VZCZCXRO8774
RR RUEHAST RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHTM
DE RUEHNE #2808/01 3040654
ZNR UUUUU ZZH
R 300654Z OCT 08
FM AMEMBASSY NEW DELHI
TO RUEHC/SECSTATE WASHDC 3939
RUEHCI/AMCONSUL KOLKATA 2946
RUEHCG/AMCONSUL CHENNAI 3705
RUEHBI/AMCONSUL MUMBAI 2760
RUEAUSA/DEPT OF HHS WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHDC
RUEHPH/CDC ATLANTA GA
RUCPDOC/DEPT OF COMMERCE WASHDC
RUEAIIA/CIA WASHDC
RHEFDIA/DIA WASHDC
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE

UNCLAS SECTION 01 OF 03 NEW DELHI 002808 
 
SIPDIS 
 
STATE FOR OES/PCI, OES/STC, OES/SAT, OES/IHB AND SCA/INS 
STATE FOR STAS 
STATE PASS TO NSF FOR INTERNATIONAL PROGRAMS 
HHS PASS TO NIH 
STATE PASS TO USAID 
PASS TO HHS/OGHA (STEIGER/ABDOO/VALDEZ), CDC (BLOUNT/FARRELL), 
NIH/FIC (GLASS/MAMPILLY/HANDLEY), FDA (LUMPKIN/WELSCH, GENEVA FOR 
HOFMAN) 
CHENNAI PLEASE PASS TO HYDERABAD 
E.O. 12958: N/A 
TAGS: TBIO SENV AMED KSCA ECON ETRD BEXP EINV TSPL KPAO
KWMN, SOCI, IN 
 
SUBJECT:  EYE INSTITUTE SEES FUTURE IN ADVANCED RESEARCH, EXPANSION, 
AND COLLABORATION 
 
NEW DELHI 00002808  001.2 OF 003 
 
 
¶1.  Summary.  Hyderabad-based L. V. Prasad Eye Institute (LVPEI) 
showcases a successful model for high-quality screening and 
treatment that benefits underserved populations of Andhra Pradesh. 
International and national collaborations on ground breaking vision 
research result in effective bench-to-bedside treatment solutions. 
In November, LVPEI researchers will visit the University of 
Pennsylvania to discuss gene therapy - providing an opportunity to 
positively highlight U.S./India science collaboration (see paragraph 
7.) End Summary. 
 
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Not-for-Profit Vision Institute with a Comprehensive 
Plan to Combat Eye Diseases 
--------------------------------------------- ---- 
 
¶2.  A 2001 epidemiological study in the journal "Investigative 
Ophthalmology and Visual Science" reported that nearly 80 percent of 
blindness in India was preventable and curable.  Accordingly, 
LVPEI's focus has been and continues to be availability of 
world-class treatment to all, regardless of ability to pay. 
 
¶3.  Founded by Dr. Gullapalli N Rao in 1986 and named after the 
Bollywood director who donated land for the institute, LVPEI is 
managed by two not-for-profit trusts, the Hyderabad Eye Institute 
and Hyderabad Eye Research Foundation.  The institute encompasses 
six goals, namely: comprehensive patient care, clinical research, 
sight enhancement and rehabilitation, community eye health, 
education, and product development.  LVPEI's quarterly report showed 
that between April - June 2008, the institute provided service to an 
estimated 171,000 patients, of whom more than 55,000 - nearly a 
third - were treated at no cost.  These numbers include just over 
17,300 surgeries, with nearly 9100 being free.  SciOffs saw an 
unending patient line wrapped nearly around the building on a 
weekday afternoon visit to the Hyderabad facility.  The actual 
number of beneficiaries is likely much greater, as the quarterly 
report does not reflect all of LVPEI's outreach programs or the 
services provided by community care centers located in rural 
villages. 
 
¶4.  The cost of screening and treatment is routinely less than a 
tenth of U.S. costs, but still out of reach for many.  Patients are 
asked to pay what they can afford for treatment, according to LVPEI 
Director of Research D. Balasubramanian, who added this system works 
effectively.  Thus a wealthy patron might pay an amount equivalent 
to U.S. treatment costs while others might pay half the Indian 
treatment cost, or even nothing. 
 
¶5.  While LVPEI's budget and operating expenses were not disclosed, 
the 2007 annual reports suggest the institute finds sufficient 
funding to cover all of its programs - including treatment - through 
a combination of this patient payment option system, government 
funding, donations, and research contracts.  India's 11th Plan 
period includes funding of INR 12.5 billion (USD 260 million) for 
LVPEI initiatives including expansion of the Primary Care centers, 
developing a network of 30 eye banks and 130 eye donation centers, 
and additional research on glaucoma and diabetes-related blindness. 
 
