Six takeaways from the International Conference for Public Health in Africa

Hortance Manjo, January 2024

In November 2023, I attended the third International Conference for Public Health in Africa (CPHIA) in Lusaka, Zambia.

At our booth and in conversations, we advocated for the inclusion of eye health in planning, policies, programmes and budgets for health, education and employment across the continent.

2023 was the first year that Sightsavers was part of the conference. It was an honour to partake in the important conversations around public health and I think our involvement was an eye-opener for many.

Alongside our partners, we have a critical role in driving better health care and promoting universal health coverage in alignment with the Sustainable Development Goals (SDGs). Sightsavers firmly believes that primary health care is the cornerstone of achieving universal health coverage, and we are committed to playing our part.

Here are six things that I took away from the conference.

Hortance Manjo at the International Conference for Public Health in Africa.

About Hortance Manjo

I support eye health programmes by working with governments and partners to improve access to high quality, inclusive and affordable refractive care, thereby increasing demand for and uptake of eye health services.

1. We still need to make the case for the prioritisation of eye health

We were invited to CPHIA by Dr Ada Aghaji, a professor of public health ophthalmology at the University of Nigeria. She led a session at the conference where she made the case for eye health as an integral part of health care.

Dr Ada started her session by asking everyone to take one step forward, two to the side and one step back. She then asked the attendees to close their eyes and see if they could find their seats. Of course, people were struggling, and that’s the reality for so many people with visual impairments. Dr Ada used this example to emphasise how important eye health is.

It was clear that we still need to advocate for eye care to be a priority in these discussions. So, you need these sessions for people to understand that if you don’t have your sight, you face many more challenges.

I think we hit home for so many people, but I’m conscious that we are still competing for attention and funding within global health.

2. The case for eye health needs to be specially made with donors

The reaction from visitors to our stand was always positive, and our work is seen as important. During one-on-one conversations, I felt people could understand the importance of eye health. We highlighted the additional barriers that people with visual impairments face and emphasised the need for everyone to have access to quality eye care services.

At the end of the day, the donor chooses where their money should go, and usually, those with bigger pockets have more influence because of the power of their finance. We need to be present in conversations to discuss the importance of eye health with the people with the most prominent voices and significant impact.

3. It is time to reprioritise the issues that were critical before COVID-19

The world is currently facing many health priorities, including post-COVID health care and the situation in Ukraine.

I spoke to my contacts at the Africa Centre for Disease Control and Prevention (which hosts the CPHIA) during the conference. It was agreed that we will be moving on from talking about COVID-19 by next year. So, I hope that, while we act on the lessons learnt from COVID-19 and strengthen our health systems to better respond to pandemics, we should also go back to addressing some issues that were on the table before COVID-19.

Hortance stands alongside a man at a Sightsavers event stand.
Hortance with a colleague at the Sightsavers booth. © Sightsavers

4. We need to be talking about (and funding) health care as a whole, not individual diseases

Often, funding is allocated for projects that tackle individual diseases rather than health care as a whole. But the health care system isn’t working effectively if you successfully treat someone for HIV and they then die of a non-communicable disease (as an example).

We need to look at health care as a system, not as one disease. We need an integrated approach to health and one where we are not funding parallel programmes or tackling single diseases. At CPHIA, there seemed to be a consensus among attendees that this is the best approach, but the problem seems to be that funding has already been committed for programmes tackling a single disease for a period of time, perhaps for the next five to 10 years. Who has the power to reallocate funding or to change that?

When we’re talking about a comprehensive and integrated approach to health care, we must make sure that eye health is on the table and is one of the priorities.

5. Eye care needs to be included in primary health care

Sessions at the conference explored how improving primary health care makes the overall health system better. It was quite interesting for me to see everybody realise that we need health security to achieve universal health coverage.

Then, we need to ensure that eye health is included at the primary level so that when we are driving that agenda, we are also pushing for the integration of eye care into primary health care.

It was promising to see sessions discussing what percentage of the health budget goes to primary health care. How much are we expecting out of our health care? If we believe that improving primary level services will address most of the problems, is this reflected in the budget? Or are we just putting pressure on primary health care to achieve something without adequate resources?

6. Technology is exciting, but we have to be careful

The conference was instrumental in furthering my understanding of where Africa and the rest of the world are heading regarding innovation and technology, with both developments affecting eye health. Technology and innovation are good, but they also have a downside. Therefore, there is a need for an appropriate governance structure for innovation and technology at different levels. There are also questions about how we regulate technology and aspirations to make sure we use it to complement our existing work, not create more parallel systems.

I think that we should look at how technology can help us. For example, when it comes to diagnostics, we must look at the technology or innovations that can help us reach the people left furthest behind.

Then, how do those diagnoses get fed back and how does this data get captured in the health system?

Final thoughts

I feel a profound sense of responsibility to play my part, however small, in ensuring that everyone has access to high-quality, sustainable, and equitable health services when they need them. No one should suffer the tragedy of avoidable blindness.

Currently, 1.1 billion people worldwide have an untreated or preventable visual impairment. And the problem is spiralling – without urgent improvement to eye health services worldwide, 61 million people could be blind by 2050.

Eye health needs to be prioritised as part of a comprehensive approach to primary health care and universal health coverage. While progress has been made, work still needs to be done to ensure eye health services are an integral part of national health care.

Countries need to ensure eye health is represented in their planning, resourcing and funding of health care.

Why? Because Eye health equals opportunity, allowing children to learn and adults to earn. It equals improved wellbeing: supporting families, communities and nations to thrive. And it equals progress towards reducing poverty and inequality.

“Eye health needs to be prioritised as part of a comprehensive approach to primary health care and universal health coverage”


Hortance Manjo is Sightsavers’ global technical lead for unaddressed refractive error.


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