Journey so far & horizon beyond dr.mariotti

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Journey so far & Horizon Beyond
Silvio Paolo (SP) MARIOTTI
Senior Medical Officer @ WHO HQ
Secretary of LCIF SAC

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LCIF Overview
• Founded in 1968 - official foundation
of Lions Clubs International
• Provides grant funding for large-
scale, Lions-led projects
• Relies on donations from Lions
• More than US$950 million in grants
awarded to-date
• Several types of grants:
humanitarian, disaster, youth,
diabetes, SightFirst, etc.

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LIONS SIGHTFIRST
SightFirst program?
Lions Clubs International Foundation’s Sight First Program
finances the efforts of Lions, non-governmental organizations, government
agencies and other bodies to fight the major causes of preventable and
reversible blindness through the support of eye health care delivery systems,
training and infrastructure development.
How?
The SightFirst program builds eye care systems, fights blindness and vision
loss and assists blind and visually-impaired persons in underserved
communities throughout the world.
Since the program began in 1990, SightFirst has helped save the sight of more
than 30 million people worldwide.

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SightFirst global data
•1,329 SF grants approved for a total amount of US$355,607,399.83
•> 2,178 new ophthalmologists trained, and 10,603 ophthalmologists who received CME
•> 29 new optometrists trained and 464 optometrists provided with CME
•> 672 new ophthalmic nurses trained and 7,989 provided refresher trainings
•9.1 million cataract surgeries conducted
•1,153 pediatric cataract surgeries performed
•13,960 DR laser treatments supported
•13,326 vitrectomies performed
•9,707 children who received low vision assessments
•274 million Mectizan treatments distributed
•851,743 TT surgeries performed
• 125 million children benefitted from LCIF-WHO ChBl program
South Asia (Nepal, India, Sri Lanka, Bangladesh) Impact:
•469 grants approved for a total amount of US$66,822,829
Out of facility building/support, outreach, missions and comprehensive care
over 1B people have been reached by SightFirst

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SightFirst Grants
• US$10 million grant approval ceiling per fiscal year
• Grants approved by the SightFirst Advisory Committee (SAC); meets in August and January
• Funds comprehensive eye care projects that target major causes of blindness and low vision,
including:
• Cataract
• Childhood Blindness
• Diabetic Retinopathy
• Education and Rehabilitation
• Low Vision
• Trachoma
• Uncorrected Refractive Error
• Project strategies include:
• Infrastructure development
• Human resource training
• Service delivery

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India Leads the World:
Total Number of SightFirst Grants
Awarded Worldwide (1990- Present)
India
345 grants
26% of all
SightFirst grants
awarded
Rest of World
984 grants
74% of all
SightFirst grants
awarded

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Total SightFirst Funds Awarded
Worldwide (1990- Present)
India
$50,771,404
14%
Rest of World
$304,835,996
86%

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SightFirst evolution
• SF started by supporting the most necessary interventions at time when vision loss
was caused by easily reversible pathologies and infectious diseases which could be
eliminated.
• The most effective strategy for cataract was mass surgery campaigns
• For Onchocerciasis and Trachoma timely lid surgery, mass treatment with donated
drugs and community education was the way forward.

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• SightFirst led efforts in the most difficult areas
SightFirst evolution

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• The epidemiology of causes of vision loss has changed in the last 15
years. Infectious diseases aren’t anymore global concerns or public health
problems
• 70s // 80s  90s // 2000  2010 -
• Emergency Eye Care  Prevention of blindness  Eye Care Services
• Infection/Cataract  Priority Chronic Diseases  Comprehensive Eye Care
• Cataract and Refractive errors continue to affect the poorest populations.
• Diabetic Retinopathy is raising with diabetes.
• Glaucoma is increasingly diagnosed, cure is complex.
• Age-related Macular degeneration is a leading cause of vision loss in high income settings
(urban, market economy).
What can SightFirst do to continue being of help?
Can we continue the campaign/camps or shall we adopt a new strategy?
Looking towards the future

