Jayanth Bhuvaraghan (l), and Hubert Sagnieres.
An exclusive interview with Hubert Sagnieres executive vice chairman of EssilorLuxottica and chairman of Essilor International, and Jayanth Bhuvaraghan, chief mission officer of EssilorLuxottica and Essilor SAS.

Hubert Sagnieres and Jayanth Bhuvaraghan were in New York on Sept. 24 to participate in a meeting on universal health coverage held on the sidelines of the 74th Session of the United Nations General Assembly. The meeting, hosted by Devex, provided a platform for them to announce the release of a new report, “Eliminating Poor Vision in a Generation,” which was commissioned by EssilorLuxottica and is based on research by McKinsey and Co.

The in-depth report calls for a global coalition of industry, governments, non-government organizations and other partners to spend $14 billion over the next 30 years to wipe out uncorrected poor vision, also known as uncorrected refractive error. It is the first study to quantify the cost of what EssilorLuxottica calls, “the world’s most widespread disability,” which affects 2.7 billion people across the globe, 90 percent of whom live at the economic base of the pyramid, and costs the global economy $272 billion in lost productivity each year, according to the new report.

By 2050, uncorrected poor vision is predicted to reach epidemic proportions, with over 50 percent of the world’s population expected to suffer from myopia, many with serious vision-threatening side effects and drastic long-term implications.

EssilorLuxottica initiated the report to gather more evidence-based insight into the scale of this vision care crisis, accelerate the identification of possible solutions and mobilize both public and private stakeholders. The report’s findings suggest that uncorrected poor vision can be eliminated by 2050 through an investment of $14 billion dedicated to creating sustainable access points to eyecare, innovating for affordable solutions, funding subsidized and free services, and raising awareness.
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VMAIL’s Marge Axelrad and Andrew Karp spoke with Sagnieres and Bhuvaraghan about how the world’s largest optical company is taking steps to accomplish this important goal.

VMail: In the context of global health care, there are many competitors looking for financing and resources, particularly when it comes to fighting deadly diseases like Ebola and plague. How is EssilorLuxottica and its partners raising awareness for vision care and making it a global health care priority?

Hubert Sagnieres: You’ve put your finger on the right issue. The impact of poor vision in the world has been underestimated for years. We see that today, close to three billion people do not see well. If you don’t see well, it impacts your life, your community and the world. So, yes, we have to solve that.

I don’t see that we’re in competition for money because there is a lot of money floating around for the key project. I think what makes our fight against poor vision unique is that maybe, for the first time ever, you can solve a handicap with what you already have in hand.

To make sure that 3 billion people can see well tomorrow, we don’t have to finance research, we don’t have to finance a new project, we don’t have to finance innovation. We have everything on hand. It’s just a matter of motivation. This is what makes us, in all of the health care area, unique.

We know how to produce eyeglasses at 50 cents and deliver them for $1 to any corner of the world. But we have to fight for accessibility and awareness. Those two things are why we still have 3 billion people who don’t see well. We have all the solutions, we have the solutions on the product, we have the solutions on the business models, we know how to reach people. We have spent nearly 10 years experimenting with various business models for how to deliver eyeglasses to someone in need, somewhere in a little valley in Pakistan. Now it’s a matter of raising the awareness, and investing money to achieve that.

With this report, “Eliminating Poor Vision in a Generation,” we have proven that by spending less than half a billion dollars a year over the next 30 years we can eradicate from the world the biggest handicap, which is poor vision.
So when you combine a little pocket money for health care, and at the same time we have the solutions, we just have to execute. We are already in execution mode everywhere in the world. What we need is for the world to open their eyes and take this handicap, poor vision, seriously.

This infographic, taken from the new report by EssilorLuxottica, shows how $14 billion should be allocated to eliminate uncorrected poor vision.

To what extent is it important to partner with other health care companies and governments in order to integrate vision care into a broad health care plan?

