Nigeria is losing $1.6bn yearly to avoidable blindness — Aghaji

Almost on a daily basis, across Nigeria and much of Africa, millions of people wake up to a world they cannot see clearly.

A farmer peeks at his cassava farms for instance, but cannot differentiate the difference between weed and crop. A trader holds her register at arm’s length, guessing at figures she once read at a glance. A child in the back row of a classroom copies from a board that is almost a blur. More often, an old woman needs her grandchild to lead her to the market because the road she walked for over 50 years has become unrecognizable.

Those are not statistics. They are the human face of a crisis that Africa has lived with for too long. As Professor Ada Aghaji told a packed hall at the University of Nigeria on October 29, 2026, this is a crisis Africa can no longer afford to ignore.

Delivering the institution’s 254th Inaugural Lecture, titled “Let There Be Sight: Building Sustainable Eye Health Systems for All in Africa,” Aghaji, Professor of Ophthalmology and Eye Health Systems, made a simple but very powerful argument: eye health in Africa is not just a medical issue. It is an economic issue. A development issue. A justice issue. And the numbers prove it.

According to her, Nigeria loses an estimated $1.6 billion every year in productivity because of vision impairment. Across Africa, the loss is about $9 billion. Globally, it stands at a staggering $410 billion.

Behind those figures are livelihoods cut short, schooling interrupted, and families pushed deeper into poverty.

Yet, as Aghaji stressed, much of this vision loss can be prevented or treated. A pair of spectacles costing less than a bag of rice. A 15-minute cataract operation. A routine screening at a primary health centre.

Why, then, do millions of Africans continue to live with avoidable blindness when the solutions already exist?

That was the question at the heart of her lecture.

Two Children, Two Worlds

Perhaps the most haunting moment of the lecture came not from statistics, but from a story. Aghaji spoke of two children born with congenital rubella syndrome; a condition that can cause cataracts, deafness and other disabilities.

One was born in Nigeria. He faced delays, barriers to treatment and rehabilitation, and ended up blind.

The other was a Somali refugee child in England. He received timely surgery, spectacles and hearing aids, and with them, a chance to learn, to play, to grow

Their medical conditions were similar. Their opportunities were profoundly different.

The contrast, Aghaji argued, is the story of Africa’s eye health system in miniature. Medical knowledge alone does not guarantee care. What determines whether a child sees or goes blind is often not the disease, but the system around it: whether there is money to pay, a health worker to detect the problem, a referral that works, a hospital that can be reached.

Drawing on her journey from clinical ophthalmology to health-systems research, Aghaji examined the barriers that keep people from care — poverty, too few trained workers, weak referral systems, and eye care that is still not properly integrated into primary health services.

“The challenge extends beyond what happens inside an operating theatre,” she said. “It includes the millions who never reach one.”

 The Economics of Sight

If the moral case for eye health is clear, Aghaji made the economic case even clearer

According to estimates presented in the lecture, “about $7 billion invested globally in eye health between 2026 and 2030 could generate $199 billion in economic benefits — roughly $28 for every dollar invested.

“For Nigeria alone, an estimated $110 million investment could generate about $2.45 billion in benefits over the same period.

 These are projections, not guaranteed returns. But they point to a truth that policymakers can no longer dismiss: restoring sight pays.

When a farmer regains sight, he returns to his farm. When a trader gets the right spectacles, she keeps her business alive. When a child can see clearly, her education improves. When an older person regains independence, a family recovers hours once spent on caregiving; hours that can be used to work, study and earn.

The lecture therefore positioned eye health as an important contributor to economic participation, education, household welfare and national productivity. 

For governments, this strengthens the case for including eye health in national development and health-financing priorities. For industry leaders, it highlights the relationship between vision, workforce productivity and economic performance. 

 Why investment must address the right problems 

One of the lecture’s central arguments was that increasing investment in eye health is necessary, but the way resources are used is equally important. 

To illustrate, she presented four hypothetical countries, all with similarly poor cataract surgical coverage, but for very different reasons.

One lacked trained surgeons and equipment. Another had services that patients could not afford. A third failed to identify and refer patients who needed surgery. In the fourth, surgery was performed, but the visual outcomes were poor.

All four looked the same on paper. The solutions they needed were completely different.

More surgeons would not help a patient who cannot afford transport. Free surgery would achieve little if no one ever finds the patient. More operations would mean little if patients do not regain useful vision.

The lesson according to Aghaji is that investment must respond to the specific barrier preventing people from receiving effective care.

Success, therefore, should not be measured by the number of consultations held, spectacles distributed or operations performed. It should be measured by whether people actually see better.

She also harped on equity. This, she noted, must be central, ensuring that women, poorer households, rural populations and people with disabilities are not left behind when services improve.

 What Rwanda Got Right

If Nigeria needs a model, Aghaji pointed to Rwanda. Through sustained government leadership, coordinated partnerships, integration of eye care into primary health services, workforce development and financial protection, Rwanda has steadily expanded access.

By training nurses and community health workers and strengthening links between primary care and specialist services, Rwanda has brought eye care closer to communities

She however, pointed out that building a system is a continuing process. As more people are identified, demand for treatment increases. Even when surgery is affordable, transport costs and other barriers can still keep patients away.

The lesson from Rwanda is not that progress is easy, but that it is possible with leadership, coordination and continuous attention to results.

Prof Aghaji’s personal research in Nigeria tells a similar story. In a study of 165 primary health-care facilities across six states, states where allocated primary eye-care budgets were actually released, recorded 16 times as many cataract referrals as states where funds were not released. Health insurance and coordination also made a measurable difference. Money matters. But released money, spent well, matters more.

 A Shared Responsibility

With an estimated 110 million Africans living with vision loss, the scale of the challenge is far beyond what ophthalmologists and specialist hospitals alone can handle, according to Aghaji.

She called for eye care to be integrated into primary health care, for referral systems to be strengthened, for financial protection to be improved, and for investment to be judged by measurable improvements in people’s lives.

Government leadership, according to her, must provide the foundation. But the private sector, professional associations, civil society and development partners all have a role.

 For businesses, there are opportunities in workforce eye-health programmes, affordable spectacles, technological innovation and investment in service delivery. For development partners, the challenge is to support national priorities and help build systems that can sustain progress long after a project ends. 

The timing of the lecture could not be more significant. As the global eye-health community gathers for the 2026 Global Summit for Eye Health in Antigua and Barbuda, new investments offer an opportunity to accelerate progress. But their ultimate value, Aghaji argued, will be judged not by pledges made, but by improvements in effective coverage, visual outcomes and equity.

 Let There Be Sight

In the end, Aghaji’s lecture returned to where it began: people. The consequences of poor vision extend beyond hospitals into classrooms, workplaces, households and national economies. Conversely, restoring and protecting sight can expand opportunities for education, employment, independence and dignity.

Africa cannot achieve its full prosperity, she argued, while millions of its people remain unnecessarily blind or visually impaired

The challenge, therefore, is not simply to increase eye-care expenditure, but to build sustainable systems that connect people to effective services, address the barriers they face and deliver outcomes that matter

For governments, industry leaders and development partners, the opportunity is to turn investment into restored sight, improved livelihoods and greater economic participation

That was the vision at the heart of the University of Nigeria’s 254th Inaugural Lecture: Let There Be Sight; not as a privilege for a few, but as an opportunity for all Africans.