August 2024
Guatemala Brillando - How We’ll Get This Done
Nearly 75% of people who are blind in Guatemala suffer from preventable or curable causes. There are an estimated 2 million people with vision loss. Of these, 94,000 people are blind.
In partnership with Visualiza, “Guatemala Brillando” or “Brighter Guatemala” is a firstof-its-kind plan to systematically eliminate avoidable blindness throughout Guatemala. We are positioned to achieve it in just 10 years and the blueprint can be scaled across the world. Within these 10 years, Guatemala Brillando is estimated to develop 30 Vision Centers (VC) and 5 eye hospitals across the country. Today, there are 10 Vision Centers and plans to open a new hospital in the Quiché region.
New Children’s Eyecare Program in India
Providing quality refraction services on a continued basis is a challenge as it requires a dedicated team and continuous monitoring and follow-up. This project aims to focus on the need for refractive error services for children in the Drishti Sehi Duniya area of India via Vision Centres (VCs) and the base hospital. The proposed project will strengthen VCs, and teams will be based at VCs.
On the day of examination at VCs, each child will undergo a complete eye check-up. A prescription will be provided, and children can choose trendy frames. The delivery date will be three days from the refraction. Annual follow-up visits ensure that children requiring a new or changed prescription are covered, giving all children regular opportunities for eye checks.
Estimated Outputs
Screening of 129,600 children
Coverage of over 700 schools
Orientation of 1,500+ school teachers
Training of 3,000+ Vision Ambassadors
Provision of 4,500 free or subsidized spectacles to children (estimated to meet the needs of
approximately 3.5% of screened children)
Performance of 75 surgeries
The Retinopathy of Prematurity (ROP) project employs a comprehensive approach to address the needs of premature infants in NICUs across Coochbihar, Darjeeling, and Jalpaiguri districts. Key components of the project include:
Utilization of ROP fundus cameras and telemedicine services in level 3 and level 2 NICUs.
Deployment of a trained technical team. Assessment of ROP severity and determination of necessary treatments.
Provision of laser therapy, injections, and vitrectomy treatments to infants diagnosed with severe ROP. Referral of identified cases to base hospitals for medical, surgical, and rehabilitative services.
Training of 350 nurses and pediatricians in local NICUs on ROP identification and management protocols.Organization of quarterly Continuing Medical Education (CME) sessions for local pediatricians, neonatal care specialists, and gynecologists to enhance awareness and expertise in early ROP detection and preventive care.
Estimated Outputs
Screen 5,800 babies for ROP
Provide laser, injection, and vitrectomy treatment to 327 babies
Train 350 nurses and pediatricians for ROP awareness
Accruals and Fiscal Year End
We processed several agreements/payments throughout May and June and submitted our accrual sheet to the finance team. Programs worked hard to end the year strong and on budget.
Conference Participation
Chundak, Heidi, Heidy, Katie, Kieran, and Suzanne represented Seva at IAPB’s 2030 Insight Live event convened in Mexico City at the end of June.
Kuldeep, Arun, Saikat, and Shradha all represented Seva at the VISION202 India Conference in July. Kuldeep also represented in his capacity as treasurer for Vision 2020 India. Njoki attended the Africa Ophthalmic Congree in Kigali, Rwanda from July 26-28.
Programs on the move
Many team members traveled together in May. Katie, Claudia, Jennifer visited Sacred Circle in Utah. Njoki and Heidi visited KCCO in Tanzania. Heidi, Kuldeep and Ravindra traveled to Cambodia to assist with the Seva Cambodia office move in June. Parami, Rolando, and Giri also spent time in Cambodia at the end of July onboarding new staff and setting up the office. Heidi spent July with the Visualiza team in Guatemala. Njoki spent a week with current and potential partners in Malawi. Kuldeep and Shradha visited a number of partners across India.
Training
Arun launched the Eyexcel Advanced Workshop at SNC, Chitrakoot in June. The following month, he held the Management Development Program at HV Desai in Pune. He also represented Seva at the first Eyexcel Global Workshop under the Dr. Suzanne Gilbert Training Academy which was completed on July 25th.
New Seva Cambodia office in Phnom Penh
Seva Cambodia opened its new office in Capital City Phnom Penh. Previously, they were based in the Battambang Province. The Phnom Penh office will allow the team to better represent the work that is happening with our Ministry of Health partners. It is also more centrally located to our program work, which have expanded beyond the northwest part of the Cambodia. We are now positioned to do more networking and work closely with the government and other healthcare organizations, as well as organizations working in other sectors. This will further strengthen program capacities.
June 2024
Budget Budget Budget
From January – April, the program team spent time reviewing their work and preparing the budget for fiscal year 24-25. This year, the team incorporated budget descriptions to bring greater context as to why we are proposing these activities/projects.
Lights, Pristine 5.0 Camera, Action!
After months of development and testing, the Pristine 5.0 camera was finally ready to be placed! Arun, Dr. Radhika, Katie, and Pranav (from Aurolab) worked to install the camera at SCEH in India and Visualiza in Guatemala.
India partner meeting
Kuldeep, Saikat, and Shradha organized an in-person partner meet for a few India-based partners. Twenty-four hospitals were represented by 58 ophthalmologists and senior staff members from 12 states. LVPEI hosted this meeting April 11-13 in Bhubaneswar, Odisha. The primary objectives were to foster collaboration among Seva's partner hospitals, facilitate knowledge exchange, and strengthen strategic planning for enhanced eye care services.
Updates from Cambodia
Seva provided replacement of cataract instruments to Battambang, Banteay Meanchey, Pursat, Kampot eye units, Siem Reap Regional Eye Hospital and Takeo Eye Hospital.
Supported to have Reverse Osmosis (RO) Water System in Banteay Meanchey and Pursat eye units, Angkor Hospital for Children, and Caritas-Takeo Eye Hospital for quality improvement in eye care.
Printed and provided medical emergency posters with frames to partner eye units/hospitals (Battambang, Banteay Meanchey, Pursat and Kampot eye units, Siem Reap Regional Eye Hospital and Takeo Eye Hospital). These posters will be helpful for staff to follow the procedures in case of emergency.
Programs Operations Team met at the Seva office in June + more updates
Seva brought the Program Ops team to Berkeley in June to meet for the first time since 2019. They focused on program planning for the coming fiscal year
Lavelle Fund for the Blind awarded Seva $1M to establish a Regional Training Center in support of Guatemala Brillando
Katie McMillan began working with Seva as the Technical Product Manager. She will take a lead role propelling our technology driver forward
IAPB organized its annual meeting in Singapore. Arun, Brad, Chundak, Jerry, and Suzanne presented Seva's work at various sessions
Seva co-sponsors International Agency for the Prevention of Blindness 2030
InSight Live Singapore
Seva had a strong presence at this in-person and virtual meeting convened during June 25 and 26 at the Singapore Eye Research Institute. In person talks were given by Seva consultant Dr. Jerry Vincent on fragile communities “From Crisis to Action” (with focus on Rohingya community) with commentary by Chundak Tenzing and Suzanne Gilbert on Technology for Access to Services (presented on the Vistaro IR retinal camera). Virtual presentations were given by Seva’s Arun Acharya and Dhivya Ramasamy to the IAPB Human Resources group and by Radhika Krishnan to the Diabetes Retinopathy working group, and by Consultant Brad Wong during a session on eye care financing. The newly formed Indigenous Peoples Special Interest Group met in Singapore with Seva’s Jennifer Leo joining virtually. The meeting was attending by 350 participants from over 40 countries.
