1. What was the key question that the Report on Cost-Benefit Analysis of Investing in Child Eye Health has attempted to answer?

The report on Cost-Benefit Analysis of Investing in Child Eye Health is an effort towards showcasing the imperativeness of investing child eye health by evaluating and establishing the impact of childhood blindness on India’s economy. The report reflects the economic losses incurred by India due to lost productive years due to childhood blindness. There are 9.3 million visually impaired and 270,000 blind children in India. The current prevalence of blindness in children is known to be around 0.8/1000. However, over 75 % of all visual impairment can be prevented or treated. Directing investment towards addressing the growing economic burden of childhood blindness is essential towards preventing avoidable blindness.

2. Why was it important to undertake a cost benefit analysis on child eye health?

Blindness in childhood has far-reaching consequences for the affected child and family that permeate through difference spheres of life including education, employment, interpersonal relationships, and social acceptance and prospects throughout life. This can further push the individual and their family into the vicious cycle and poverty and dependency. Mitigating childhood blindness can help individuals become productive and contributing members of the society and enable them to stir up change within their communities. These ripples of change would further contribute to the economy by preventing the loss of USD 118 billion annually in cumulative gross national income.

3. How can the Orbis report help in setting priorities for Child Eye Health at a national level?

Estimates on the economic burden of childhood blindness help in planning interventions in India and judiciously allocate resources, tailored to the needs of the community. This report will help drive initiatives in eye care by policymakers, public health professionals, community-based organizations, educators, and academicians, among others. The report is the first of its kind since 1997 and is aimed at updating the economic burden of childhood blindness post 1998. Orbis endeavors to strengthen the foundation of the eye care ecosystem with research-based interventions to encourage investment in treatment and prevention of avoidable blindness

4. What were the key findings?

Some of the most interesting findings of this study are-

• The country loses an estimated USD 118 billion annually in cumulative gross national income (GNI) due to childhood blindness, spanning over a period of 35 years, and rising to USD 158 billion for 40 working years.
• An increase of direct GNI loss due to blindness from INR 496 billion in 1997 to INR 768 billion in 2020.
• An increase of 35% in the economic productivity of blind persons to USD 835 million in 2020 compared to 1997 estimates.
• 35% of blindness in children is preventable and treatable.
• Hospitalization rate for eye ailments in India stood at 3.6 per 1,000 people in rural areas and 3.5 per 1,000 people in urban areas annually.
• Care givers spend about 50% of the time taking care of children leading to a total indirect cost of INR 167 billion (USD 2.2 billion).

5. The report states a threefold rise in the indirect costs of blindness in children even with a comparatively reduced prevalence when compared to previous years. What does this imply?

The indirect cost of blindness in children has increased three times. This may be due to the increase in per capita income, economic productivity and increase in lifespan of the population and more people contributing to labour force. This is a significant development, as the economic productivity and per capita income rise, the economic impact of childhood blindness on the economy is more severe.

6. Were there any gaps found? Or questions you were unable to answer? What could be the focus for more future research?

More research is needed to identify and analyze intangible costs and qualitative aspects of blindness. This will give the social and cultural aspect of children with childhood blindness and visual impairment, for instance, gender, societal and cultural impact, and the quality of life of the child and family. There is also a need for more concrete disaggregated surveys to get the prevalence of childhood blindness. Further, the economic burden could be different in different parts of the country. But it could not be ascertained due to the lack of region-specific prevalence and economic data for adults and children.
Early and targeted intervention towards ocular morbidity in children is needed as opposed to the late consequence of blindness in children when reversal of visual disability is difficult.

7. What are you hoping will occur as a result of this research?

Prevalence data combined with cost-effectiveness analyses will give us a robust picture and help us in appropriate resource allocations towards ocular morbidities in children. The economic burden of blindness in children has become a rallying point in advocacy with the local and national governments and also at the global platforms. This information can help inform the planning and decision making and contribute to the knowledge base in the country.

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