From establishing intraocular lens manufacturing facilities in Eritrea and Nepal to making cataract surgery more affordable, building social enterprise models to such as Alina Vision in Vietnam, The Foundation has consistently sought solutions that can achieve impact at scale.
Building on this legacy, The Foundation continues to demonstrate how partnerships, market-based approaches and new financing mechanisms can unlock additional resources for eye health and accelerate progress towards ending avoidable blindness.
Today, innovative finance is an important part of that evolution. By bringing together investors, philanthropists, governments, healthcare providers and entrepreneurs, The Foundation is helping develop new pathways to finance proven eye health solutions, strengthen local health systems and support innovations that can reach millions more people.
The Cameroon Cataract Bond and Africa Eye Health Accelerator are two examples of how we are applying these lessons to mobilise capital, scale impact and create sustainable access to eye care for underserved communities.
Innovative finance to improve the lives of millions living in Africa
In Sub-Saharan Africa, at least 111 million people have a vision impairment that could be improved with easy, cost-effective interventions. Without urgent action, this number will more than double to 266 million by 2050.
Good vision leads to improved education, employment, gender equity, healthy ageing and economic productivity.
It results in a healthier, more productive workforce, better attendance and educational outcomes at school, greater participation in society, fewer injuries and lower dependence on the wider health and public health systems.
Yet eye health is too often overlooked when public health budgets are tight.
Research shows that, globally, nine out of 10 people do not need to be blind or vision impaired and the most common eye conditions – cataract and refractive error – can easily be prevented or treated through cost-effective interventions.
This is true in Africa and ending avoidable blindness in the region requires more than a business-as-usual approach – the eye health sector needs urgent action to unlock new investment from the private sector.
Cameroon Cataract Bond: proving a new model for eye health investment
In 2018, The Fred Hollows Foundation convened partners to test whether innovative finance could expand access to quality eye care while creating accountability for social outcomes.
The result was the Cameroon Cataract Bond, one of the world's first results-based financing models dedicated to eye health. The Bond generated strong social outcomes, strengthened local service and demonstrated that capital can be mobilised effectively to address avoidable blindness at scale.
The Bond restored sight to almost 17,000 people, providing a blueprint for long-term investment in global eye health.
As a results-based contract, impact investors provided the upfront finance with donor organisations repaying their principal plus a return if the program achieved pre-defined social outcomes.
At the completion of the project, the Cameroon Cataract Bond achieved the following results:
- Quantity: Restoring sight to 16,800 people and delivering more than 450,000 consultations
- Quality: More than 70% of surgeries surpassed WHO-global standards, meaning the eye hospital could achieve scale, while maintaining quality.
- Equity: More than 40% of patients whose sight was restored were from the most marginalised in the community, thanks in large part to the outreach camps that provided free or subsidized surgeries to those most in need
- Gender: More than 60 percent of the patients were women and more than 60 percent of the ophthalmologists at the MICEI were women
- Financial: At the end of the project, the eye hospital had a positive EBITA (Earnings Before Interest, Taxes, and Amortization – a financial metric which measures a company's operational profitability by excluding interest, taxes, and non-cash amortization expenses. It helps investors evaluate core performance and compare companies with different capital structures or tax rates), and full repayment to investors, plus an 8 percent return.
The Cameroon Cataract Bond was delivered through a consortium of outcome funders (The Fred Hollows Foundation, the Conrad N. Hilton Foundation, and Sightsavers), investors (DFC and NETRI Foundation), and implementers (Africa Eye Foundation and Magrabi ICO Cameroon Eye Institute), with Sagana serving as the Coordination Manager.
The lessons from the Cameroon Cataract Bond continue to inform The Fred Hollows Foundation's innovative finance strategy. Building on this experience, we are working with investors, philanthropists, healthcare providers and innovators to accelerate solutions that can expand access to eye care across Africa and beyond.
The Fred Hollows Foundation Africa Eye Health Accelerator
We have joined forces with Villgro Africa in Nairobi to launch the world’s first accelerator dedicated exclusively to eye health innovation.
The Accelerator supports high-potential ventures developing scalable solutions for eye health delivery, including AI-enabled screening, portable diagnostics, community-based service models and digital platforms that can improve access, efficiency and quality of care
The Africa Eye Health Accelerator will help improve the lives of millions of people across Sub-Saharan Africa. It will help more children stay in school and more working-age adults earn a living.
We are seeking partners who share our belief that innovative finance can accelerate progress toward ending avoidable blindness. We welcome conversations with investors, foundations, development finance institutions, philanthropists and strategic partners interested in supporting scalable eye health solutions across low- and middle-income countries.
Investing in eye health delivers returns
Research by The Fred Hollows Foundation, the International Agency for the Prevention of Blindness and the Seva Foundation shows that investment in eye health is one of the most cost-effective health interventions in low and middle-income countries.
The Value of Vision report illustrates that every dollar invested in eye health delivers a return of $28.
The report shows that investing in eye health leads to more opportunities in education, drives job creation and economic development, enables people to live longer, more fulfilling lives, and contribute to their families and communities.
Restoring someone’s sight has far-reaching benefits, such as fewer road accidents, fewer people living with depression and relieves people from unpaid caregiving duties.
The evidence is clear – investing in eye health can transform lives.
As a High Impact partner at the Global Summit for Eye Health, The Fred Hollows Foundation is helping drive momentum towards this pivotal moment for global eye health.
We know what to do and your support can help us scale innovation, transformative solutions to increase scale, efficiency and quality of eye care to improve the lives of millions.