HS: It is extremely important to mobilize everyone around our cause. We can’t wait to mobilize everyone, because we have the solution, so we have to develop what we started to do in the past 10 years, and along the journey mobilize more and more people.

I think it’s extremely important to understand that it is doable, and it’s not a dream, we can achieve it. We have to gather any type of resources, people within health care but also outside of the health care because we have impact on education, we have impact on the economy and in a lot of other areas. Achieving this can’t be done alone. Someone has to drive the initiative and gather any type of entities, whether it’s companies or governments, needed to achieve our goal.

Governments are all welcome. I want them to be supported, but just the same they are occupied with tons and tons of projects. Our plan is a 30-year business plan. There are not that many countries that can think about a 30-year business plan with the same focus as other things, so that’s why sometimes corporations can be stronger than governments because we are always long-term.

We are not in the mode of begging for support. We have this huge challenge, and we say, ‘Join us.’

VM: So that’s the rationale for this report, to have McKinsey quantify what is necessary to meet this challenge? Is it because it’s an abstract idea that you needed to quantify?

HS: It’s just a matter of catching the opportunities. We are optimistic. When we started 10 years ago when we had this idea measuring the impact of delivering eyeglasses to people in need. Along this journey that we have defined, McKinsey decided to help us. We also need you in the media to endorse this project and talk about it.

VM: The new report mentions the need to eliminate import duties on Rx lenses and affordable frames. This requires political action on a country by country basis. How can this be achieved?

HS: If we can decrease costs, let’s decrease costs. This is a wish. If doesn’t happen, we’ll continue anyway.

VM: The report calls for the establishment of hundreds of sustainable access points to deliver eyewear and eyecare throughout the world. How do you define a sustainable access point?
HS: I think there are maybe 50 definitions for this. I will start from the need of the people in the street, in the field. An access point in Manhattan is not an access point in Nebraska or Delhi or a little city in Bangladesh. It doesn’t even have to be a place, because electronic technology exists. We at least have the formula for a refraction that people need for their vision. Then it’s a way, or a place where we can deliver glasses. That’s a sustainable access point.
In China, we working with Alibaba, turning the Alibaba countryside shops into optical access points.

VM: Does Essilor plan to scale up production in order to provide reading glasses or prescription lenses to those in need? Will that mean building more laboratories or extending the global supply chain into areas where it currently doesn’t reach?

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Richard Jones of Devex (l) interviewed Hubert Sagnieres during a meeting on universal health coverage, held last week on the sidelines of the 74th Session of the United Nations General Assembly.
HS: All of the above. Because in some countries there’s a lot of free capacity. You have in Asia plants that have been built not by us, but by suppliers in Laos, in China, in Vietnam, producing very affordable and good quality frames. So we won’t need to turn that into EssilorLuxottica plants. We’re leveraging what already exists.

We have all the solutions. In some cases, we make new production. In other cases, we can work with 25 suppliers who are doing a great job and want to be actually be part of the story. There is no one unique success model. It requires flexibility and adaptability in order to provide eyeglasses, at the right price at the right point to the right person.

VM: The report talks about the importance of using portable digital devices, such as smartphones, to do eye examinations in the field. Is that technology being used to do more than just refractions? Is it being used to detect more serious ocular conditions?

Jayanth Bhuvaraghan: The answer is definitely yes. This first phase of our campaign focuses on creating a network of primary health care providers, because in many parts of the world that network doesn’t exist. The job of the primary health care provider who we train and with whom we create those primary access points is to do a simple refraction and a simple eye examination.

But what we also are doing now is to have these primary health care providers be able to refer patients to the eye hospitals. This is true innovation. We are trying to connect them with an app. So when they spot a problem like redness of the eye, or glaucoma, cataracts, etcetera, which they don’t know, they simply send them to the eye hospitals, who then take care of them.

The eye hospitals struggle to spot these patients because it costs a lot of money to locate them. By having a primary health care provider, which is like a hub and spoke model, he or she is able to recommend them to the eye hospitals. That’s the first step.