Suzanne and Chundak note the value of getting to connect with representatives from more than a dozen Seva partner institutions while catching up in general on what is happening with WHO, Ministries of Health, and other eye care NGOs.
Updates from Nepal
This year’s target was to reach 3250 volunteers. Our partners have been successful in reaching 3605 Femal Community Health Volunteers, teachers and mothers’ groups. This last quarter alone, partners reached 2622 volunteers. 4 Vision Centers became operational this quarter.
Updates from India on training
April: 37 Dr and AOPs (9 Women) from 10 Hospitals (India and Nepal) completed 5-day Eyexcel to help trainers train young trainees who deliver quality eye care services in underserved communities
May: 68 Dr, Admin and AOPs (25 Women) from 14 Hospitals in Nepal completed Eyexcel, Quality and Management Development workshop to deliver high-quality eye care in Seva partner hospitals
June: 35 Dr, Admin, AOPs (13 Women) from 12 Hospitals across India, Nepal and Cambodia completed the Observe-Understand-Change Workshop to improve Quality and Safety systems
Observe, Understand, and Change
Observe, Understand, and Change is a training program conducted twice a year, sponsored by Seva Foundation in partnership with Zamindar Microsurgical Eye Center, Bangalore, India. In June 2023, the third batch of participants (about 40) from three countries (India, Nepal and Cambodia) observed the standard operating procedures implemented at the center, followed by a group discussion. Participants then shared the current practices at their respective centers and presented the desired changes for improvement to maintain minimum standards for patient safety. The following video clip shows the program.
Financing 2 Eye Care Articles
Given there is limited high-quality data for global economic estimates in eye health, particularly for low-income and middle-income countries (LMICs), two years ago Seva started an initiative to bring the spotlight on the ‘cost of community and primary care in the eye health’ and ‘The economic and social costs of visual impairment and blindness’ with the aim to generate the firsthand evidence. As an outcome of these efforts led by Seva, two separate studies have been published by leading peer-reviewed journals.
- ‘The economic and social costs of visual impairment and blindness in India’ published by the Indian Journal of Ophthalmology
- ‘Strategies for cataract and uncorrected refractive error case finding in India: Costs and cost- effectiveness at scale’ published by The Lancet Regional Health - Southeast Asia – This is one of its kind study (in terms of scale and geography) to highlight the evidence on major eye health interventions championed by leading Seva partners (including Vision centers, School eye screening, eye camps, and door-to-door screening.)
Quality Workshop News
A workshop titled “Quality- Journey towards Patient Centric Care” was organized by Seva Quality Team. 34 participants representing all parts of Nepal received refresher training. These participants included Quality Champions from Seva and non-Seva partners. The workshop reviewed the existing quality initiatives, discussed the good practices, and drew a roadmap and action plans to ensure quality emphasizing on people-centered eye care in Nepal. We’re excited to have additional workshops lined up for December and January in India for hospitals across the Asia region.
Seva Foundation received 4 National Awards
Seva Foundation received 4 national awards from the Government of Cambodia, signed by the King and the Prime Minister. These Awards were conferred in recognition to Seva’s contributions in Eye-Care Services since 1999. It also recognized Seva’s special contributions in recently promulgated National Strategic Plan for Blindness Prevention and Control (NSP-BPC 2021-2030) and the Provincial Roadmap on Blindness Prevention and Control 2021-2030.
Vistaro Camera: The Camera that Saves Lives
Vistaro image quality compared favorably vs more expensive high end cameras.
Seva-Remidio team visit to Mozambique reinforced training on use of Vistaro and update on HIV and eye conditions.
Staff of YRG Care Center in Chennai were training in vision testing to enable adding visual acuity to patient monitoring.
Using evidence for program improvement
Seva published a Case Study on the Operations Research program and an article on small scale research in the Community Eye Health Journal. Three of the four Seva research teams published their project results or had their paper accepted. Conducted a survey of GSI mentors and selected other mature institutions to determine priority issues on use of routine administrative data. Seva's Introduction to Evidence Informed Practice course design & materials were completed. Strong interest by WHO and International Agency for the Prevention of Blindness in promoting the Seva course
Eyeglasses for Everyone
Seva joins Aurolab for strategic planning on affordable, quality eyeglass lenses
Aurolab inaugurated its Optical division, thus underscoring the commitment to quality, affordable eyeglasses. David Green and Suzanne Gilbert conducted a learning saloon on Opticals with the Board. Seva consultant reports are contributing to business planning and selection of manufacturing technologies. With Seva involvement, Aurolab has hired additional staff to head up Opticals sales & marketing. WHO and major global eyeglass providers are following this Opticals project with interest.
Data, anyone?
After two years of virtual research skill learning, Seva partners finally got to have an in-person data analysis workshop at Seva partner India Institute of Public Health - Hyderabad. The two week training built upon multiple online workshops and preparatory use of the Stata software so teams arrived ready to work. Research teams from Nepal and India are using the newfound skills to analyze results of their randomized control studies to improve service delivery. Services for kids, Vision Center patients, and people with Diabetes will be improved as a result.
Quick update on operations over the last quarter
More than 60 participants from 7 hospitals across Latin America gathered for EYExcel LA, a workshop designed for trainers to improve their training methods and results.
Through collaboration with Standard Chartered Bank, Seva and partners are establishing 65 new vision centers with partners in India. So far, 8 VCs started operating through this initiative.
As a result of our Call for Ideas, Seva began working with two new partners to bring eye care to Native Communities. The Minnesota Vision Health Task Force, created to build a comprehensive system of eye care in Minnesota, and to support and sustain capacity building for eye health within Native communities. This is a partnership of local health, education, and non-profit organizations aiming to prevent vision loss and blindness by aligning strategies that create equitable access to vision health care across Minnesota. Through a partnership with Seva, this program is focused on providing eye screenings care to Native school children within the state of Minnesota. The Tundra Health Initiative provides access to eyecare in rural villages in western Alaska. This involves making trips, by air, to communities scattered throughout the region. During trips, vision screenings and services are provided. With support from Seva Foundation, Tundra is working in increase access to eyecare for remote communities Native communities in the areas around Nome, Alaska.
