Improving access to donation and transplantation services through global cooperation and harmonization | Eversight webinar recap

By Michael Szkarlat, Partner Development Director

Heather Machin, RN, MBA, PhD, begins the webinar with her case for cooperation and harmonization among the world’s eye banks as an avenue to improve access to donated corneal tissue worldwide. Dr. Machin defines harmonization as sharing knowledge, openness, transparency and finding our commonalities and points of difference. 

She provides an overview of the field of eye banking which is, compared to many other medical fields, a small and niche community. The small size can have some downsides, such as creating silos where information is not shared between organizations, especially countries. 

There are many high-resource countries with advanced eye banking services such as Australia and the United States. In these systems, there is often competition, which she argues can be both productive and hindering depending on how it is managed. Dr. Machin highlights profitization as being unaligned with the ethical principles supported by the larger eye banking community. 

Finally, high-resource countries are privileged to be able to look more into the future (cell therapies, biosynthetic materials, etc.). In lower- and middle-resource countries, the focus in contrast tends to be more on the present. They are typically concerned with creating sustainability, accessing resources and opportunities to advance. 

Dr. Machin then describes some of the complexities and idiosyncrasies in the field of eye banking, such as the discrepancies between surplus and deficits in tissue between countries among others. 

Of course, as Dr. Machin highlights, personhood must always be considered in all issues surrounding donation of eye tissues. This consideration should be pervasive in all aspects of the field from donor consent and screening all the way through transplant and beyond, especially with future treatments such as cell therapy.  

She provides a review of the history and development of the Global Alliance of Eye Bank Associations (GAEBA). In 2013, Dr. Machin was charged with four tasks by the World Health Organization (WHO): create harmonization in eye banking, establish a bioethical framework, create universal medical and procedural standards, and to create a framework and system for data collection and sharing.  

Harmonization is focused on building an organization charged with creating more collaboration within the field of eye banking on a global scale. Established in 2014, GAEBA set out with several aims including developing a set of universal best practices, creating a worldwide registry of eye banks, and advocacy for corneal tissue donation and eye banking. Dr. Machin reviews the numerous members and collaborators within GAEBA and challenges faced, including representation, resources, momentum and lack of balance in involvement amongst the membership.  

Dr. Machin discussed another task charged by the WHO: to create a bioethical framework for eye banking. This was accomplished with the development the Barcelona Principles in 2018. This provides a framework for everything from consent, to donation, transplant, research and beyond. 

Next, Dr. Machin discusses other efforts of GAEBA, including the development of position statements and standards, collaboration with the field of eye care, sharing of knowledge and resources, networking efforts, celebrations and awards. 

Finally, she reviews the present and future efforts of GAEBA, including a call to action to get involved to those on the meeting and to you reading this now to get involved with GAEBA and in your countries’ eye bank associations. 

Current GAEBA projects include developing a strategic plan for 2024 and beyond, creating global medical standards, and creating a global database for eye bank related information.