SDG 3: Good Health and Well-being | SDG 5: Gender Equality | SDG 10: Reduced Inequalities
Ministry of Health and Family Welfare | National Programme for Control of Blindness and Visual Impairment (NPCBVI)
The World Health Organization (WHO) has raised an alarm over the slow pace of progress in addressing cataract-related blindness, despite the availability of a simple, affordable, and highly effective surgical solution. A study published in The Lancet Global Health (February 2026) reveals that while global coverage has increased by 15% over two decades, progress must accelerate sharply to meet the World Health Assembly target of a 30 percentage-point increase in effective cataract surgical coverage (eCSC) by 2030. Cataract—the leading cause of blindness—affects more than 94 million people globally, yet can be treated with a simple, cost-effective 15-minute procedure. The study highlights significant inequities, with women and rural populations consistently experiencing lower access to care due to structural barriers such as high out-of-pocket costs and an unequal distribution of eye-care professionals.
Key Findings on Global and Regional Surgical Gaps The eCSC Study Group analysis identifies several critical foundational pillars and barriers in global eye care:
The eCSC Target Deficit: Latest modelling predicts coverage will rise by only 8.4% this decade, far below the required 30% jump needed to meet 2030 commitments.
Disproportionate Impact on Women: Women across all regions face lower access to cataract surgery compared to men, reflecting deep-seated gender-based inequities in healthcare seeking.
Regional Disparities: The gap is most severe in the African region, where three in four people needing surgery remain untreated.
Quality of Outcome Matters: Effective coverage (eCSC) measures not just the number of surgeries, but those resulting in a “good quality” outcome (visual acuity of 6/18 or better), ensuring that surgery actually restores functional sight.
Primary Care Integration: Success depends on embedding vision screening into primary health care and better distributing the eye-care workforce to rural and underserved areas.
What is “Effective Cataract Surgical Coverage” (eCSC)? Effective Cataract Surgical Coverage (eCSC) is a health indicator that measures the proportion of people in a population who have received cataract surgery and achieved a successful visual outcome. Unlike traditional coverage metrics that only count the number of operations, eCSC combines “access” with “quality”. It is calculated by looking at the number of people who have had surgery and can see 6/18 or better, divided by the total number of people who either had surgery or currently have a vision-impairing cataract. This indicator is critical for tracking progress toward universal health coverage in eye health.
Policy Relevance
The latest eCSC findings represent a transition from high-volume surgical camps to a “Quality-First” integrated eye-care model. By highlighting the “quality-access gap,” the study provides a mandate for the Ministry of Health and Family Welfare to refine the National Programme for Control of Blindness (NPCBVI) to prioritize effective outcomes over simple surgical targets.
Strategic Impact:
Achieving 2030 Global Targets: India, as a major contributor to global cataract surgical volumes, must raise its eCSC by a significant margin to help the world meet the 30 percentage-point increase target.
Eliminating Gender Inequity: Evidence of lower surgical access for women necessitates targeted “Vision Centres” in rural areas that provide safe, accessible screening specifically for women and elderly marginalized groups.
Digital Public Infrastructure (DPI) for Eye Health: India can leverage the Ayushman Bharat Digital Mission (ABDM) to track longitudinal outcomes of cataract surgeries, ensuring that “quality” (post-operative visual acuity) is recorded for every beneficiary.
Primary Health Care Strengthening: Integrating vision screening into Ayushman Arogya Mandirs (Health and Wellness Centres) can detect cataracts earlier, reducing the burden of avoidable blindness in rural India.
Relevant Question for Policy Stakeholders: How can the Ministry of Health integrate Cataract Surgical Quality metrics into the 'Digital Public Infrastructure' (DPI) of Ayushman Bharat to ensure that post-operative visual acuity data is captured at the grassroots level for every beneficiary?
Follow the full update here: WHO: Cataract blindness and surgery access
One in two people facing cataract blindness need access to life-changing surgery