Domestic travel started up again this quarter with international travel starting up in July. We're excited to combine virtual meetings and discussions with some in-person consultations and exposure visits for staff and partners.
Vistaro Camera
Seva's Vistaro retinal camera went into high gear testing this past quarter with devices in use in Thailand, India, Ukraine (yes, Ukraine!!) and most recently, Mozambique. This second version of the camera already offers ease of focus and other functionality that improves over the original model. Remember, this device is designed for use frontline HIV workers who have never done an eye exam. Inputs from HIV clinics and eye departments inform Remidio Technology's design of version 3, to come out early 2023 for wider testing and examination data collection. Pleased to note that the large HIV center Seva is partnering with in Chennai requested eye exams for its very special patients: children who as babies contracted HIV from their mothers. Our friends at Aravind Eye Hospital, Chennai sent a team to examine 80 people including kids and their caregivers, with arrangements for follow up care at the eye hospital. For many of the children, this was their first eye exam.
Organizational Development Training
An organizational development training program for SCEH (Dr. Shroff’s Charity Eye Hospital, New Delhi, India) was developed by Arun Acharya (Global Training Specialist, Seva Foundation) after consulting with their top management, HODs and Administrators.
This program was needed to fill the gap in the number of skilled management personnel who could lead quality and process improvement projects. The purpose was to train their high potential employees such that SCEH becomes a Centre of Learning and Excellence in terms of high-quality patient-centered eye care.
This initiative is part of the GSI as a global platform initiative and fuels one of Seva’s core drivers I.e., “Training and Job creation”
“What is the Quality of the Surgery Being Performed?”
Seva’s Response to COVID-19, SOP Starter Kit
The COVID-19 SOP Starter Kit was developed by dedicated Nepali medical and paramedical personnel under the leadership of Dr. Samina Zamindar. This Starter Kit focused on outpatient care at the beginning of COVID-19, providing the eye hospitals with the groundwork in COVID preparedness, so our partner hospitals could easily adapt these SOPs into their own hospital operations. As the authors’ hospitals test and further refine these SOPs based on real-life applications, Seva will update and republish them accordingly.
Safety and Quality
The agreement with Medical Council members have been signed and finalized. Some of the members have started the mini grant project activities. Interested team members from N. India have been registered to participate at Dr. Zamindar eye center, Bangalore, in two days of Quality related workshop followed by three days of observation as per the requirement of the attending trainee.
Three Bucket System — Community Eye Health Journal
The article from The Community Eye Health Journal is supported by the Conrad Hilton Foundation, Sightsavers, CBM, Orbis, The Fred Hollows Foundation, Tijssen Foundation, Seva Foundation, BHVI and the International Trachoma Initiative.
The Community Eye Health Journal (international edition) is a quarterly publication sent free to over 22,000 health care providers worldwide, mainly in low and middle-income countries. The aim of the journal is to ensure that up‐to‐date and relevant information reaches eye care workers of all levels in the countries where the burden of eye disease and blindness is greatest. Journal readers often have little access to other sources of information. Our peer-reviewed articles are written by experts in the field and combine clinical issues with public health approaches, such as research, planning, management, training, technology, sustainability and advocacy.
All Call Thursday’s But Monday Workflows
Each week I sponsor what is called the ALL CALL. Recently, the Program team shared their new information management platform with the rest of the Seva team. If you want a 'peek' behind our management cupboard enjoy this insight into a portion of our weekly ALL CALL session!
Africa Landscape Analysis
Seva has been working in Africa since 2001. We started first in Tanzania through our partnership with KCCO in 2001. As we consider the vast eye care needs in the region, we recognized that there was more work than one partner alone could achieve. When we began working in India, we worked with Aravind. But in order to have the intended impact we needed to have to achieve our mission, we built our network of committed partners. Now we are fortunate to work with a diverse network of more than 50 partner clinics in India. That approach has happened in all of the regions we work in.
Given the vast needs across the continent and to achieve our mission, we want to build upon the work that is already happening. We are starting with people and partners we know as we look to diversify. At this time, we are not looking to expand into new countries but rather leverage and deepen our commitment in countries where we are already working, specifically those in eastern Africa. Allowing us to strengthen our overall investment. We are focusing on locally-led, clinical health providers.
Specifically we:
Added a new partner hospital in Tanzania last year supported by Kilimanjaro Centre for Community Ophthalmology (KCCO) and in coordination with the Ministry of Health
Decided to sunset our work in Benin by end of 2023
Are finalizing a new two-year agreement with KCCO
Began working with Centre Tertiaire de Sante Oculaire De L'enfantin Burundi, the local organization that Dr. Levy established
Beyond these initial steps, our work has been in stasis as we prioritized staffing for the Implementation team (successfully recruited three positions, including one new position to manage our work in Latin America) and are focused on realizing our bold solution for the Latin American region. We also decided not to make new major investments in the African region while travel and in-person consultations have been stopped or limited due to the ongoing COVID-19 pandemic.
During the coming fiscal year, Seva is positioned to refocus on this region. The Africa Landscape analysis Seva commissioned last year, will be used as a reference for undertaking this work.
IAPB’s Eye Health Hero and Future Leader, Kuldeep Singh!
Introduced at the 9th General Assembly in 2012, the Eye Health Hero program is a recognition of front-line staff whose work in the field and engagement in the community makes a real difference in aiding vision and restoring sight all around the globe.
Each hero is named by an IAPB member organization or their partners to recognize those exemplary workers whose efforts are seldom in the limelight. They are the change-makers, innovators, and emerging leaders from all areas and backgrounds in eye health. Eye Health Heroes are managers, community workers, health professionals, or government officials, those working in clinical, hospital, research, INGO/NGO, business, and public policy settings their efforts and stories deserve to be shared.
Seva’s Four Drivers: Vision Centers, Children, Technology, Training & Job Creation
Spotlight on Training!
Seva staff celebrated the final ceremony for an Organization Development Program for Dr. Shroff's Charity Eye Hospital, Delhi in January 2022. Purpose: To build in house workforce capabilities in Eye Care Management focussing on 5 key themes that are aligned to SCEH Values:
Effective Interpersonal Communication Skills
Quality Consciousness (Customer-Focus)
Planning and Prioritizing, Organizing Skills
Implementation, Initiatives, and Challenges
Analytical Skills
The end outcome was to upskill participants as future master practitioners and trainers and thus build the SCEH workforce in delivering High-Quality Eye Care.
Participants: 18 senior eye care workers (2 Females, 16 Males); (Optoms, Nurse, Administrators, Eye Bank Manager, Quality Lead, Stores in charge, Finance Managers, HR, Outreach program manager, etc.). Also, indirectly their department heads (Clinicians, GMs, Assoc. Director, Optometry, and Exec Director) were involved in SMART goal settings, Feedback, and project planning and delivery.
