IFOS Notes:
Comments Requested on Draft Strategic Plan for ICO/IFOS

Dear IFOS Members,

The strategic planning meeting for the International Council of Ophthalmology/ International Federation of Ophthalmologic Societies (ICO/IFOS) in Zurich in July far exceeded my expectations. Your new Officers and other members of the planning group are proposing a new vision of what the organization could be and the role it can play in ophthalmology, eye care and preservation and restoration of vision.

We are suggesting a greater emphasis on helping ophthalmologic societies develop, renewed focus on enhancing ophthalmic education and a new commitment to improving access to eye care around the world.

I am pleased to report on results of the strategic planning session in this IFOS Notes and request your comments on the proposed Plan. I also offer some personal observations to try to put the draft Plan in perspective.

1. Your Input Was Helpful

First, let me thank all of you who contributed your perspectives and ideas for strategic planning in the ICO/IFOS Forum on the Future (www.icoph.org/plan). We received more than 150 comments before the planning session, and all of them, plus some that you sent by e-mail, were distributed to the participants in the agenda book for the meeting.

Your comments stimulated and supported our thinking and discussions in Zurich. Without them, we would not have reached the conclusions that we did. Thank you again.

2. Follow-up Planning Session Scheduled

We have circulated the report on the planning session/draft partial Strategic Plan to members of the Council and its Advisory Committee for comment. Most of those who responded expressed strong support for the directions proposed. But we have also heard serious concerns about some of the directions and changes that have been proposed for the organization and are yet to reach consensus.

We are planning a follow-up planning session in November both to resolve areas of difference and define more clearly how to move in the directions suggested. It would be very helpful for us to have feedback from IFOS Members to guide us in those discussions.

At the meeting in November, we will consider all comments received and suggest changes in the draft Plan as needed. We will also define more specifically what could be done on each of the six proposed goals.

In December, I will report to you again on what is proposed and ask for your comments. We hope to approve a Strategic Plan when the Council meets in Cape Town in March, which would allow IFOS to act on any changes needed in the Statutes when it meets in June 2008 in Hong Kong.

3. Comments Requested in the Forum on the Future

We have posted the draft Plan on the ICO Web site, starting at www.icoph.org/plan/part1.html. Or you can download the entire document from www.icoph.org/pdf/ICOdraftplan.pdf.

I would request that you comment on the draft plan in the Forum on the ICO Web site so that everyone can read the responses. I have posted these new questions there:

• Do you agree in general with the broad future directions proposed for the ICO/IFOS in Part 1 of the draft plan, or not? If you disagree with any of what has been suggested, how would you change it?
  
  
• Of all of the future directions suggested, to what would you assign highest priority?

To answer, go to the Forum at www.icoph.org/plan, click on “comments” below each of these questions, and type your answer in the box that's provided. Then select "Other," type in your name, and click "Publish Your Comment."

You don’t need to register or sign in. You can select “Anonymous” if you prefer, but we would rather know who is submitting the comments.

If for some reason you can't access the Forum or contribute there, you are welcome to respond by replying to this e-mail. We will add your comments to the Forum unless you ask us not too. But it would be helpful if you can respond at www.icoph.org/plan.

5. Observations and Conclusions from Zurich

To put the draft Plan in perspective, it may be helpful for you to be aware of some of the logic behind it. Following are some personal observations and conclusions I reached during the planning session and in response to comments from the Council and its Advisory Committee:

Awareness and Understanding of ICO/IFOS

• The ICO has accomplished a great deal in recent years, particularly by establishing strong programs, such as the Basic and Clinical Science Assessments and IFOS/ICO International Fellowships. Yet the organization is still largely unknown by ophthalmologists around the world. Even the leaders of many ophthalmologic societies are unclear about what ICO/IFOS is and our relationship to other organizations. Having two names for the organization (ICO and IFOS) confuses people and makes the lack of understanding worse.

Ophthalmologic Societies

• The ICO’s definition of International Clinical Guidelines, standards for vision measurement and driving safety, and curricula for training of residents, medical students and allied health personnel have been major accomplishments. Yet many ophthalmologic societies, particularly in developing countries, do not have the capability or resources to adapt these guidelines, standards and curricula for use by their members. Ophthalmologic societies vary widely, from sophisticated organizations in industrialized nations and some subspecialties, to societies that exist in name only in some countries.
  
