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pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows Foundation September 2012 IAPB 9 th General Assembly

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Page 1: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

pwc.com.au

Investing in VisionComparing the costs and benefits of eliminating avoidable blindness and visual impairment

Brian DoolanThe Fred Hollows Foundation

September 2012

IAPB 9th General Assembly

Page 2: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

Shifting Paradigms in Health CareThe Economic Case to achieve VISION2020 goals

Too often the costs of poor health are borne by society – eye health is no different

Often the monetary hurdles have been viewed as overly high

PwC and The Fred Hollows Foundation

Investments are therefore both cost effective and sustainable. Indeed, when combined with the broader social benefits, eliminating avoidable blindness is the genuine unpicked low-lying fruit of development policy

In pure monetary terms the economic case for achieving the VISION 2020 goals is compelling, the Benefits: Costs Ratio = 4:1 is productivity enhancing

Our work sets out to shift this paradigm.

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Page 3: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

Globally, the benefits of eliminating avoidable blindness and visual impairment outweigh the costs by a multiple of

Total benefits are estimated to be at least US$522.6 billion from 2011 to 2020, outweighing the additional investment required (US$127.4 billion)....

In developing countries...

...which is equal to a benefit cost ratio of 4.1

2.8

PwC and The Fred Hollows Foundation

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Page 4: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

The series of reports by PwC addressing the costs and benefits of VISION 2020:

* Developed in partnership with Three Rivers Consulting

The global initiative for the elimination of avoidable blindness

The Price of SightEstimates the global cost of eliminating avoidable blindness and visual impairment*

Total investment of $378.9 billion required ($127.4 billion in developing countries)

A benefits framework for eliminating avoidable blindness and visual impairment

The Value of SightEstimates the value of benefits associated with the effort to eliminate avoidable blindness and visual impairment*

Benefit value of $1,115.4 billion ($522.6 billion in developing countries)

Investing in VisionCompares the cost to eliminate avoidable blindness with the corresponding benefits.

Benefit cost ratio of 2.8 and 4.1 in developing countries

IAPB ConferencePresentation of Investing in Vision

1 2 3 4

PwC and The Fred Hollows Foundation

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We would like to acknowledge the contribution to various phases of this work by key individuals and from the following NGOs:

Page 5: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

The benefits of eliminating avoidable blindness and visual impairment far exceed the investment required

PwC and The Fred Hollows Foundation

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Benefits$8.9 per capita (in developing countries)

Costs$2.2 per capita (in developing countries)

Economic benefits

Health benefits

SocialInvestment in primary and secondary health care systems Investment

to treat the backlog

Page 6: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

Social benefits are weighted towards developing countries

Benefits not quantified in monetary terms

Reduced Child Morality

Increased Primary Education

Improved Independence, Self-esteem, & social networks

Improved quality of life

Reduced extreme poverty

Increased gender equality

Social benefits will be realised predominantly in developing countries

$

PwC and The Fred Hollows Foundation

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Page 7: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

Future research will help to overcome the data limitations encountered, strengthening the analysis of costs and benefits

Key areas for future research that would help to refine future estimates of both the costs and benefits include:

Despite the data limitations, sensitivity analysis shows that the benefits of eliminating avoidable blindness and visual impairment substantially outweigh the costs

Prevalence 15-65 yrs

Average income and employment for blind & visually impaired in developing world

Impact of caring on productivity

Current expenditure on eye health services by country

Current workforce in respect to eye health and primary care by country

PwC and The Fred Hollows Foundation

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Page 8: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

An innovative financing mechanism

There is therefore likely to be a key role for donors:• For the poorest nations donors can

fund the entire package• For less poor donors can provide

initial financing, with the positive pay-off from reforms being gradually used to offset donor funding

Making this Possible

Initial Donor support transitioning into self financed

Donor financed

Self - financed

$

$ $ $

PwC and The Fred Hollows Foundation

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Investment in eliminating avoidable blindness is both cost effective and sustainable.

For the world’s poorest countries finding the requisite funds will be a challenge, and for others still it will likely be insurmountable.

The only existing barriers are political.

Page 9: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

The Fred Hollows Foundation is hosting a Breakfast session

Wednesday, 19 September, 7.30-9.00amHall A

Presentation of the methodology used for the Price of Sight report and the Benefits Framework report, The Fred Hollows Foundation

Mr Jeremy Thorpe, Partner, PwC Australia and Mr Marty Jovic, Director, PwC Australia

PwC and The Fred Hollows Foundation

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Page 10: Pwc.com.au Investing in Vision Comparing the costs and benefits of eliminating avoidable blindness and visual impairment Brian Doolan The Fred Hollows

©2012 PwC. All rights reserved. "PwC" refers to PwC, a partnership formed in Australia or, as the context requires, the PwC global network or other member firms of the network, each of which is a separate and independent legal entity.