Duration: ~18 months (Planned for 12 months - delays due to covid). 2-4 hours per week, ~150 professional development hours per participant.
Methodology: A blended online workshop that included
Social learning - Peer to peer in small groups
Didactic learning - Instructor-led training by Arun Acharya
Project-based learning - by solving real-world problems using SMART goals.
Outcome: An Executive Summary Report will follow in Feb 2022 (watch this space!) In the interim, I am elated to inform you that this program has led to the creation of a series of training assets (Slides, Videos, Action Learning Projects, and Mind Maps) that will form the foundation of a competency framework for future eye care workforce development across Seva GSI Partner Network
Arun Kumar Acharya
Global Training Specialist | Seva Foundation
April 2022
Seva Wins Kristof’s Holiday Impact Grand Prize!
“It feels miraculous to watch people regain their sight, but it's a miracle that we can all make happen. Seva Foundation, the Grand Prize Winner of this year’s Holiday Impact Prize, is transforming people’s lives for as little as $50 per cataract surgery. Seva works in more than 20 countries abroad and in Native American communities in the United States, and nothing is more joyous than seeing the impact of its work on people who had thought they would never see again.”
— Nicholas Kristof
The Life You Can Save - The Votes are In!
Renowned philanthropist Peter Singer gave away $100,000 to three of The Life You Can Save's recommended charities based on a public vote and after thousands of votes were cast, we are pleased to announce Seva was one of the three charities that received the most votes: Here are all the recipients.
Fistula Foundation, a global leader in treating obstetric fistula — a devastating childbirth injury that leaves women incontinent, humiliated and often shunned by their communities — received the most votes and will receive US$50,000.
The Seva Foundation, a global nonprofit eye care organization that transforms lives and strengthens communities by restoring sight and preventing blindness, came second and will receive US$30,000.
GiveDirectly — a nonprofit that provides unconditional cash transfers using cell phone technology to some of the world’s poorest people, as well as refugees, urban youth and disaster victims — was third and will receive US$20,000.
April 2022
Seva Foundation Vision Report - Part I of a four-part report
Seva is committed to ending avoidable blindness in our lifetime. This is the first of several reports that take a deep dive into the economic burden of blindness and its negative impact on one of the world’s largest economies. By the end of 2021, we will release the solutions - what will it cost to provide the bold solutions required to secure sight for all.
Seva Foundation Commitment to Gender Equity
Gender equity is a long-standing priority for Seva Foundation, an organization co-founded and currently managed by women. Over the past forty years, we have intentionally sought to understand how and why women throughout the developing world struggle to get quality care. Our Vision Centers—located in impoverished and often remote areas of the developing world—integrate gender-informed practices that ensure women and girls can access vision care, despite formidable barriers. We also train and employ local residents as eye health professionals, contributing to the economic empowerment of this workforce, which is predominantly female. Working in more than 20 countries to increase the efficiency of local hospitals and develop sustainable eye care programs, Seva also promotes the career advancement of women, from paraprofessionals to ophthalmologists. As we emerge from the pandemic, we intend to honor the strengths and innovations of our in-country partners by expanding the double use of our Vision Centers as centers for pandemic relief—distributing food and vaccines—as well as for eye care.
An Investment Program Consistent with Our Values
Seva’s board had long aspired to reflect the values of the organization in its investment portfolio through social screening, not holding the stock of companies deemed objectionable (e.g., fossil fuel, tobacco, etc.). Unfortunately, given our size, a cost-effective socially screened option was not available, and the board decided to invest Seva’s assets in a low-cost passively managed target-risk fund. The purely passive implementation kept costs low but meant that Seva could not eliminate certain objectionable securities from its portfolio holdings.
In 2018, Seva received a sizable bequest which increased its investible assets meaningfully, although the portfolio is still small by institutional investment standards. At the request of Dr. T. Stephen Jones, Seva co-founder, honorary lifetime board member, and fossil fuel divestment advocate, a search was again conducted to identify an option that would allow for screening. This time though, another option was identified. Rhumbline Advisers (“Rhumbline”), a Boston-based investment firm, offered to create a custom strategy that substantively mimicked the risk profile of Seva’s existing investment program but would allow for social screening. The customized strategy consists of three accounts to be held at a custodian bank: a US equity separate account, a non-US equity separate account, and a US fixed income strategy. The two equity accounts are socially screened. The fixed income strategy is invested in an Exchange Traded Fund and is not socially screened. Rhumbline has the authority to rebalance among the asset classes in accordance with guidelines determined by Seva’s board.
Seva’s board elected to eliminate the producers and manufacturers of fossil fuels, tobacco, guns and ammunition, and prisons from its investment portfolio. Although the implementation of this strategy is more complex than buying and selling a mutual fund, our investment costs have not increased. The new investment program has been in place for nearly a year now, and we are pleased to report that the strategy is performing very much in line with expectations. The board is delighted that the organization’s values are now a part of the investment program!
Lisa Laird
Lisa M. Laird, CFA, is an institutional investor and Seva board member. Previously, Lisa was the Chief Investment Officer of Providence St. Joseph Health and a Towers Watson consultant.
Lancet Report is Official on February 16, 2021
The full Lancet report is embargoed until February 16, 2021. Given Seva Foundation’s role in the development and support of the report we are able to participate in the advance promotion and formal press release. For your early reference, the IAPB link below gives a comprehensive, and somewhat chilling overview and findings of the new study - bottom line: targets for avoidable blindness are not being met. Read more here IAPB link to an at-a-glance overview of findings
February 2021
Members of the Seva Foundation Board
Seva Foundation has an invitation to the IAPB Vision Atlas launch on 24 February.
We are delighted that this powerful tool for advocacy and knowledge-sharing will now be online with key data from the Vision Loss Expert Group (VLEG) and, in a week, the Lancet Global Commission on Eye Health. We believe the Vision Atlas is a benefit; bringing together the latest high-quality data and insights on vision loss into a single platform. It is an interactive tool that will help us present our case to policy-makers, use accurate data-points for training, fund-raising, or any critical aspect of our work. With this in mind, we would like to share top-level data that will be going live on 24th February. This information has been shared with the Communications team here at the Foundation and we will be actively promoting and sharing this information. Please note, these points are under embargo until 24 February.
Key Stats:
90% of vision loss is preventable or treatable (this used to be 75%)
55% of people with vision loss are women and girls
73% of people with vision loss are over 50 years old
1.1 billion are living with vision loss around the world. This number could increase to 1.7 billion people by 2050 without significant investments.
