Closing The Gap For Vision

9 May 2017

Building a sustainable eye health system for Indigenous Australians

Today we announce a four year investment in Indigenous Eye Health at the University of Melbourne School of Population and Global Health. Following on from inital support provided by the Ian Potter Foundation, this $1.5 million investment will support the implementation of the Roadmap to Close the Gap for Vision, a costed, sector endorsed, whole of system approach to build a sustainable eye health system by 2020. The Roadmap aims to eliminate the known differences in the standard of eye health in Indigenous Australians compared to Non-Indigenous Australians. Since its inception the implementation of the Roadmap has already made significant progress towards eliminating avoidable vision loss in Indigenous populations.

Today we are faced with the staggering reality that over 90% of vision loss in Indigenous adults is preventable or treatable. Vision loss accounts for 11% of the health gap between Indigenous Australians and Non-Indigenous Australians, placing it third behind cardiovascular disease and diabetes, but ahead of alcoholism and stroke, as the main contributors to the health gap. Despite these alarming statistics, a third of Indigenous adults have never had an eye exam. Those who have are often confronted by a system that is fragmented and disconnected, and fails to meet their needs. Patients fall through the cracks of poorly coordinated referral pathways and therefore never receive the appropriate level of care. The system of Indigenous eye health care is clearly ripe for change and the Foundation believes that an investment in the Roadmap will accelerate progress towards closing the gap in vision.

If successful, full implementation of the Roadmap could have some highly significant outcomes for eye health in the future, most notably the elimination of trachoma from Australia. Currently Australia is the only developed country in the world to still have trachoma and whilst it was eliminated years ago from Non-Indigenous populations is still prevalent in many Indigenous communities.

The Paul Ramsay Foundation is committed to supporting interventions that will enable systems level change. Professor Hugh Taylor and his team at the Indigenous Eye Health Unit have designed a framework that demonstrates a comprehensive understanding of what is required to re-shape a system by re-allocating existing resources. This investment forms part of a broader Foundation strategy targeting interventions that analyse and influence the system or systems in which they operate. The Foundation is looking to partner with organisations that demonstrate an understanding of the complexity of the environment in which they work and are developing projects that challenge the current structures, processes and relationships within systems. The Foundation is willing to play a variety of roles working with organisations to help them develop their capacity and capability to work in this way.

Professor Taylor has spent the last 10 years collecting evidence about the barriers and constraints of eye health care in Indigenous communities and testing ways in which the system can be realigned and resourced to allow it to function effectively. It is this work that the Foundation believes is most important to ensure a proposed intervention will have a sustainable effect at a population level.