Eye Health Buchan et al. note that cataract is the leading cause of global blindness [1], largely in lowand middle-income countries, and call for research funding to be allocated accordingly. In 1998, about 19 million people were blind worldwide from cataract, and in 1999 it was estimated that in India about 3.8 million people become blind each year [2]. The barriers to cataract surgery are high cost, low number of ophthalmologists, and poor quality outcomes in low volume units [2]. The costs of treating one eye of four million cataract blind people, at about US$50 per case [3], are about US $200 million per annum. India is a country which spends about US$5000 million each year on maintaining its existing nuclear weapons [www. icanw.org/diversion_of_public_resources]. Less than 5% of this budget would clear most of India’s cataract blindness. It is worth noting that 2019 figures show that there are about 138 Indian citizens whose wealth exceeds US$1000 million each, and their collective wealth is about US $440,000 million. If only 100 of these individuals donated as little as 0.25% of their wealth each year, India’s cataract blindness would be largely eliminated. Across Africa >40% of the population live in poverty, yet corruption costs about 25% of the national incomes of African countries. More than 25% of citizens pay bribes to access public services. More than US$148,000 million are lost to corruption in Africa each year, to the profit of the international banking system and international businesses [4]. Only small improvements in governance could result in significant improvements in health care, given the large sums currently lost to corruption. Social and political policy choices contribute substantially to the burden of untreated diseases in poorer countries. To the extent that research in applied sciences, and particularly medicine, does not engage or confront questions of significant inequity where encountered, it fails. No amount of research funding will correct this.

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点评：全球眼健康的逆向研究规律

眼睛健康 Buchan 等人。请注意，白内障是导致全球失明的主要原因 [1]，主要发生在低收入和中等收入国家，并呼吁相应地分配研究资金。1998 年，全世界约有 1900 万人因白内障而失明，1999 年估计印度每年约有 380 万人失明 [2]。白内障手术的障碍是成本高、眼科医生人数少以及小手术量单位的结果质量差[2]。治疗 400 万白内障盲人的一只眼睛的费用约为每例 50 美元 [3]，每年约为 2 亿美元。印度是一个每年在维护其现有核武器上花费约 50 亿美元的国家 [www. icanw.org/diversion_of_public_resources]。不到该预算的 5% 将清除印度大部分的白内障失明。值得注意的是，2019年的数据显示，财富超过10亿美元的印度公民约有138人，其集体财富约为4400亿美元。如果这些人中只有 100 人每年捐出他们财富的 0.25%，那么印度的白内障失明将在很大程度上被消除。在整个非洲，超过 40% 的人口生活在贫困中，但腐败造成的损失约占非洲国家国民收入的 25%。超过 25% 的公民通过贿赂获得公共服务。非洲每年因腐败、国际银行系统和国际企业的利润损失超过 1480 亿美元 [4]。鉴于目前腐败造成的巨额损失，只有治理方面的微小改进才能显着改善医疗保健。社会和政治政策选择大大增加了较贫穷国家未治疗疾病的负担。如果应用科学，特别是医学研究，在遇到重大不平等问题时，没有涉及或面对，它就会失败。再多的研究经费也无法纠正这一点。