On 17 February, the Lancet Global Commission on Eye Health will be publishing their papers, which will give us a wealth of data and evidence. Two new top-level statistics that we will be highlighting at the launch will be on:
The relationship between vision loss and mortality
The global cost of vision loss
These numbers and other Commission data will be part of the IAPB Vision Atlas on the 24th of February. You can access the site here: https://atlas.iapb.org
Key ask:
Please strictly enforce the embargo – 24 February 2021
February 2021
Seva Foundation Launches our Global Medical Director’s Council
Like most industries the field of ophthalmology is rapidly changing with new surgical techniques and technology (e.g telemedicine and AI), Seva has assembled the best local practicing ophthalmologists and optometrists in our newly minted Medical Director’s council. Meeting four times a year to assist Seva Foundation Senior Program Staff as we evaluate our efforts, and prepare for the budgets to come.
What & Who: An elite invitation-only, membership extended to practicing Ophthalmologists, Optometrists, and the newly minted Seva Foundation Global Fellow (read more on this below!) will give advice and support to the Seva Foundation program and leadership team.
The council has members from every region and will report to the Seva Foundation Global Medical Director - Dr. Chundak Tenzing and the Executive Director. Senior Program staff has access to this council for purposes of evaluating new directions, innovations, and otherwise novel interventions in communities where Seva Foundation GSI networks have programming.
February 2021
Budget Update: AIDS Camera that Saves Lives
In June 2020 the board of trustees approved a $300,000 budget to explore the supporting Seva Foundation’s AIDS Eye Initiative with a camera that could help detect CMV-retinitis as well as TB.
Why examine the eye to find CMV & TB?
Seva’s 30 AIDS EYE INITIATIVE workshops in 8 countries have revealed the importance of examining the eye. AIDS-related CMV retinitis is a common clinical problem in patients with advanced HIV/AIDS in resource-limited settings, which includes most HIV/AIDS clinics in Asia, sub-Saharan Africa, and Eastern Europe. The disease causes >90% of AIDS-related blindness and contributes to mortality. In most settings, the disease is neglected, with delayed diagnosis and poor outcomes because diagnostic capacity is inadequate; timely access to specialty care (ophthalmologist) is typically not available. The solution is transfer of skills to the point of care, to the HIV clinician. This strategy increases detection of CMV retinitis approximately tenfold; diagnosis is achieved within days of first entering medical care, permitting early treatment and better outcomes. Importantly, this same eye examination can detect TB in the eye, thus permitting early immediate treatment.
Why is a camera needed?
A fundus camera looks at the back of the eye (similar to looking at the inside of a ball) through a small hole (the eye pupil). Most fundus cameras have narrow vision and can only see the central part of the back of the eye. That view is all that is needed for macular degeneration, diabetic retinopathy, and glaucoma. However, signs of CMV and TB appear well away from the center. A fundus camera that can see them is a much greater technical challenge. It is this wide field of vision that our AIDS program requires.
In July 2020, Seva engaged two innovative for-profit organizations to address this challenge.
February 2021
The Camera that Saves Lives Second Path with IrisVision
Iris Vision is a respected Silicon Valley-based company with an award-winning virtual reality head-mounted low vision assistive device and plans to build a suite of diagnostic devices including a fundus camera. Although Iris Vision fundus camera development was originally conceptualized as focusing on the US market, the company was intrigued by the opportunity to meet Seva’s HIV/AIDS camera specifications and serve an unmet need. In addition to meeting Seva’s specs, IrisVision’s camera would be designed to not require the patient’s eye to be dilated for the examination.
February 2021
Update on Seva HIV/AIDS Camera Development with Remidio.com
Remidio is an Indian-based award-winning for-profit with a proven track record of adapting expensive medical equipment, including fundus cameras, at an affordable price and publishing results in the toe-to-toe comparisons with Zeiss and other high-end fundus cameras. In keeping with the specifications from Seva, the Remidio HIV camera would require that the patient’s eyes be dilated. Remidio did its own proof of concept engineering and shared sample fundus images before agreeing to the project with Seva. Since then, the Remidio camera has completed its Alpha prototype phase and is into Beta prototype validation in HIV settings.
February 2021
Professor Kanaan
Nanotechnology isn’t just for the science fiction books - Seva Foundation partnership with Professor Kannan.
Nanotechnology-based drugs can provide an essential platform for sustaining, releasing, and a specific targeting design to treat retinal diseases
Presentation: “Targeted systemic nanomedicines for age-related macular degeneration, diabetic retinopathy and beyond - from basic science towards clinical translation” -- Prof Kannan
In the Fall Seva Sr. Director for Research, Suzanne Gilbert along with David Green and Kate Moynihan set up a special presentation with the renowned Professor Kannan to further explore the benefits of Seva joining in exploration along with Ashvattha and Aurolab.
As you listen to the link provided, enjoy the areas where we feel Seva inputs can effectively and radically improve access to otherwise unattainable therapies. Note to board readers, Seva investment/risk would be made only when the product is found to be viable.
What makes this so extraordinary? Below are excerpts from David Green’s Oct 20 email which highlighted the extent to which Ashvattha is on a promising trajectory, however without Seva intervention and the Aurolab tie in they would not have a way to serve the LMIC market:
1) Ashvattha via their animal studies has already accomplished a very robust proof of concept for a treatment that will be groundbreaking and state-of-the-art when it hits the market. It will not only be a subcutaneous injection by the patient in their home, but it will be more effective than any other treatment for DR and AMD on the market today.
2) It’s a great opportunity for Seva to be in on it from the start and to help formulate how a company can, from its inception, have a bifurcated approach to the market where it is able to price the product affordably via a virtuous network for the developing world.
3) I’ve been working with Kannan and Sujatha to help them make the case to their team, board, and shareholders on an approach to address needs in the developing world in ways that do not jeopardize but enhance the company's overall financial position. In the process of those discussions, I have shared with Kannan a lot about how we have developed both manufacturing and service delivery models that address needs for lower-income populations.
4) I am working with Kannan and the Aurolab folks to preliminarily define development steps, regulatory pathway, and timing; and how Aurolab, Aravind, and other Indian partners can be of assistance for clinical trials, product launch, and training.
Enjoy the presentation (click on the bottom left image) at your convenience - for the board only do not forward or share outside the Seva Foundation.
February 2021
Fellowship in Global Ophthalmology
The Fellowship in Global Ophthalmology, a collaboration of CPMC Department of Ophthalmology, Pacific Vision Eye Institute, Seva Foundation in conjunction with Aravind Eye Care System.
The Opportunity: A “pilot Fellowship”, with an excellent candidate already identified to run, 1 April 2021 – 1 July 2022
What is the Fellowship in Global Ophthalmology? Over the past 3 decades, there has been a steadily increasing interest in Global Ophthalmology. Five academic departments of Ophthalmology in the USA (Wills, Salt Lake City / Moran Eye Institute, Stanford, Emory, Chicago), have already established Global Ophthalmology Fellowships, which are primarily aimed at additional grooming for an academic career. Seva and PVF have participated in several planning sessions with directors of the other Fellowship programs and formative discussions with AAO and the Association of University Professors of Ophthalmology. Our Fellowship is similarly designed to take an individual who has already been fully trained in Ophthalmology as practiced in the United States. This will be a doctor who intends to spend a substantial part of their career working to prevent blindness in resource-limited settings.
