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International health policy and German development cooperation focus primarily on preventive measures. This is evident, for example, in diseases such as childhood blindness, which can be prevented through vaccinations or vitamin A supplements. However, eye diseases such as cataracts and glaucoma cannot be prevented. Only early diagnosis and surgery can protect affected children from going blind. The Leopoldina discussion paper therefore recommends that German development cooperation should focus on both strengthening medical treatment and maintaining a strong emphasis on prevention. The paper illustrates these proposals with practical examples from southern Africa.
Between 1 million and 1.5 million children worldwide are blind. Almost a quarter of them live in Africa. The most common cause of blindness there is cataracts, which can only be treated surgically. Using the example of childhood blindness, the authors of the discussion paper show how a balanced global health policy can combine prevention and treatment to achieve positive effects on life satisfaction as well as on society and the economy; an approach they refer to as “Global Clinical Care”. They describe the progression of congenital cataracts in children and how targeted treatment can prevent childhood blindness. This enables children to attend regular school and later pursue a career. In the discussion paper, the scientists explain how treatment can also impact gross national product, and how the investments necessary to establish healthcare provision pay off both socially and economically.
The “Global Clinical Care” approach aims to create local self-help structures. In the case of childhood blindness, this means identifying affected children at an early stage, strengthening local care capacities and providing further training for ophthalmic specialists. From the authors' point of view, institutionalised partnerships are a key instrument for this. The discussion paper presents two partnerships as examples: a partnership between Rostock/Germany and Kinshasa/Democratic Republic of Congo and a partnership between Tübingen/Germany and Blantyre/Malawi. Healthcare structures were established within the framework of these partnerships. Specialists were trained both locally and during stays in Germany. According to the authors, these long-term partnerships have the potential to strengthen sustainable healthcare provision locally. They therefore recommend that the German government, in continuing its Global Health Strategy, place greater emphasis on the connection between prevention and treatment and, among other things, provide a framework programme for state funding of institutionalised partnerships.
The discussion paper “Focus on childhood blindness – Rethinking prevention and treatment” is published on the Leopoldina website: https://www.leopoldina.org/en/childhood-blindness
Publications in the “Leopoldina Discussion” series are contributions by the authors named. With its discussion papers, the Academy offers researchers the opportunity to provide thought-provoking impulses, stimulate discourse, and formulate recommendations flexibly and without a formal working group process. The theses and recommendations contained in discussion papers thus do not reflect the official positions of the Leopoldina.
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About the German National Academy of Sciences Leopoldina:
As the German National Academy of Sciences, the Leopoldina provides independent science-based policy advice on matters relevant to society. To this end, the Academy develops interdisciplinary statements based on scientific findings. In these publications, options for action are outlined; making decisions, however, is the responsibility of democratically legitimized politicians. The experts who prepare the statements work in a voluntary and unbiased manner. The Leopoldina represents the German scientific community in the international academy dialogue. This includes advising the annual summits of Heads of State and Government of the G7 and G20 countries. With around 1,700 members from more than 30 countries, the Leopoldina combines expertise from almost all research areas. Founded in 1652, it was appointed the National Academy of Sciences of Germany in 2008. The Leopoldina is committed to the common good.
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