Assistive technology enables and promotes inclusion and participation, especially of persons with disability, aging populations, and people with non-communicable diseases. The primary purpose of assistive products is to maintain or improve an individual’s functioning and independence, thereby promoting their well-being. They enable people to live healthy, productive, independent and dignified lives, and to participate in education, the labour market and civic life.
WHO estimates that today 2.5 billion people need one or more assistive products such as wheelchairs, hearing aids, or apps that support communication and cognition. With a global ageing population and a rise in noncommunicable diseases, this number will rise beyond 3.5 billion by 2050, with many older people needing two or more products as they age.
Examples of assistive products include hearing aids, wheelchairs, spectacles, prostheses and devices that support memory, among many others. While supporting independence and well-being, these products can also help to prevent or reduce the effects of secondary health conditions, such as lower limb amputation in people with diabetes. They can also reduce the need and impact on carers and mitigate the need for formal health and support services. Moreover, access to appropriate assistive products can have a tremendous impact on community development and economic growth.
Despite the global need and recognized benefits of assistive products, access to assistive products remains limited. Addressing this unmet need is essential to progress towards the achievement of the Sustainable Development Goals and realizing the Convention of the Rights of Persons with Disabilities.
Despite the growing number of people in need of assistive products in every country, currently nearly one billion do not have the access they require. This is particularly the case in low- and middle-income countries, where access to these life-changing products has been found to be as low as 3%. These gaps exist for a number of reasons, including high cost and a lack of financing, availability, awareness and trained personnel.
Challenges exist both in low- and high-income countries. Very few countries globally have developed a national assistive technology policy or programme and so provide assistive products through the private sector. Even in high-income countries, assistive products are often rationed or not included within health and welfare schemes, leading to high out-of-pocket payments by users and their families. People may be left to rely on erratic donations or charity services, which often means the products are of low quality or inappropriate for the person’s needs. Those who can afford them often purchase items from pharmacies, private clinics, or workshops. In these scenarios, people often are not taught how to use the product safely and lack access to follow-up appointments, which are essential to ensure that the product meets the person’s needs and that it is in good working order.
Assistive technology services are often stand-alone programmes and not integrated across all the levels of care, from primary to tertiary. People may be forced to attend multiple appointments at different locations, which are costly and add to the burden on assistive product users as well as caregivers, and on health and welfare budgets. Another challenge is represented by the shortage and uneven distribution of the health workforce, which often does not have the skills and competencies to address the needs of the population.
WHO’s vision is that everyone, everywhere, has the right to the highest attainable standard of health. Assistive products are fundamental to achieve this vision, as they ensure that people with disability, older people and those affected by chronic health conditions are able to live a healthy and dignified life and are included in society.
As part of that commitment, the 2030 Agenda for Sustainable Development places well-being and universal health coverage at the centre of its development vision, with the commitment to leave no one behind. In addition, the Convention on the Rights of Persons with Disabilities has recognized access to assistive technology as a human right and has called for international cooperation to improve global access (Article 32).
In 2018, delegates at the Seventy-first World Health Assembly adopted the resolution Improving access to assistive technology, urging Member States to develop, implement and strengthen policies and programmes to improve access to assistive technology as a move towards universal health coverage.
WHO coordinates the Global Cooperation on Assistive Technology (GATE) as a step towards realizing the Sustainable Development Goals, the Convention on the Rights of Persons with Disabilities and implementing the resolution WHA71.8 on assistive technology. The GATE initiative has the goal to support countries in addressing challenges and improving access to assistive products within their context.