What does Global Health Reform mean for eye health?

Fiona Lawless is a Policy Adviser covering Health and Inclusive Data at Sightsavers. She is a co-lead of the Women in Global Health Ireland chapter and is on the board of the Irish Global Health Network.

Over the past 12 months discussions about reform of the global health architecture have started in earnest.

There is widespread recognition that the existing systems have faults, inefficiencies and duplications and that country ownership and sovereignty needs to be central moving forward. From the Accra Reset to the Lusaka Agenda and from HEAR-CSO to the European Commission, we have seen proposals put forward as to what a reformed architecture should be. In May of this year the World Health Assembly passed a resolution on the proposed process for deciding what this reform would look like.

A common thread throughout the proposals is a need for strengthened health systems, particularly at primary care level, while reducing silos and placing greater emphasis on country ownership. There is also a call to ensure that funding mechanisms are aligned with national priorities and not the other way around. This shift provides an important opportunity for eye health.

For a long time, eye care has been provided primarily by the private sector in many countries around the world. With 1.1 billion people who are blind or have a vision impairment that could have been prevented or is yet to be addressed, it is imperative that public health systems include access to eye care.

A huge part of our work at Sightsavers has been working to strengthen health systems and ensure that eye care is considered a critical part of those strengthened systems. We have supported governments to develop eye health policies and strategies and advocated for eye health to be included in broader health system policies and plans. We use experience and learning from our programmes to support governments decision making and have driven resolutions at international fora to elevate eye health as a health and development issue. As the eye care sector we cannot bridge the gap between the needs and services available without advocacy and government buy in.

This year, with the first ever Global Summit on Eye Health taking place, the sector is calling on governments to make commitments to advance eye care in their national contexts. We have been working with governments to identify areas to prioritise and advocating for concreate, measurable commitments to be made on 2 November 2026.

The case for making commitments is compelling. When governments include eye care in their national policies, planning and budgets, we know that it unlocks potential both at an individual level and at an economic level. Recent research shows a return of $28 for every $1 invested in eye health, the two most common eye care interventions, cataract surgery and the provision of glasses, are some of the most cost-effective health interventions available. They unlock benefits far outside of the health sector including improved learning, increased future earnings, reduced road traffic incidents and enhanced productivity.

When we talk about reform of the global health architecture, strengthening primary healthcare should be prioritised as the foundation for equitable and people centred health systems. While placing primary healthcare at its core and reducing fragmentation and improving coordination across different health programmes, eye care should be explicitly included in essential service packages alongside other sectors of health that are often excluded from routine delivery so that people can access the services they need.

By showing up at the Global Summit on Eye Health and committing to prioritising eye care in their countries, governments can help unlock funding to support national priorities, whatever the future global health architecture looks like. This in turn will not only improve health outcomes but can also unlock a country’s economic potential by allowing people to reach their full learning and earning potential.

As governments rethink how health programmes are funded and delivered, there is a unique opportunity to ensure that eye care is no longer treated as an optional extra, but as an essential part of strong and sustainable health systems.