Clear vision for global development avoids philanthropic blind spots  

While it is technological breakthroughs, geopolitical disruption and climate change that dominate public discourse, one of humanity’s most prolific yet solvable problems remains largely invisible.

At least 2.2bn people around the world live with poor vision, of whom more than one billion have uncorrected vision impairment.

These numbers paint a stark picture of neglect. Of the one in eight people globally who live with preventable, uncorrected vision loss, 90 per cent live in low- and middle-income countries. The geographic concentration of the problem underscores continued global inequities.

Unlike infectious diseases that generate emergency responses or conditions that produce visible suffering, poor vision is consistently deprioritised. Those with impaired vision adapt — squinting through daily tasks, accepting diminished productivity — yet this rarely makes headlines. Children struggle in school, adults lose economic opportunities, and elderly populations become increasingly isolated — all while a solution sits within reach.

It is arguably the world’s largest unaddressed disability. Yet it has received a fraction of the attention and resources dedicated to other global development challenges by political leaders and philanthropists alike.

Venture-style ambition

Recent innovations demonstrate the transformative potential of applying venture-style ambition to basic socio-economic problems. Low-cost, locally manufactured glasses can be produced for less than $2, while smartphone-based vision screening apps enable community health workers to conduct eye exams in remote locations.

These technological advances represent more than incremental improvements — they’re paradigm shifts that make universal vision care economically viable.

The potential impact extends far beyond individual vision correction. Recent trials have demonstrated a significant 21.7 per cent increase in the productivity of rural Indian tea pickers with uncorrected near vision loss, after receiving reading glasses.

So, if the solutions sit right in front of our faces, why is it that the problem persists?

The answer lies in a historical blind spot within both markets and philanthropy. Traditional healthcare systems focus on acute conditions, while global health initiatives have historically, and understandably, prioritised high-profile diseases.

The economic model for vision care contributes to this neglect. In wealthy nations, eyecare operates as a profitable retail market with high margins. Translating this model to low-income populations requires fundamental restructuring — exactly the kind of systems-level thinking that global leaders are reluctant to embrace, requiring significant investment in long-term outcomes, rather than short-term wins.

Beyond traditional aid

To truly address the global eyecare challenge, we need to move beyond traditional development aid, providing incremental improvements to healthcare delivery or education access.

A more powerful approach comes from what I call the ‘moonshot mindset’. What this requires is patient capital — a willingness to invest in infrastructure, workforce development, and supply chain innovation without immediate returns. It demands the kind of risk tolerance typically reserved for venture capital, applied to social challenges that markets have failed to address.

That approach has shaped the past two decades of my life, and one aspect of this approach has been the work of Vision for a Nation (VFAN) in Rwanda.

From 2008, I worked with colleagues in the vision space and the government of Rwanda to launch the VFAN programme. Instead of simply distributing glasses, we looked to build an entire vision care ecosystem. Over the course of three years, we developed and tested our approach, formally launching the programme of training nurses in health centres across the country.

By training more than 2,700 local nurses on how to deliver eye tests, we established a nationwide service in just over five years, accessible to all 11.8m people in the country, fully integrated into the health system and national insurance scheme.

This approach demonstrated that a simple solution, backed by bold thinking, can solve a massive problem. And do it at scale.

Philanthropic blueprint

What particularly excites me is that the opportunity to apply this ‘moonshot mindset’ goes far beyond vision. It’s about how we see the role of philanthropy in a world where solutions feel increasingly uncertain.

We must ask ourselves; do we retreat into short-term incrementalism? Or do we challenge the status quo and ask: ‘Why can’t we solve this?’

With this motivation, we can keep pushing forward until we find that it is possible. It’s a deceptively simple but powerful thought that has guided me through my own philanthropic journey.

The real challenge is not just to give more, it’s to give differently. Systemic issues are like uncharted assault courses. They require deep commitment and resilience; we have to repeatedly innovate, fail, reassess and go again. To clearly see what’s broken, to overcome the barriers and to believe it must be possible. 

What gives me greatest hope is that this mindset comes more naturally to the new generation picking up the gauntlet, and as part of the old guard, I see it as our duty to do everything we can to support them.

James Chen, Hong Kong-based philanthropist, founder of Clearly and chair of The Chen Yet-Sen Family Foundation