Our Fellowship will provide experience and granular understanding of how ophthalmology cares (or fails to care) for the world’s 3 billion people with the least economic, social, and political resources. The trainee will learn what innovative techniques have already come forward and what is needed; what bottlenecks are most problematic, and what social, medical, and political issues need to be understood and/or overcome.
Why is this Fellowship unique? This is the first and only Fellowship in Global Ophthalmology to have the advancement of Humanitarian goals as the specific training priority. In the field of medicine we tend to assume that among medical activities in resource-limited settings, Academic work and Humanitarian work are the same things. In fact, they are complementary. Yet, the humanitarian community eye health is rarely an explicit focus. Academic work directly improves our body of knowledge. Humanitarian work directly improves a person’s life.
What is the goal of this Fellowship? This Fellowship is designed to develop leaders in Global Ophthalmology who will give an insistent voice to Humanitarian priorities. What resources make this Fellowship unique and positioned to succeed? The Fellowship will succeed because of the people who are involved and will provide leadership; the personal relationships that have been developed over the past 40 years with the most vibrant and innovative eye hospitals worldwide; the extensive partnerships that have been developed with major Eye Care NGOs (Non-governmental organizations); the academic strengths of the department of Ophthalmology at CPMC and substantial legacy and global partner network of the Seva Foundation; and finally, the close working relationships with the leading humanitarian international institutions concerned with the prevention of blindness (World Health Organization, International Agency for the Prevention of Blindness).
February 2021
UPDATE: Angel Funding Approved by the Board June 2020. Criteria Approved by the Board November 2020.
We have worked through and with our partners against the board-approved criteria in three areas of PPE / Safety, Vision Centers, and Innovation.
PPE & Safety
The team is in the process of issuing out $133,745 in PPE and safety funding requests received to date (to be completed by the end of February). Investments include:
Protective equipment for at least 15 partners in Asia, Africa, Latin America, and the US
Vaccination roll out support for partners in Nepal
$150,745 earmarked for PPE & Safety
Vision Centers
Also, we are in the process of moving forward to fund 17 vision centers. ($541,000) in Asia and Latin America. We have additional funds set aside to ensure no existing Seva-supported vision centers need to close due to lack of funds during this cash critical time ($100k).
$641,000 earmarked from the Angel Fund for Vision Centers.
Innovation
With the other two criteria funding first, we have a balance of approximately $200k that can be applied toward the Innovation Criteria. We will have a specific innovation investment plan by March 2021.
$200,000 earmarked for Innovation
Note: $9,000 is set aside to address emerging or additional PPE, Safety, and Vision Center need should they arise.
February 2021
Seva Foundation & Johns Hopkins Partnership
GIVE Proposal and Thought Leadership
Great news! Seva’s GIVE partnership was accepted into the I-Corps program. What is this you may ask? I-Corp is a program that uses experiential education to help researchers gain valuable insight into entrepreneurship, starting a business, or industry requirements and challenges. Our acceptance allows Seva to conduct a deeper dive into considerations (clinical value proposition, training, the burden of evidence, adoption, workflow, cost, etc) relevant to enabling broad adoption of the GIVE (Johns Hopkins) disposable cataract surgery technology in low resource settings. Dr. Tenzing is a technical advisor and is reaching out to prominent partners such as Dr. Mariano Yee and others to help test this device and provide feedback to the focus group. Dr. Chundak will host a learning saloon on this topic once the program is finished and we have preliminary findings to report.
February 2021
Seva Foundations GSI Tech Call for Ideas! The press release October 2020
June 2020 Seva Board of Trustees approved a budget to explore innovation in technology.
The Program Staff of the Seva Foundation is proud to announce the winners of its 2020 Call For Ideas to identify innovative technology-based solutions to improve eye care delivery. The Berkeley-based vision care humanitarian organization has committed up to $250k to spark innovation in technology to transform lives by restoring sight. This year’s winners are as follows:
● Aravind Eye Care System, India. Aravind, along with Oregon Health & Science University, USA, seeks to develop artificial intelligence assisted Retinopathy of Prematurity (ROP) screenings on multiple lower-cost camera systems so that other health systems can implement AI-assisted telemedicine with minimal capital investment.
● Dr. Shroff’s Charity Eye Hospital, India. Dr. Shroff’s aims to upgrade existing software to be cloud-based, allowing for remote monitoring of clinical quality and referral from Vision Centers to hospitals.
● LV Prasad Eye Institute, India. LVPEI and the Global Alliance for Medical Innovation, Harvard University, is developing a smartphone-based system to diagnose corneal disease, prescribe treatment, and help prevent it in some patients.
● University of Washington, Bothell, USA. UW Bothell is developing the NeuroOptometric (N-OD) Toolbox, a cloud-based package of software that provides secure and effective training helps coordinate electronic medical records, facilitates collaboration between eye clinics, and allows for remote treatment interventions. UW Bothell will make the N-OD Toolbox available to other clinics once it has developed server and support infrastructure.
● Visualiza Clínica de Ojos, Guatemala. Visualiza seeks to integrate its telemedicine services with an app. The project will send images taken at Vision Centers and school screenings to the main hospital for diagnoses and treatment prescriptions. The app will also provide information, process payment, remind patients about appointments, and help them manage chronic eye diseases.
Globally, at least 2.2 billion people have a vision impairment, and of these, 1 billion people have a vision impairment that could have been prevented or has yet to be addressed. “For over four decades, Seva has invested in and used cutting edge technology to deliver world-class care for people in need,” says Kate Moynihan, Executive Director of Seva Foundation. “Through our Global Sight Network, these innovations will help us to extend our reach further and transform more lives than ever before.”
February 2021
Seva's Key Impact Measurement Dashboard—Is Finally Here!
You can find access to the dashboard at the top navigation of the ED Blog. Please join me in a walkthrough of the dashboard before our budget meeting. There are two times to accommodate Board members from Boston to Madurai. Pencil me in on May 10, at 7:00 AM or a second virtual tour at 7:30 PM for those of you outside a USA zip code.
Click here for the 7 AM morning session.
Click here for the 7:30 PM evening session.
COVID-19 “Grab ‘n’ Go Reading List”
What’s the staff reading to keep on top of the shifting advice about this virus, you might ask? These are some of our top picks. During my weekly Program meeting, we update this listing and plan to have a curated list of must-read links available to our partners and staff on our website. For now, here are a few of my favorites:
Bipartisan US Public Health leaders open letter to Congress
Dr. Larry Brilliant is the third signatory of the 15 leaders!! Step by step detail on what the US Govt needs to do.
Aravind DIY hand sanitizer dispenser step by step video.
