Retinoblastoma in Sub-Saharan AfricaRetinoblastoma is a childhood cancer affecting the eye. In sub-Saharan Africa, its incidence is high and survival is low. The VISION 2020 LINKS program aims to address this issue by forming partnerships between U.K. and African eye health care departments.

What is Retinoblastoma?

Retinoblastoma is a childhood cancer of the light-sensitive cells at the back of the eye (the retina). Symptoms of retinoblastoma can include vision problems, irregular eye movements and inflammation of the eye. Treatment options usually include surgery, chemotherapy, radiotherapy, freezing therapy and laser therapy.

What is the Incidence of Retinoblastoma in Sub-Saharan Africa?

It is estimated that there are over 1,950 cases of retinoblastoma in Africa per year. The symptoms in children in sub-Saharan Africa are found late and they become more troublesome and severe. Unfortunately, this means children have lower chances of survival. Overall, the survival rates for retinoblastoma in sub-Saharan Africa are as low as 26.6%, compared to 99% in the U.K.

What are the Barriers to Proper Management of Retinoblastoma in Sub-Saharan Africa?

  1. Shortage of Ophthalmologists: The World Health Organization recommends a minimum of one ophthalmologist per 250,000 people. However, in many places in Africa this falls as low as one ophthalmologist per 1,000,000 people.
  2. Inaccessibility of specialist eye health care: Two-thirds of these ophthalmologists are located within major cities, despite the majority of the population of sub-Saharan Africa living in rural areas. Lack of transport and large traveling distances make proper eye care inaccessible and/or costly. This means that most children receive eye care from local primary health care workers or traditional healers. However, neither is adequately trained to competently identify and manage complex ophthalmic conditions such as retinoblastoma.
  3. Unaffordable cost of treatment: A study in 2018 found the average cost of treatment for retinoblastoma in sub-Saharan Africa amounted to $1,954. With an estimated 40% of the population living below $1.90 a day, the cost of life-saving health care is unachievable for many.

What is the VISION 2020 LINKS Program and its Efforts to Curb Retinoblastoma?

The VISION 2020 LINKS program was established to correct the disparities in ophthalmic care in low-resource settings, such as Africa, with the goal of preventing and managing avoidable blindness.

The VISION 2020 LINKS program was founded by the London School of Hygiene & Tropical Medicine’s International Centre for Eye Health in 2004. The aim of the program is to build long-term partnerships between eye health care workers in the U.K. and low- and middle-income countries (LMICs). These partnerships aid the development of skills and knowledge of eye care workers in LMICs and U.K. eye care workers. Through skills and knowledge training, the VISION 2020 LINKS program is addressing the lack of adequate ophthalmic care in LMICs.

Currently, 30 partnerships exist between the U.K. and LMICs, predominantly in Africa. VISION 2020 LINKS has 16 partnerships working to improve pediatric eye health care and establish retinoblastoma as a priority within this.

Though retinoblastoma is viewed as curable in high-income countries, the consequences in sub-Saharan Africa can be devastating. The VISION 2020 LINKS program aims to minimize the disparities in ophthalmic care, with retinoblastoma as a key focus of many of their partnerships.

– Jess Steward
Photo: Flickr