who is also Orbis’s Tech Adviser (North Asia Clinical Service) and a professor at Queen’s University Belfast, described Bangladesh as “a very exciting opportunity overall for Orbis and for Bangladesh,” citing the organisation’s new collaboration with the Palli Karma-Sahayak Foundation (PKSF).
“Bloomberg Foundation is the funder of this project, and Bloomberg has invested in the past in areas like traffic safety and water safety, but never in vision care. So, this is their first foray into support for vision care,” he said.
“They’ve selected Orbis from all the different organizations in the world they could have chosen, and in particular, they’ve chosen Orbis Bangladesh. So, it’s very exciting for us.”
Linking cataract surgery to poverty alleviation
Prof Congdon stated that the partnership between Orbis and PKSF aims to explore how low-cost vision care can act as a tool for poverty reduction.
“Orbis is principally interested in blindness prevention and eye health, whereas PKSF works in communities here in Bangladesh to try to carry out poverty alleviation,” he explained.
“It turns out we’ve got a lot more in common than you might think between these two organizations. Orbis is increasingly interested in the idea that vision care, low-cost vision care like cataract surgery and glasses, can be an exceptionally powerful poverty alleviation tool.”
According to him, under the new project, Orbis and PKSF will test whether microfinance tools, risk mitigation measures and low-cost health insurance can help families afford cataract surgery that would otherwise be out of reach.
“We want to make sure that this project can continue. We want to make sure that there can continue to be beneficiaries, but it’s also important to our donor,” he said.
“Bloomberg Foundation has a lot of money, but they also recognise that it’s not inexhaustible, and they want to see clear evidence from us after the first two years of work together that we have a concrete data-driven plan to see how cataract surgery can be scaled and sustained after their donations are no longer there.”
Economic and social benefits of improved vision
Prof Congdon said the research would look not only at the impact on patients but also on family members who provide unpaid care.
“What we’re currently exploring is the idea that cataract surgery can help the beneficiaries to return to work either inside of the house doing economically important things in the house or even pay labour outside of the house,” he said.
“But beyond that, the caregivers, the family members who are spending time taking care of these patients who are currently not able to care for themselves because they’re blind … that means those caregivers can also re-enter the workplace.”
According to Dr Congdon, the project also seeks to discover whether successful surgery makes families more likely to use PKSF’s other services.
“If that’s true, that’s very exciting to Orbis because it shows the potential for low-cost vision care not only to help people to see again, but potentially to open the door to better health in ways that they maybe have never experienced before,” he said.
From reading glasses to randomised trials
Asked which interventions hold the most promise for investment, Prof Congdon pointed first to the simplest -- reading glasses.
“Even a simple pair of glasses can make a huge difference in lives,” he said. “Most of us, the way we work, whether you’re a professor or a farmer, we work with things that we can reach out and touch. Once we reach a certain age, usually around 35 or 40, our ability to see those things that are near, the tools that we work with, gradually and naturally erodes.”
Referring to Orbis research findings, the expert said delivering glasses can dramatically boost productivity and earnings.
“We’ve shown that tea pickers will increase the amount of tea they pick by five kilos a day. We’ve shown that people working in garment industry can improve their efficiency working in the factories. And we’ve also demonstrated here in Bangladesh that we can increase earnings over six months by 30 per cent among people who are working in handicrafts, shopkeepers, working in a variety of different areas,” he explained.
According to the professor, glasses also help children learn.
“It does so with greater impact than any other healthcare intervention that’s been looked at in schools, bigger impact than giving iron and vitamins. It also has a bigger impact than family earning, than family income and parental education levels. So it offers a huge opportunity to redress inequities in society,” he said.
Diabetes and new research frontiers
While cataract and glasses are the most common interventions, Orbis, according to him, is also focusing on diabetic retinopathy, a growing cause of blindness among working-age adults.
“What we’re finding is that the vision loss that accompanies diabetes, if it’s not well managed, is actually the leading cause of blindness among people of working age… Coming up with better solutions to diabetic retinopathy, better treatments, better approaches to try to improve uptake, that’s also a source of focus of Orbis research that’s ongoing right now,” he said
Prof Congdon said another frontier is addressing “red eye” conditions such as allergic conjunctivitis in schoolchildren.
“We believe that we can come up with school-based approaches to treat those conditions … Together with simple treatments to reduce the itchiness, we think that can reduce those diseases,” he said.
“We think that it will allow children to learn better … and also has the potential to prevent blindness over many years later. That’s an exciting new area that we’re hoping to move into soon.”
Creating global evidence from Bangladesh
Prof Congdon stressed that the research under way with PKSF will not only benefit Bangladesh but also shape global policy.
“This research we propose is going to help us to demonstrate that cataract surgery is one of those best bargains in health care,” he said.
“We’re proposing to do high quality randomised controlled trials with PKSF and expert Bangladeshi economists to try to demonstrate exactly how much return on investment is there for cataract surgery for governments like those of Bangladesh.”
He believes the evidence generated could be “transformative” for governments worldwide as they allocate scarce health budgets.
A vision for sustainable development
Prof Congdon said Bangladesh’s enthusiasm for eye health gives him hope.
“Young ophthalmologists are eager to learn, NGOs are active, and the government recognises the importance of vision care,” he said.
“We’re not just trying to treat eye disease. We’re trying to create systems that prevent blindness, improve lives, and generate knowledge the whole world can learn from.”
With more than a million people to be screened and 100,000 to receive cataract surgery under the Orbis-PKSF programme, Bangladesh could become a model for integrating eye care into broader development goals — and a global leader in research on how restoring sight can transform lives.