Jordan Kassalow is addressing the market-failure for affordable eye care in the developing world, and the resulting economic burden of vision disability by transforming the eyewear delivery system to ensure that every person has access to the glasses required to live a full, productive life.
The New Idea
An optometrist and public health entrepreneur, Jordan has spent much of his career showing the link between vision and economic productivity at the base of the pyramid. He introduced improved care for river blindness, and founded the Global Health Policy Council at the Council on Foreign Relations.
Through VisionSpring, the not-for-profit organization he co-founded as Scojo in 2003, Jordan is creating new markets and delivering affordable glasses and other vision services and products to the world’s poor. He does this by arranging low-cost manufacture of sought-after goods; distributing these through direct sales and partner organizations; and signaling a new market opportunity to industry players that currently pursue a high-margin, low-volume approach to sales in emerging markets. Jordan and his team have supplied over 400,000 pairs of ready-made glasses, contributing health and increased wage-earning capabilities to this underserved group and surfacing a demonstration model for the industry. Now he and his colleagues are piloting a “full service” approach that builds out a diversified product range, and approaches profitability through the introduction of some higher-margin products (i.e. prescription glasses) that are still affordable to customers earning as little as $4/day. The global system he has engineered links production in East Asia with consumers and VisionSpring teams in Central America, India, Bangladesh, South Africa, and Indonesia.
For sighted people, good vision is inextricably linked to overall health and to economic productivity. If you can not see well, you often can not work and earn a living. While simple, ready-made eyeglasses can correct most common vision problems, millions of people who need glasses are not getting them. This often means they can not work and lead fully productive lives: The global cost of vision loss was estimated at $3 trillion in 2010.
The problem is not a new one, nor is the product that represents a solution—eyeglasses were invented in the 1200s. The distribution system has been evolving for 800 years to the point of near market saturation in most developed economies. The challenge—and opportunity—is reaching everybody else. An estimated 410 million people are unable to perform basic tasks due to presbyopia (i.e. blurry up-close vision, resulting in middle age) because they don’t have ready-made glasses, and another 158 million are visually impaired because they have blurry distance vision (myopia) and do not have glasses.
Various charity-based organizations gather eyeglasses that are discarded from customers in wealthier countries. Through the best of intentions, these approaches are limited in impact and do not represent a viable long-term solution. While a market-based approach makes sense as a longer-term solution, cost and distribution are the big barriers, so challenging that most mainstream eyewear manufacturers can’t see past them to the market potential. Manufacturers who sell in developing countries—most of the big companies are based in the U.S. and Europe—pursue a model that is low-volume, high-margin—and high cost to the consumer. In cities across much of the developing world, you can buy a custom pair of glasses from an eye doctor or optical shop for $40 to $60. But if you’re earning the equivalent of, say, $4/day, there’s nothing available anywhere near your price point.
For its first eight years, VisionSpring focused solely on distributing ready-made, non-prescription reading glasses. Reading glasses are inexpensive to produce, do not require a doctor to distribute, and have a direct impact on the work and productivity of tailors, artisans, mechanics, and other professions common in many parts of the world.
Jordan and his team are iteratively evolving distribution approaches, and molding distribution/sales to fit the local reality. Distribution therefore looks quite different in different parts of the world. There are three main approaches: Direct sales, sales through distribution partners, and an emerging “full service” model.
To directly reach customers in rural areas, VisionSpring directly manages 50 Vision Entrepreneurs, the on-the-ground sales team. Typically women, Vision Entrepreneurs generate awareness, conduct screenings, and sell low-cost reading glasses in their communities. Jordan and his team have developed a “Business in a Bag,” a kit containing everything needed to launch a one-person eye care business. While VisionSpring began with this sales model, Jordan’s team is now focusing efforts on this channel mainly to innovate, but is not actively expanding it, due to the expense of working solely in rural regions, low margins from the core suite of ready-made reading glasses and sunglasses, and increased demand from customers and Vision Entrepreneurs for additional affordable vision products.