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• From SF 2 the strategy has moved to building sustainable comprehensive eye care
service systems.
• Focus has moved from eye to person.
• Aim is at moving the patients from passive recipients  active care seekers
• Support is provided to those projects which cater for all people in need, not single
disease focus. Priority given to the poorest, neglected, underserved.
• While the entry point for service might be focal (DR, Cataract, Vision Rehabilitation,
Child eye care) the support shall respond to what people need, not to our wishes.
• Criteria for grant acceptability include 1. demonstrated needs, 2. sustainability of
care, 3. accessibility for each contribution capacity, 4. high quality standards, 5.
efficiency and effectiveness of strategies.
• As a global program SF follows internationally agreed criteria for care, quality,
acceptability, effectiveness and impact.
• SF and Lions contribute to the global SDG 2030 agenda
Looking towards the future

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Goal 3: Ensure healthy lives
and promote well-being for all
at all ages
Universal health coverage (UHC) means that all people and communities receive preventive, curative,
rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring
that the use of these services does not expose the user to financial hardship.
UHC embodies three related objectives:
1. Equity in access to health services - everyone who needs services should get them, not only those who
can pay for them;
2. The quality of health services should be good enough to improve the health of those receiving services;
and
3. People should be protected against financial-risk, ensuring that the cost of using services does not put
people at risk of financial harm.

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full spectrum of essential, quality health services,
from health promotion to prevention, treatment, rehabilitation, and palliative care.
• For eye care this translates in Comprehensive Eye Care:
• Quality: apply international standards
• Timely: according to science
• Effective: demonstrated interventions
• Accessible: for each individual
• Sustainable: lasting the longer term

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HOW CAN THIS BE ROUTED IN
SIGHTFIRST?
• It requires a set compendium of criteria
to be satisfied: the SightFirst policies.
• The SF policies ensure that all projects presented for funding have
the basic requirement to provide quality care for people in need,
addressing the most urgent needs and securing to advance health
and well being of people we care for.
• All SF proposals presented for discussion in the SAC satisfy the
criteria set for in the SF Policies.

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Lions Involvement
• Lions must be involved in LCIF-funded projects
• Project planning/management
• Eye health education and awareness
• Promotion/events
• Patient transportation, outreach, etc.
• Monitoring and evaluation
• Grants applications must be endorsed by Lions Leaders
• Project funds managed by Lions
• Regional Technical Advisor assist with proposal revision and formulation

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SAC
Secretariat
SightFirst
Advisory
Committee
(SAC)
Technical
Advisors
GHI
Staff
GHI staff register
and review
applications, serve
as liaisons between
Lions and TAs, and
oversee approved
projects via reports
and monitoring visits
TAs serve as a
consultant to Lions
on the development
and implementation
of SightFirst projects
The Secretariat is
an eye care expert
based at the World
Health Organization
who reviews all
applications prior to
presentation at the
SAC meetings
Comprised of 8 eye
care experts, 5 Lion
leaders, and the LCI
and LCIF Executive
Administrators
Who’s Who

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Review
SightFirst
Policy
Papers
Perform a
needs
assessment
to identify
community
needs
Consult
project idea
with the TA
Complete
SF
application
and
supplement
ary
questionnair
es in
consultation
with TA
Obtain TA
signature
endorsemen
t
Obtain
Council
Chairperson
and District
Governor
signature
endorsemen
ts
Submit
application
to GHI staff
Receive
review letter
and revise
application
Presentation
to SAC
SightFirst Application Procedure
Upcoming review deadlines:
October 12, 2018
May 10, 2019

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Is SF fit for the future?
SF is an advanced, high quality, comprehensive global eye care programme
SF invests resources in research related to best practices for project
implementation. Regular evaluation, assessments, filed visits are the basis for
good practices in public health and eye care.
There is flexibility in SF for considering new and emerging practices, procedures,
disease trends and people’s needs
An ongoing program of revision of the existing policies allows for listening to Lions
requests and identify the best ways to deliver quality eye care
SF links in a global network of eye care professionals which ensures our practices
are updated, consistent with international standards, taking advantage of modern
science and prospective applications
SF needs to be better known within the Lions community and outside it.

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Protecting, restoring, improving vision and provide life skills with
vision rehab contributes to the progress of humanity, not only to
sight.
Education, economic development, employment, independence,
self determination are all contributed to by vision
Providing vision rehabilitation is critical for people who have lost
all or part of their sight to stay independent and conduct an
enjoyable life.
Good vision, quality eye care contribute to preventing depression
and anxiety, main causes of suicide; life skills protect vision
impaired adults from undergoing abuse and isolation.
Vision is essential for life, it needs education to its value,
protection, timely care and quality services.
Lions SightFirst values

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Thank you for your attention