Using PVC pipe and solvent, any hospital can create a safe hand sanitizer station. No wiring, no water, no fuss. It can be placed anywhere. What innovation!
Thank Goodness for LARRY LARRY LARRY!
He's terrific, and we like to brag to anyone who will listen, he is our founder!
Our very own founder and resident pandemic specialist is now the nation's go-to person for COVID-19. I've collected some of his most exciting and riveting interviews of late, enjoy!
TIME interview with Dr. Larry Brilliant - Taped April 23, 2020. This segment immediately followed the TIME interview with Dr. Anthony Fauci.
Larry's convo with Chris Anderson - Taped April 24, 2020. Shared by me to the board via email on the same day. This is a 15 minute conversation with TED curator Chris Anderson on 15 years since Larry's TED Prize to end pandemics & NOW.
Speaking of Just Now, this morning Larry agreed to do a second Covid-19 update with our partners hold June 12, 2020 @ 9:00 AM and look for more information by the end of May
Seva, IAPB, ICO and WHO
What We’re Up To…
Thanks to Suzanne's longevity in the field, we are front and center in many multilateral and bilateral organizations.
Seva on the emerging International Agency for the Prevention of Blindness (IAPB) Sector COVID workgroup: Seva’s discussion with the CEO of IAPB was on May 5, 2020.
The World Congress of Ophthalmology, organized by the International Council of Ophthalmology (ICO): Seva has been invited to convene on the Late-Breaking COVID update flash session during the last week of June. PAID CONFERENCE
Seva is positioned to launch the World Health Organizations (WHO) World Report on Vision in the US (July 15 at 9 AM to 12 PM, EST in DC or virtual) and Canada (June 26 at 11 AM virtual). This session is hosted by IAPB, North America Region, of which Suzanne is Chairperson. EVENT UPDATE TO COME
National Institutes of Health, National Eye Institute - Seva liaison re: COVID and eye response priorities within the US.
Update on Affordable Avastin
Those reading this will recall, 422 million individuals are affected by diabetes globally. 75% of these individuals live in Low and Middle-Income Countries (LMICs), which face significant challenges in diagnosis and treatment. By 2040, it is expected that 642 million will suffer from diabetes, threatening the vision of more than 70 million worldwide. India faces the greatest burden of this growing global threat. Avastin drug therapy can require nine injections per patient. In the US, the cost runs $2,200 per injection. Thanks to the approved budget from last year, Seva is helping to make Avastin affordable.
The GOOD NEWS is that Seva is on target with the Feasibility plan from the Spring of 2019.
Our efforts and work with David Green and representatives from AuroLab have identified a source and vetted 20 companies to identify an optimal match with Seva's social mission and AuroLab's production capacity.
So, what is ahead? We will seek regulatory approval for the safety of the drug with Indian regulatory authorities as well as in selected countries such as Guatemala. Additionally, we are getting the ecosystem to scale Avastin use. How? Today, Avastin is administered by ophthalmologist specialists. Seva, under Suzanne's leadership, is studying validated methods and approval processes for injection of Avastin by general ophthalmologists and well-trained allied ophthalmic personnel. We are studying the number of injections needed at different stages of Diabetic Retinopathy and other factors that will enable or prevent scaling of affordable Avastin in the communities we serve. If you are new to the board, scroll down to read Dr. Dick Litwin's message in my earlier blog from September.
Suzanne’s Answers to My Call to Action:
How Can We Build Seva Staff and Partner Research Capacity?
Capacity is a strategic focus for Seva. Together with Ken Basset from Seva Canada, Suzanne's work this past year has focused on partners in Nepal, India, and Cambodia with training and coaching from expert public health research faculty of the Indian Institute of Public Health – Hyderabad (IIPHH). This innovative 15-month program is the first Seva project specifically designed to build Seva staff and partner internal capacity to conduct practical inquiries into how to improve program decision making and impact.
To date, four eye hospital teams plus three additional Seva partners are creating intervention studies to improve program performance on successful patient referrals from Vision Centers to referral eye hospitals. This includes follow up with children who require multiple hospital visits; follow up treatment of patients with Diabetic Retinopathy; strategies to increase vision center utilization and sustainability; and mechanisms to improve the effectiveness of community outreach, among others.
How's it going? All participating Seva teams are rapidly gaining skills and understandings in how to plan and conduct practical, systematic research. COVID impact -- This program is underway with activities redesigned to fit COVID lockdown realities. Seva staff, partners, and IIPHH Faculty guides continue to work via ZOOM with an emphasis now on producing robust research protocols for implementation when conditions permit. For the future success of Seva's research function – a cyber “hats off” to Suzanne for finding creative solutions to keep the work moving forward during this turbulent time.
Infectious Disease and Quality Controls - In a Time of Covid-19
Dr. Chundak has worked with me for the past 12 months to transition into the World Wide Medical Director. As part of this work, and before the virus was a world-wide pandemic - we had organized our first pilot training for Quality Champions in Nepal. Led by the extraordinary Dr. Samina Zamindar who finished the in-person portion of her quality training program and throughout the Covid-19 crisis has sponsored the weekly zoom sessions with the pilot cadre of trainees. Dr. Marty Spencer is an active advisor and participant as well. By the end of May, we anticipate publishing a "Starter-kit" SOP that we will distribute to partner hospitals and translate into Spanish for distribution to Latin America. I've asked Dr. Chundak and Dr. Samina to pen the forward to this workbook and starter kit.
Additionally and as part of the Quality Controls workshop Dr. Zamindar is leading with Nepal hospitals, the Seva staff launched a poster competition to communicate best practices around COVID preparedness on the following topics:
1. Hand Washing
2. Social Distancing
3. Wearing masks
4. Do not touch
5. Be mindful
A copy of the winning poster, as well as the starter kit SOP, will be distributed to the board when we distribute it to our partners.
Native Communities
September was a month of Native Community outreach and learning opportunities. John Plowright, who expressed interest from earlier blog invitations to join us in Alaska was unable to attend the Alaska-specific due to work-related reasons. We were able to invite him to join the NIHB (National Indian Health Bureau) conference in southern California. Thank you to Yvette Joseph who spoke with John in advance to further ready him for this learning experience.
Three Seva representatives — Ali Prince, our Native Community Program lead, Dr. Marvel our consultant and I had the opportunity to travel to Alaska.
The principle purpose for the Alaska trip was to meet and learn from our new partner Southcentral Foundation (SCF). Enjoy reading more about what we witnessed first-hand the Nuka System of Care Simply put, this remarkable organization reformed health care delivery to improve outcomes and reduce costs.
Southcentral Foundation (SCF) is an Alaska Native-owned, nonprofit health care organization serving nearly 65,000 Alaska Native and American Indian people living in Anchorage, Matanuska-Susitna Borough and 55 rural villages in the Anchorage Service Unit.
Click Here to learn more about the Alaska Native Health System and who SCF serves.