  
• There is huge potential and need for the ICO to help national societies develop and become more effective. We could work with supranational societies to offer courses on organizational development and management, organizing Congresses, developing educational programs, advocacy, communications, etc. We could develop other resources for societies, such as manuals and practical guidelines, and an international leadership development program.

Individual Ophthalmologists

• In many areas where the public need for eye care is greatest, there is no ophthalmologic society at all, and the few ophthalmologists have to fend for themselves. Even where there are societies, in many countries they don’t have the resources to do much more than organize a Congress. So many ophthalmologists around the world do not have adequate opportunities for continuing education or other resources available to ophthalmologists in developed countries.
  
  
• The ICO/IFOS could do a lot to educate and help individual ophthalmologists, particularly in developing areas. Working in cooperation with national and subspecialty societies, we could offer courses, manuals, online resources and products to help ophthalmologists provide better care to more people. We need to facilitate the availability of existing educational materials to those ophthalmologists who most need them.

Enhancing Ophthalmic Education

• As suggested in the Forum on the Future, one area where the ICO/IFOS can contribute most is working to enhance training of ophthalmologists, particularly to serve in developing countries and underserved areas. It would help to have broadly agreed on minimum standards for residency training, and we could do a lot more to help residency program directors improve their programs.
  
  
• But ophthalmologists cannot provide the care that is needed alone. There is also a critical lack of subspecialists in many developing areas; medical students are not being educated adequately about ophthalmology; and many more mid level eye care providers and other personnel are required to provide the care that is needed. Ophthalmology, and the ICO/IFOS, should also take the leadership in enhancing training of subspecialists, medical students and allied eye care providers to work together to meet public needs.

Access to Care

• Even with an adequate number of providers, there would be millions of people around the world without eye care or vision services, due to mal-distribution, poverty and other barriers to obtaining care. If we are really committed to preserving and restoring vision, our mission must cover not only enhancing ophthalmic education, but also improving access to care.
  
  
• One exciting way to do enhance both training and access is the establishment of self-sustaining eye centers, such as those being supported by Zeiss, Lilly and others. The ICO could make a huge difference by defining principles and models for self-sustaining eye centers and working with national societies to stimulate their development.

Advocacy and Research

• To improve access to care, ophthalmology needs to become a more effective advocate for increasing support for prevention of blindness and eye care, working closely with the VISION 2020 initiative, IAPB, WHO, Non-Governmental Development Organizations (NGOs) and others. National societies are the best potential advocates for ophthalmology and eye care within each country, but the ICO could do a lot to help you be more effective advocates, including offering courses on advocacy at supranational Congresses and defining policies and materials for your use.
  
  
• Part of our advocacy should be stimulating support for research, particularly operational research to determine how best to improve access to care and clinical studies to address the most critical problems that are not receiving attention now. The ICO cannot conduct or pay for studies, but it must be a strong advocate for research.

Resources, Membership and Name

• These are clearly ambitious goals, and there are more good ideas in the draft Plan. We cannot expect to be successful if we continue to rely on a few volunteer officers and program directors to contribute a great deal of their time. Instead, we need to get many more ophthalmologists involved and hire professional staff to help us. That will require more financial resources, and we cannot expect ophthalmologic societies to cover what that would cost.
  
  
• As we accomplish more, we can anticipate more support from industry through the ICOFoundation. But that will not be enough, and we do not want to be dependent on support from industry.
  
  
• If we agree that part of our mission is to serve individual ophthalmologists, in addition to ophthalmologic societies, then it would make sense to create a membership category for individual members, so the organization would have both organizational and individual memberships. That would not only create another source of income, but also signal our commitment to serve both societies and individuals.
  
  
• Finally, if we are going to strengthen this organization and move it in new directions, it makes sense to agree on a single name that everyone can understand and will reflect our plans for the future.

I would also welcome your comments on these observation and conclusions, but am most eager to hear your comments on the draft Plan at www.icoph.org/plan.

Thank you in advance.

With warm regards,

Bruce Spivey, MD
ICO President

945 Green Street
San Francisco, CA, 94133, USA
(1-415) 409-8410
Fax: (1-415) 409-8403
spivey@icoph.org
www.icoph.org