GLOBALLY, AROUND 466 MILLION PEOPLE HAVE DISABLING HEARING LOSS, and this number is expected to double by 2050 due to ageing populations, and new cases of hearing loss caused by untreated ear infections, ototoxicity, and noise exposure. The World Health Organization (W.H.O.) estimates that unaddressed hearing loss poses an annual global cost of U.S.$750 billion with negative impact on education, social life and employability of those with hearing loss.
A hearing aid is a rehabilitative device that amplifies sound for those with hearing impairment that cannot be resolved medically. Currently, W.H.O. estimates that 72 million people worldwide need hearing aids, but only 10% that need at least one have them, with coverage less than 3% in low- and middle-income countries (L.M.I.C.s). Hearing aids should be delivered in the context of a Ear and Hearing Care (E.H.C.) programme within the health system, which is capable of screening for, diagnosing, and resolving the causes of hearing loss, as well as providing aural rehabilitation, other assistive listening devices and aids, and peer support.
Five suppliers control more than 90% of the hearing aid market and focus primarily on high-income countries (H.I.C.) and high-value market segments in L.M.I.C.s, such as wealthier, often urban populations. Market entry barriers and acquisitions have kept the market consolidated.
Key barriers that perpetuate the current situation of low interest from global suppliers in L.M.I.C. markets and low access to hearing aids include: limited investment by governments; high cost of product and services to the end users; lack of quality standards; and a service delivery model that requires high levels of resources in terms of personnel and infrastructure. Innovations in service delivery, diagnostic devices, and hearing aids themselves may provide opportunities to address these barriers.
Developing a market for hearing aids in L.M.I.C.s will require affordability and availability of optimal hearing aids and services. Products and services can be defined as “optimal” if they meet a target/preferred product profile, meet the needs of the end user and are of suitable quality (i.e. compliant with high engineering and clinical standards). To achieve this, we propose five strategic objectives (S.O.) that can strengthen the market in both the near and longer-term:
A healthy market, defined as sustainable where demand meets supply, requires consensus around service delivery norms and product selection (S.O. #1). This consensus would serve as the foundation to build service delivery infrastructure via the public and private sector and rationalise procurement mechanisms (S.O. #2 & #3). More predictable and growing demand will enable economies of scale and support market shaping interventions proposed in S.O. #4 to support suppliers and distributors entering L.M.I.C. markets. Game-changing technologies that can help increase coverage are emerging and would benefit from investments now. (S.O. #5).