Intraocular lenses: Pioneering Social Impact Investing
The Fred Hollows Foundation’s journey into social impact investing began in the early 1990s, inspired by Fred’s vision to make modern cataract surgery accessible in developing countries. At the time, intraocular lenses (IOLs) were essential for surgery but came with a prohibitive cost of US$200 each—well beyond the reach of many.
Fred approached manufacturers, urging them to produce affordable lenses, but they refused. Determined, he explored purchasing the machines to manufacture IOLs himself. When that, too, was denied, Fred resolved to help developing countries produce their own lenses, creating a pathway to self-reliance.
The Foundation invested in two groundbreaking factories: one in Kathmandu, Nepal, operated by Dr. Sanduk Ruit’s Tilganga Institute of Ophthalmology, and another in Asmara, Eritrea, managed by the Eritrean government. These facilities used a social enterprise model to produce low-cost lenses for Asia and Africa, disrupting the market and setting the stage for today’s thriving low-cost IOL industry.
Image: Professor Fred Hollows pictured with an Intraocular Lens that revolutionised cataract surgery in the developing world and has restored sight to millions.
Today, the factory in Nepal, equipped with the original machines alongside newer models, produces over 600,000 lenses annually and continues to expand.
Fred’s bold vision lives on, proving that innovative social enterprise can catalyse lasting change.
A new chapter in this legacy is unfolding with the construction of a state-of-the-art IOL factory in Nepal, set to open in 2026. Once operational, this facility will boost production to over 1.5 million lenses annually, further revolutionising access to affordable eye care. To achieve these ambitious targets, the factory is actively seeking investors to help scale its impact and meet the growing demand for sight-restoring lenses.
The need for innovative finance
Improvements in eye health are not keeping pace with the number of people living with blindness or severe vision impairment, and we know that philanthropy and institutional funds alone are not sufficient to bridge the gap. The Fred Hollows Foundation recognises that innovative finance solutions such as social impact investing, are essential for creating the systemic changes needed to advance eye health. By channeling private capital via investments, we can maximise our impact and provide sight-restoring care to more individuals in need.
In 2013, The Foundation commissioned PwC to conduct a pivotal research study titled The Price of Sight. This study aimed to determine the costs associated with eliminating avoidable blindness globally. The findings were illuminating: while our work directly benefits individual patients and has a significant return on investment, it also serves as a catalyst for systemic change in eye health. However, the global financial needs far exceed the current capacity of philanthropic funding. This highlighted a critical need for alternative financing mechanisms to mobilise the necessary capital for eye health investments.
Our strategic response
In light of the findings by PwC, The Foundation has intensified efforts in several key areas:
- Advocacy for National Investment: We actively advocate for national governments to invest in their eye health systems and integrate eye care into broader healthcare. Our research demonstrates an exceptional return on investment for sight restoration, showing a 20:1 return for cataract surgeries. This compelling evidence underscores the potential benefits of investing in eye health infrastructure.
- Promotion of Social Finance models: We are committed to advocating for social impact investing as a means to scale up our eye health initiatives.
Investing in Impact
The Fred Hollows Foundation has significant experience in harnessing innovative social finance models to transform eye health:
Alina Vision
We provided seed funding for a social enterprise eye health hospital network in Vietnam, known as Alina Vision. We successfully attracted growth capital from a private equity firm for the enterprises expansion, enabling the network to reach even more people in need.
The Cameroon Development Impact Bond (DIB)
We launched a DIB to finance cataract surgeries at a hospital in Cameroon, demonstrating the effectiveness of innovative financing solutions in delivering essential eye care.
Research and future directions
One of the primary barriers to the growth of social impact investing is the lack of readily investable initiatives. To address this challenge, The Foundation is funding research to assess the current landscape of opportunities in eye health, and the role the Foundation can play with the purpose of scaling our potential impact. We anticipate the findings will be available in 2025.
Join us in ending avoidable blindness
The Fred Hollows Foundation is eager to collaborate with those involved in eye health that are suitable for social impact financing. We also welcome discussions with social impact investors seeking to support the eye health sector. If you are interested in exploring these opportunities, please reach out to us at socialimpact@hollows.org.
You have got to get people involved, you have got to mobilise them, you have got to make the healthy system part of them.
