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The Sustainable Development Goals and Implications for Eye Health Research

On Friday 25 September 2015, world leaders met at the United Nations (UN) Sustainable Development Summit in New York and committed to the 17 Sustainable Development Goals (SDGs) which follow on from the Millennium Development Goals (MGDs). The SDGs are very broad and ambitious in scope, with 169 global, social and environmental targets and indicators that UN member states are expected to achieve by the year 2030. The SDGs are transformational, with the vision of ‘‘a world with equitable and universal access to quality education at all levels, to health care and social protection, where physical, mental and social well-being are assured.’’ In terms of health and well-being, member states are charged with achieving universal health coverage and access to quality health care. Several of the MDGs relate directly or indirectly to eye health, as do the new SDGs. For example, there is increasing evidence that poverty is both a cause and consequence of blindness, with cataract surgery improving household economic status, for example, so contributing to SDG 1: ‘‘End poverty in all its forms everywhere.’’ Many sight-restoring interventions improve quality of life, participation and engagement in income-generating activities, as do interventions for prevention of vision loss from conditions such as diabetic retinopathy, an important cause of visual impairment among those of working age in high income countries. These eye care interventions contribute to SDG 3: ‘‘Ensure healthy lives and promote well-being for all at all ages,’’ and to SDG 8: ‘‘Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all.’’ Global efforts to scale up the SAFE strategy (surgery for trichiasis, antibiotics, facial cleanliness and environmental improvement) for trachoma control will contribute to SDG 6: ‘‘Ensure availability and sustainable management of water and sanitation for all.’’ However, as indicated in a recent editorial in Ophthalmic Epidemiology, SDG 10: ‘‘Reduce inequality within and among countries’’ remains a challenge in relation to eye disease and visual impairment within all countries regardless of their level of development. A key question is how might the SDGs guide priorities for research in relation to eye health? There seem to be four key areas: research which promotes the scale-up of effective treatments or preventive measures, particularly among those with poorer access; studies which focus on quality assurance of eye care delivery; research on barriers and solutions to achieving universal eye health care, as promoted by the World Health Organization Global Action Plan 2013–2020; and last, evaluation of interventions for conditions where effective and acceptable treatments or preventive measures are not yet available. Research which leads to the scale-up of effective treatments would entail identifying subgroups in the population with poorer access, identifying their barriers to access, and designing and evaluating scalable interventions which promote access and uptake. Despite multiple papers which report barriers to the uptake of cataract surgery, for example, there is very limited evidence on which interventions are effective at improving uptake, particularly among disadvantaged groups. As many of the interventions are likely to be complex, suitable methodological approaches will be required, including formulation of a theory of change,