We were a busy delegation we also met with the Alaska Native Tribal Health Consortium (ANTHC): recognized as the largest, most comprehensive tribal health consortium in the US and the specific program departments of Alaska Dental Therapy Educational Program, The Alaska Community Health Aide Program, and AFHCAN Telemedicine Cart/Telehealth
Enjoy these links. As this work takes shape across Native Communities in the USA I’ll share more on Seva’s efforts.
The Americas
Leverage versus a lifeboat - that is the question Mr. Nagarajan asked me when I first came to Seva. Would we see the significant gift from Jerry Jones as a lifeboat or leverage to bigger things? The board is supportive of the staff exploring ways to leverage the good work of the Foundation and our talented partners. In doing so one area that quickly came to mind is the Americas. Seva has innovative and hard-working partnerships across Central and South America in addition to our expanded work with Native Communities here in the US. To help better tell our collective story we have developed the first-ever regional landing page. Click here to see the first edition of The Americas Page.
While focused on Guatemala for now, we envision by June 2020 to have a spotlight to our work in Mexico, Paraguay, Peru, Alaska, Wisconsin, Oklahoma, and New Mexico. For details on our expanded work with Native Communities see the blog entry (below) entitled Seva's Call for Ideas.
Seva's Call for Ideas: Native Communities Across the USA
June 2019 the Seva Board approved a new approach to working with Native Communities across the USA. Seva together with our iROOTS partners in New Mexico launched our "Call for Ideas" that would identify new partners, programs and ideas that improve eye health of Native communities. Our key priority funding areas included: primary eye care clinics, training, pediatric programs and technology. By doing so we aligned with our programmatic drivers (Kids, Tech, Vison Centers and Training). Seva embarked upon this new partnering process to identify new ideas, innovation, and partnerships that will meet with growing eye health needs of Native American communities. After extensive vetting and review, awardees in five new states: Southcentral Foundation (AK), Oklahoma City Indian Clinic (OK), University of Washington Bothell (WA), University of Michigan (MI), and Menominee Tribal Clinic (WI). We carefully chose these awardees due to their readiness and capacity to implement eye care programs that will greatly impact eye health in Native Communities reach communities those with high unmet need. Hellen Keller International has committed $250,000 a new partnership that will afford Seva investing a total of $539,750 will be distributed amongst the five new partners with programs. In September two visits will take place that will help to further our partnerships and understanding. Board members are encouraged to visit the What's on the Horrizon section of this blog for more details and how you might get more involved.
Avastin Feasibility Study
AuroLab 2.0? Maybe …
This past June 2019 the board approved staff engaging in a feasibility study for the cost-effective production of Avastin. The work began back in November 2017 when the board approved my exploration of ways Seva might grow. With a Lancet report outlining how we will see a tripling of avoidable blindness by 2050 - we wanted to know if the work of our partners coupled with Seva’s value add could make a bigger difference to more people.
I began a series of Synergy Series designed to help partners, staff, and board members think outside the box. One in particular series was co-hosted with the Wilmer Eye Institute at Johns Hopkins University. In preparation for this series, I engaged in a series of innovation conversations with the likes of David Green and others. Avastin coming ‘off patent’ was an immediate opportunity we thought to explore. As we further opened the design conversation for this series Thulsi, Dick Litwin and Marty Spencer we then began to wonder — could this be an AuroLab 2.0? I invited Dr. Dick Litwin— architect, technical adviser and donor for the feasibility study — to put down his thoughts on the emerging work with Avastin. His contribution is below. Enjoy the read!
Four decades ago, the introduction of intraocular lenses made a huge advance in the quality of cataract surgery. Unfortunately, at $100 a lens, it was unaffordable for most of the developing world. Seva, partnering with Aravind, made a unique decision; doctors would create a factory at Aravind to make low cost intraocular lenses. At a production cost of $1, that made possible a surge in cataract surgery all over the world. Currently, Aravind’s factory, Aurolab, makes 3 million low cost implants a year; twelve percent of the entire world’s supply.
Today, a similar situation has presented itself. Many of the major diseases of the retina can be treated by injecting a medication, Avastin, into the eye. Diabetic retinopathy, Macular Degeneration and Retinopathy of Prematurity, as well as others, are being treated in India at a cost about $120 per eye, $240 in many patients because the disease is present in both eyes. This treatment is unaffordable to most people in India and throughout the developing world, at that price. The alternative is blindness.
Recently, Seva was the recipient of the fifty thousand dollar Chang Award by ASCRS, the largest organization of cataract surgeons in the world. Seva and Aravind, have taken this opportunity to use the award money to explore the possibility of duplicating our success with Intra-ocular lenses by making Avastin available at a low price. Our consultant, David Green, who won a MacArthur Award for his work with the lens implant factory, is carrying out this mandate. Soon we will know if this project is feasible. If so, another home run for Seva, Aravind, and those with retinal blindness throughout the world.
Dick Litwin, special contributor
TOMS
A significant milestone reached and what this means for the people we serve.
Seva and TOMS first partnered in 2011 to launch TOMS One for One Sight Giving Program providing more than 400,000 eye care services throughout this partnership. In July 2016, TOMS and Seva built on lessons learned and introduced a more sustainable approach to the One for One Sight Giving Program. Our pivot — direct investment in Primary Eye Care Vision Centers. In June 2019 TOMS’ first investment in Primary Eye Care Vision Centers completed. Through Seva’s Gloval Sight Initiative partnerst we completed 22 PECVCs that provided more than 100,000 services. This month, we are starting our 10th funding cycle with TOMS and will establish 15 new primary eye care vision centers in the year ahead.
AIDS Camera and IOptix Technologies
A bold new partnership to take Seva's big idea to the next level.
Seva is exploring a partnership with Daniel Friedman a newly minted PhD in Biomechanical & Biomedical Engineer and Mike D'Ambrosio a PhD in Biochemical & Molecular Biology. David Heiden and long-time Seva colleague Rod Watkins (who cracked the code on low cost high quality ophthalmic imaging years ago) gave this Berkeley-lab team the specs for the AIDS Camera. Daniel and Mike have visited Seva and met with Kate and Suzanne. Early explorations look promising in terms of this team being the right fit for the project in terms of expertise and passion.
“Think Bigger, See Smaller”
The Berkeley team is in the process of creating “IOptix Technologies” with the tag line “Think Bigger, See Smaller.” Their aim is to design and build medical devices targeted to low resource areas. Their forte is non/minimally invasive automatic diagnostic devices for tropical diseases including TB. In fact, the Gates Foundation just granted the talented duo $2MM to scale and field test a handheld gizmo which screens blood for a parasite, giving on the spot results. The next few weeks will be pivotal in framing the project plan and ensuring that this is a fit for IOptix and Seva. It's looking good. And if all goes well, we anticipate a learning “break out session” at the Synergy Learning day prior to the fall board meeting.