From wheelchairs to memory aids, over 2.5 billion people in the world today need at least one assistive device either for communication, vision, mobility, as well as for certain cognitive functions, like memory aids. 

And the number is set to rise to 3.5 billion people by 2050 due to an ageing population and the prevalence of non-communicable diseases, such as heart attack and stroke, which are a major cause of disability. 

That’s the bottom line of a first-of-its kind report by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) on the needs and gaps in assistive devices that are critical to the health, safety and independence of billions. 

The report also highlights  the “vast inequalities in access to assistive technologies in high-income versus low-income countries, ranging from less than 3% in poorer countries to 90% in wealthy ones. 

“This is a stunning disparity and is one we can and must address,” Dr Tedros Adhanom Ghebreyesus said at a press conference launch today.  

Barriers – lack of awareness, affordability and supply chain challenges

Assistive technology is a broad term covering a wide range of services and devices that range from wheelchairs, protheses, eye glasses, hearing aids and other sorts of communication aids, to pill organizers and other kinds of memory aids.  

“Assistive technology is an umbrella term for the products that people with disabilities and older people need to live their lives more fully,” states the report, adding. “The global need is much larger than previously thought.” 

Indeed, the new estimate of needs globally is more than double previous WHO estimates that around 1 billion people need such devices.

According to the report, barriers to access include a lack of awareness and affordability, inadequate product quality, and procurement and supply chain challenges. 

The report for measuring accessibility was made after surveying over 330,000 people from 35 countries in all WHO regions. The study found that the most needed assistive product is a simple pair of spectacles. Other products that were in high demand are hearing aids, canes and crutches, chairs for shower, bath and toilet; different types of wheelchairs, orthoses and prostheses.

High Costs, Low Availability, and Stigmas

The most common barriers to accessing assistive products are their high cost and low availability.

Cost barriers are further exacerbated by the fact that most individuals surveyed reported having paid for assistive technologies from their own pockets – despite the fact that the devices are critical for people to live productive and independent lifestyles.

“Without this technology, people are thrust into poverty and dependency.” Dr Tedros pointed out before calling for governments, donors and civil society to fund and prioritise these neglected but critical products as part of the country’s journey towards universal health coverage. 

The results underscore the importance of having a robust policy in place with legislation and adequate funding, along with permanent implementation systems and structures to ensure universal, rights-based assistive technology access for everyone, everywhere.

“Assistive technology can literally mean the difference between denying or providing a child with all the education or the skills training they will need someday in the workforce, or just a chance to play with friends and contribute fully to their communities,” said Catherine Russell, Executive Director of UNICEF. 

She added that such lack of access to basic assistive technologies has very “predictable results like lower rates of school completion, higher rates of unemployment, reduced household income and dependency later in life say nothing of the lasting harm of exclusion and stigma.” 

According to the findings in the study, some countries reported that products and technologies also are not gender-friendly – and access may be skewered by gender as well. Some countries showed that men were twice as likely than women to access assistive products. The socio-cultural, financial and structural barriers that women face makes them more likely to suffer than men with need for assistive products. 

The Way Ahead 

The report also makes recommendations on how to better integrate the provision of assistive technologies within health and social care systems.

Among those, it recommends that health systems organise assistive technology services around the person and the environment in which they live, rather than around one particular disease or disability or financing flow.

Furthermore, there is a need for every country to collect and update population-based data in this domain to understand the gaps and trends in the needs as well as supply of such technologies, to  enable evidence-based strategies, policies and more comprehensive programmes. 

The first @WHO/@UNICEF Global Report on Assistive Technology reveals that ≈1 billion people in need of assistive technology are denied access: children & adults with disabilities & older persons. The fact that this is the first report on this problem shows how neglected it is. https://t.co/jpmxutwn0g

— Tedros Adhanom Ghebreyesus (@DrTedros) May 16, 2022

When it comes to humanitarian crises – and on the back of the Ukrainian crisis – the WHO has developed two lists of assistive products for children and adults with disabilities in emergencies. 

The first, and most basic list, includes wheelchairs and cushions, elbow and axilla crutches, walking frames and mobile toilet and shower chairs. The second list also includes static toilet, absorbent products and different types of catheter kits – all of which are among the devices most often needed by internally displaced people and refugees.

According to Anne Rabitte, the Irish Minister of State at the Department of Children, Equality, Disability, Integration and Youth and at the Department of Health, the timing is crucial and we need to act now to stop the gap in needs and access. “We know that one in three people require some assistive technology…This number is expected to increase exponentially the potential for innovation and development cannot be underestimated. Timing is important. And the quick key question really is if not, when?”

Image Credits: flickr, WHO/UNICEF, WHO/UNICEF , WHO/Otto Mejía.