To achieve greater scale, VisionSpring partners with distribution partners—citizen organizations with complementary rural sales networks, such as microfinance institutions and community health worker organizations. This approach allows greater impact without committing additional human and financial capital. Partners are attracted to VisionSpring because they can easily incorporate eyeglass sales within their programs and they receive product and training support. VisionSpring provides them with the Business in a Bag program, performs initial due diligence, conducts a pilot program to train-the-trainers, and provides ongoing support as the partner continues to grow the program. In 2008 Jordan developed a partnership with BRAC, which accounts for 75 percent of VisionSpring’s sales. A challenge of this approach is that the sales team is not dedicated and may have a number of other products in their bag, many of them less expensive, repeat-sales items, like sanitary napkins and condoms.
To address some of the challenges of the other models, Jordan and his team are piloting what they call the “full service” model in peri-urban areas of El Salvador, India, and Indonesia. The idea emerged from a Vision Entrepreneur in El Salvador who felt that she was disappointing as many people as she was helping, because some clients needed prescription glasses and she had only ready-made. The full service approach provides affordable, high-quality prescription glasses as well as ready-made reading glasses and engages an optometrist to host regular campaigns from an urban/peri-urban optical shop. VisionSpring compensates Vision Entrepreneurs for creating demand in rural areas and driving targeted potential customers to the optometrist. Jordan and his team plan to scale this approach either by building the Vision Entrepreneur network or through the partner channel once refined and proven successful. In El Salvador, the team has developed relationships with local lens manufacturers to make low-cost prescription lens, and are showing the viability of a high-volume, low-margin approach.
Jordan and his team are always improving the cost of goods. Currently, they source manufacturers in China through a full-time VisionSpring staff member, who is constantly scouting the best manufacturers, negotiating lower prices, and ironing out other supply chain problems, such as efficient, on-time, cross-border shipping. At present, Jordan and his team are working with three Chinese factories for the manufacture of ready-made reading glasses. They are also looking at possible partnerships with U.S.- or Europe-based companies. Last year, they were 90 percent through a negotiation with a U.S.-based manufacturer who was willing to make the glasses at 25 percent less cost than directly sourcing the manufacturers. The company was sold, and new leadership did not want to pursue working with VisionSpring at this time.
Jordan is beginning to showcase the learning’s by convening large eyeglasses companies in North America and Europe in an effort to show the potential of setting the industry on a course of high-volume, low-margin, which shows huge social and profit returns.
VisionSpring has teams in the U.S., India, El Salvador, and Indonesia. Because much of its operational expenses are handled by local partners, it operates on a lean budget—in 2010, $1.6M. VisionSpring is a not-for-profit and all revenue is reinvested in the organization.
Jordan grew up in New York City, the son of an optometrist who built a special and successful practice with the city’s wealthy, connected clientele. Jordan devised several small businesses as a child, showing an early instinct for entrepreneurship. His interest in and exposure to the developing world emerged from his love of the world’s mountains and of climbing.
Jordan trained as an optometrist, taking a partner role in the family business. But his interest in the developing world drew him to participate in eye camps in Central America, where he saw the real need for vision services, and grew frustrated by the band-aid approach to meeting that need. He also arranged an apprenticeship at Aarvind Eye Hospital in India during its early years.
Jordan studied public health, becoming an expert in Onchocerciasis (river blindness). He led the Onchocerciasis Division at Helen Keller International and over an 8-year period took the two-country program reaching 50,000 people to a 9-country effort reaching 1 million people.
Through these experiences with eye care in developing countries, he began to focus strongly on the link between health—specifically eye health—and economic stability, for individuals and families and also on a larger scale of nations. Learning of his interests, one of his patients pointed him to the Council on Foreign Relations, where Jordan became a Fellow (1999 to 2004) and established the Global Health Policy Council, which sought to reframe investment in health not as a humanitarian concern, but as a matter of national and economic security.
Jordan lives with his wife and three children in New York City.