# EXECUTIVE SUMMARY

Well over one billion people around the world require the use of at least one assistive technology (AT); by 2050, the need is expected to double due to ageing global populations, increased prevalence of non-communicable diseases, and other factors. AT is an umbrella term for devices and associated services—from eyeglasses to wheelchairs—that help users1 live with greater autonomy and choice by improving their functioning in daily activities. Global commitments recognise AT as a human right, yet only 5-15% of the population that needs AT have access to it. This injustice reduces the economic opportunities of individuals, families, and entire nations; not to mention that it comes at a great cost to the quality of life of people who need AT.

Access to four products - hearing aids, prostheses, eyeglasses, and wheelchairs - can have enormous positive effects in promoting more equitable outcomes for hundreds of millions of people living in low- and middle-income countries (LMICs).

The case for investing in increased access to AT is built on three key benefits – economic, health, and social. In tandem with other critical efforts to expand the rights and participation of people with disabilities and impairments, AT can help unlock the full potential of hundreds of millions of people and promote more equitable outcomes for all. The benefits of AT, focusing on four products (hearing aids, prostheses, eyeglasses, and wheelchairs), are:

ECONOMIC RETURNS. AT has a significant effect on lifetime earning potential. Sustained provision of the four products in LMICs can yield about USD 100,000 in average increased income over the life of a child who receives AT. These benefits accrue through improved educational outcomes among younger users, better paid employment and higher productivity among adult users, and the reduction of challenges caused by ageing, helping users to work longer. Together, these factors can drive significant increases in lifetime income for AT users and their families with ripple effects that accelerate national-level economic growth. Altogether, providing AT to all who need it would yield more than USD 10 trillion in economic benefits over the next 55 years.

HEALTH IMPROVEMENTS. AT improves users’ health and wellbeing. The health benefits of increased access to the four products and related services are equivalent to an average 1.3 additional years of ‘perfect health’ 2 (quality-adjusted life years or QALYs) over the life cycle of each user. Over the course of users’ lives, AT can facilitate their ability to move, communicate, and see better than before. This directly contributes to improving users’ physical and mental health, while also increasing access to broader health services for ongoing care. Across LMICs, this adds up to over one billion QALYs for those in need today.

SOCIAL INCLUSION. Increased access to AT facilitates greater inclusion of users of all ages in society. AT facilitates the engagement of younger AT users in meaningful play with their peers, supporting the development of friendships, independence, and lifelong learning skills. Greater societal inclusion and easier interpersonal interaction facilitated by AT also help to lower otherwise elevated risk of chronic loneliness and foster a sense of belonging for AT users including older people.

Investment to realise these benefits will result in a return on investment (ROI) of 9:1. Our analysis traces the ripple effects of AT’s impact in LMICs to show how these three benefits for an individual can have a strong, positive impact on the families of people in need of AT— and consequently how these effects flow outward to impact communities and entire nations. The investments required to strengthen and improve product / service delivery systems and provide the assistive products while significant are small relative to these benefits. In fact, investing in increased AT access will generate a ROI of 9:1.

Countries have begun taking important steps to expand access to AT and realise these benefits, but significant challenges remain. Through growing advocacy efforts, policy changes, and supply chain strengthening, some countries have begun expanding access to AT. The efforts of these countries offer insight to others looking to increase AT provision and realise this ROI. However, persistent shortcomings in supportive systems and policies, market failures, and inadequate user awareness hamper progress. Overcoming these challenges will require coordinated action by global and local stakeholders.

With this report, ATscale, the Global Partnership for Assistive Technology, aims to provide compelling arguments to stakeholders around the world for increasing access to AT. ATscale was launched in 2018 with the goal of catalysing action to reach 500 million more people with assistive technology by 2030 to enable a lifetime of potential. As a cross-sector partnership to amplify existing work and coordinate and mobilise global stakeholders, ATscale aims to increase the availability of and access to affordable and appropriate AT. We hope this report makes the case for stakeholders to join in this mission and work with us towards achieving these ambitious goals.

Given the benefits and 9:1 ROI for investments in AT, the case for action is clear. As a sector, AT has too long remained fragmented, under-resourced, and neglected in global discussions of economics and health. Yet, investment in AT is essential to the implementation of the 2030 Agenda for Sustainable Development and its global commitment to ‘leave no one behind.’ It is both the right thing and the smart thing to do.

Figure 1: Key economic, health and social benefits of AT provision

Image Description

In this inforgraphic AT provisions are shown to benefits users, family and society. The Economic Benefit is ‘Increase Income’, total lifetime benefits are $10 Trillion USD

The Health Benefit is ‘Improve Health and well being’, total lifetime benefits are 1 billion QALYS

The Social Benefit is ‘Facilitates greater inclusion’, total individuals benefiting are nearly 1 billion

Return On Investment is in the ratio of 9:1

Key Factors | Economic Benefits | Health Benefits | Social Benefits
User | Education: Better academic outcomes leading to greater earning potential. Employment: Greater opportunities for paid work. Productivity: Increased productivity and higher wages. Working timespan: Reduced challenges of aging allowing work until retirement. | Improved outcomes: Prevent or ameliorate comorbidities. Access: Increase access to existing services. | Interaction: (Re-) integration of users into society. Independence: Increased ability to live an independent and fulfilled life. The social benefits flow from users to society
Family | Time: New opportunities to take on paid work. | Stress: Reduced fatigue and anxiety of support provision. |
Society | Multiplier effect: User and family spending ripple through the economy. | System savings: Greater access to preventive care generates long-term savings. Safety: Reduced accidents and safer engagement between users and society. |

End of Image Description