Glaucoma - the African exception

Khaled Ben Amor,

The WGC Boston in July 2009 had 2666 attendees: 36 % from Europe, 35% from America and 25% from Asia. African attendance was not reported, because it was insignificant. Disappointingly, during the African Society of Glaucoma session only a handful people were present. All participants, even the few Africans ophthalmologists I met in Boston, were attracted by the parallel prestigious symposia from other, better recognized societies. On the other hand, Africa, with its 51 countries and over 700 million inhabitants, has probably the highest prevalence of glaucoma in the world, with an early onset/severe progression pattern. Most of blindness due to glaucoma is there. The number of ophthalmologists is very much less than needed, less than ten in all of the sub-Saharan countries. Needless to say, with so few ophthalmologists, glaucoma as a specialty has not really emerged.

The year 2010 is the mid-term of the worldwide and successful 2020 program of prevention of blindness. Although glaucoma is the second cause of blindness in the world and the first if we consider definitive blindness, it has been carefully (and wisely?) avoided by this 2020 initiative.

Year 2010 is also the 50^th anniversary of independence from colonization of at least 17 sub-Saharan African countries. This wave of decolonization brought a lot of hope in 1960 that has subsequently sometimes disappointed either by the fact of man or nature (climate, AIDS...). But still, several countries managed to do well by the end of this first half century of independence, and offer a reasonable environment of human resources and infrastructure to build upon for an efficient glaucoma care program. Several initiatives have started during the last decade initiated by local or regional societies and NGO's. But the challenge is huge! Delivering glaucoma education to African colleagues, adapting guidelines to the African social and economic reality, improving awareness of the glaucoma threat among governments and population, and helping to build a nucleus of local glaucoma centers of excellence to spread care, education and research is, in my opinion, a preferred approach. The WGA World Glaucoma Project Committee will initiate its first program in Ghana this year. But the African challenge will require the support of the large glaucoma community throughout the world. Who else should be more aware about the glaucoma burden in Africa? Can WGA be our U.N. organization without most African countries really represented? Shouldn't a continent that contributed to humanity from Lucy to Mandela deserve a 'Glaucoma Marshall Plan' for this second decade of the 21^st century?

Happy 2010!