But to answer your question, yes, we are working on a lot of innovation, both digital and non-digital, starting with the refraction side, which is the biggest bottleneck. Hubert had thrown a challenge to the whole R&D team, saying, “Look, this is a bottleneck. I want a solution in 12 months.” So we did an open innovation challenge outside the industry called See Change about a year and a half back. All the universities around the world participated.

What came out of it was actually a non-digital solution. It’s called Click Check. It’s been commercialized now. By using that, with a simple click, in a couple of minutes you can get a starting point for your refraction. You don’t need an auto-refractor meter, which costs about $10,000. Once you have a starting point, you can do a subjective refraction to get to the final power. So we already have solved that first step.

But is that enough? No. We know there’s a lot of work happening to bring this to the mobile phone. With the iPhone 11 you have three cameras with high resolution. It’s just a matter of time before it comes in. We’re also talking to people like Peek and other companies working on this, where we can do a non cycloplegic refraction for kids without dilating the eyes. So there is development happening. We’re confident that in the next 12 to 24 months this will come about. It will be disruptive, but it will actually open up a huge market.

Today, when we launch this report, it’s an outline. What it will do is create awareness for the cause. It will start the dialogue. Nobody talks about vision care except people like us who are in the industry. Hopefully, this will raise awareness at a time when the U.N. is debating Universal Health Coverage (UHC).

At the meeting on universal health coverage, Devex hosted a panel discussion how to solve the global crisis resulting from uncorrected poor vision. (L to R) Richard Jones of Devex; Jayanth Bhuvaraghan of EssilorLuxottica and Essilor SAS; Nick Martin of The Fred Hollows Foundation; Professor Serge Resnikoff of the Vision Impact Institute; Allyala Nandakumar, Office of the Global AIDS Coordinator, USA and Vision Impact Institute; and Liz Smith, co-founder and CEO, Eyelliance.

VM: How does EssilorLuxottica deploy its teams who are focusing on this issue?

HS: The way we describe the company now is we have one purpose: to eliminate poor vision in the next 30 years. In order to do so, we are organized into three business models. The traditional business model you know, those old days of Varilux and LensCrafters, which is one side. At the opposite of this is all the charity activities to help 1 billion people who need help. In the middle you have the social impact business model.

We produce at 50 cents, we sell at $1.50, and we create customers who maybe, in a few years, will be able to purchase $20 eyeglasses. And we have impact, and yes, we make money in the long term. So we are pursuing those three business models, step by step, country by country. Now we have developed that in 40 or 50 countries and we are rolling it out to more countries.

VM: So social impact—meaning productivity, working the economy—can help tell the story to these outside groups about the impact of vision?

HS: Social impact is also about your role in your community, whether it’s Manhattan or a little village. You feel comfortable and happy because you see well and you can contribute.

VM: People all over the world want to see well and look good.

JB: In the last few years, there has been a paradigm shift when thinking about people at the bottom of the [social-economic] pyramid. Historically, the view from the West has been people who are poor, they don’t have two square meals, give them hand me down products, collect used stuff and give it to them and they will be happy. That’s not true. The value of a spectacle for a man or woman in a village and for you or me is the same. Three to five days of salary. You calculate it either way.

So in terms of purchasing parity, what he or she is paying, in terms of value, is the same as what you are paying in Manhattan. Why should their aspirations be different in terms of style, color and choice. So we put the consumer at the center and that’s when we started looking at developing products, models, etcetera, than just going by the historical grant giving route which is not sustainable.

With that model, if they break their glasses they can’t go get another pair. In fact, you’re doing them a disservice by giving them the glasses, and if they enjoy it but six months later they break them and can’t get another pair. That’s where we talk about sustainable clinics. There should be a place where they can go buy another pair of glasses. Otherwise, it’s just another mission. It will make us feel good, but it’s not good for them.