The challenges of advocacy in sub-Saharan Africa.

1 The factors that contributed to these successes include: increased political commitment • increased commitment from eye health • professionals increased commitment and support from • national and international non-governmental organisations (NGOs) increased involvement of, and partnership with, • the corporate sector. However, VISION 2020 has not achieved the same level of success in all parts of the world. In sub-Saharan Africa, where a large number of people still suffer from blindness, national governments have not shown much political commitment. This is despite the fact that they have signed the VISION 2020 declaration, which means that they endorse all World Health Assembly resolutions on the initiative. In addition, commitment from health professionals remains limited to a few converts and the private or corporate sector is only involved at a very basic level. Were it not for the commitment and support of the few NGOs operating there, the initiative would have struggled to make any progress after its launch in 2002. In the West African sub-region, in particular, the need for advocacy features prominently on the agenda of every meeting or workshop to plan or review national VISION 2020 plans. It is true that advocacy is needed in order to speed up implementation of the plans and make progress towards achieving the goals of the initiative. However, little or nothing happens after these meetings. Two possible causes are: 1 Lack of government commitment. National governments are expected to lead and be the champions of VISION 2020 in their countries. Unfortunately, governments still need to be on the receiving end of advocacy efforts. They cannot yet be expected to be advocates for VISION 2020. Usually, the coordinator or manager of a country's national programme is responsible for working towards the objectives of national VISION 2020 plans. But these leaders, and their counterparts in other areas of public health, often find it difficult to get support from their own governments. 2 Lack of know-how. Advocacy requires planning, strong evidence, and effective delivery of messages – the latter requires strong communication skills. However, most people involved in the implementation of VISION 2020 are health practitioners with limited knowledge or skills in social communication. Although they may have the ability to put together strong evidence, they may not be able to select the best facts for advocacy and create a coherent message. Their evidence could therefore be of limited interest to, or have limited impact …