Demographics will continue to be a major force to consider. The earth's population is increasing, people are living longer, blindness in the industrial world is about multiple impairments, while blindness in the developing nations is endemic and about preventable diseases. Disability seems on the decrease in the industrial world and on the increase in the poorer regions of the planet. The shift of power into the hands of individuals and consumer groups is a strong trend that seems destined to continue. What these new institutions will be is any bodys guess.
Globalization is already here, but expect the trend to intensify.
Diversity is the key word as cultures become less homogenous. Globalization decreases the power of old centralized authorities. This is related to a decentralization that is drying up centralized federal funding and guidance. Contracting and privitization appear to be increasing trends related to the shifting of power away from centralized systems. The tendancy to see disabilities in a generic way, rather than favoring one group over another is another consequence of globalization, and it portends negatively for blind rehabilitation.