 
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Treatment for All, Rural to Urban 
---------------------------------- 
 
¶6.  LVPEI's network provides tiered stages of patient care to 
identify eye disease early on, and treat or escalate to the next 
level of care as appropriate.  The first three levels of the system 
are primarily located in Andhra Pradesh, though Balasubramanian 
indicated that as funding increases the institute hopes to expand 
the network into other states. 
 
 -- Community Eye Care.  At the village level, volunteers conduct 
basic screening and work with the next level of care for referrals, 
 
NEW DELHI 00002808  002.2 OF 003 
 
 
monitor those who have had surgery, and provide ready-made 
near-vision glasses. 
 
-- Primary Care Center.  Vision Technicians receive a year of 
training to conduct full vision screenings, provide prescriptions 
and low-cost glasses, and refer to the next level of care for 
surgeries and other conditions.  Each Primary Care Center caters to 
about 50,000 people comprising about 20-25 villages. 
 
-- Secondary Care Center.  Overseeing 10 Primary Care Centers, these 
centers can provide comprehensive outpatient services, surgical 
services, rehabilitation, and a full range of optical and 
pharmaceutical support.  They also refer cases to next level of care 
as required. 
 
-- Tertiary Care Center.  Spread across India, these hospitals and 
eye institutes work in affiliation with LVPEI to provide advanced 
care and rehabilitation, as well as training programs and clinical 
research. 
 
-- Center of Excellence.  The LVPEI facility in Hyderabad is 
considered the peak of eye care in India.  The institute also 
provides training for trainers and specialists, focuses on advanced 
research, has a strong advocacy and education program, and engages 
in clinical trials. 
 
--------------------------------------------- ---- 
Collaborative Research Activities, Practical 
Application of Science 
--------------------------------------------- ---- 
 
¶7.  LVPEI has an extensive list of publications and conducts its own 
research in addition to being a premier site for clinical trials by 
international health agencies and companies.  According to the 
research director and LVPEI's website, current collaborations 
include such prominent U.S. entities as NIH, Alcon, Allergan, Bausch 
& Lomb, i2 Foundation, and several universities.  Research is funded 
by several Indian national agencies, international grants, and 
contracts.  A full accounting of research activities can be found on 
the web at http://www.lvpei.org; post would like to highlight three 
projects of particular interest. 
 
-- LVPEI researchers will be visiting in November University of 
Pennsylvania faculty Dr. Jean Bennett to discuss her research on 
using gene therapy to non-surgically treat childhood glaucoma.  Dr. 
Bennett has had success with animal models and in a small group of 
human trials.  Balasubramanian believes this treatment, which would 
be the first ever gene therapy in India, could be made both 
inexpensive and accessible. 
 
-- Using stem cells taken from the limbus of a patient's eye, or the 
eye of a near relative, LVPEI conducted clinical trials over the 
past two years to treat corneal injuries by either implanting 
healthy cells or in some cases by growing a new layer of cornea for 
transplant.  Balasubramanian claimed their success rate is near 76 
percent, and the continuing studies include attempts to grow a full 
cornea for transplant. 
 
-- In an effort to identify cross-cultural variations in expression 
of the genetic components of eye diseases, LVPEI's molecular 
genetics researchers have undertaken a study in conjunction with the 
U.S. NIH to compare eye disease in India with eye disease in the 
U.S.  LVPEI expects the results to be useful in predictive genetic 
testing and early prevention or treatment. 
 
----------------------------------------- 
Extensive Education and Training Programs 
----------------------------------------- 
 
¶8.  LVPEI's education center provides comprehensive in-depth 
training programs that cover eye care personnel at all levels - 
 
NEW DELHI 00002808  003.2 OF 003 
 
 
front office, counselors, ophthalmic nursing assistants, 
administrators, vision technicians, optometrists and 
ophthalmologists - and also encompass outreach to primary school 
children and the production of educational videos.  The programs are 
both supported and attended by international eye care 
practitioners. 
 
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Comment 
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¶9.  LVPEI is a model for improved patient care and international 
collaboration, despite its limited geographic focus in Andhra 
Pradesh.  Indications are that it will continue its positive 
performance in both patient care and research.  Funding does not 
appear to be an issue at this time.  The institute has an 
established relationship with HHS through NIH, but is eager for more 
collaboration with U.S. researchers and industry to advance eye 
disease treatment capabilities.  This is a good news story for both 
the Indian medical system and U.S./Indian scientific collaboration. 
End Comment. 
 
MULFORD