Chronic diseases and health promotion

Part Four - Taking action: essential steps for success

Chapter Two - The private sector, civil society and international organizations

Product development. Spotlight: hearing aids

Many chronic diseases would benefit from the development of new medications or medical devices. The private sector has a significant role to play in closing these gaps, as do public-private partnerships, which can invest strategically to accelerate progress with regard to specific diseases.

For example, biotechnology-based diagnostics can provide accurate and less expensive blood sugar and lipid assays, thereby eliminating the need for high technology laboratories and technologically trained personnel in the field. Alternatives to insulin delivery technologies, such as nasal sprays, could reduce the need for trained personnel, injection needles and refrigeration, and could revolutionize the management of diabetes. Affordable hearing aids (see spotlight below) are another public health priority.

Spotlight: Affordable hearing aids

WHO estimated in 2001 that over 90% of the 250 million people worldwide with disabling hearing impairment and deafness (of whom two thirds live in developing countries) would benefit from hearing aids. Current annual production of hearing aids provides approximately 33% of those needed in high income countries, but less than 3% of those needed in low and middle income countries.

Hearing aids in low and middle income countries range in price from US$ 200 to over US$ 500, prohibitive for the majority of people living there. Major companies are also reluctant to provide affordable hearing aids on a large scale because of their perceived lack of a sustainable market, and the lack of infrastructure to provide them.

Providing appropriate and affordable hearing aids and services worldwide would be a highly effective and cost-effective way to make a positive impact. Sustainable provision on a sufficiently large scale in low and middle income countries would also be crucial in terms of improving equity and access.

WHO has developed Guidelines for Hearing Aids and Services for Developing Countries as a tool for such programme development. The guidelines state that public–private partnerships between the governments of developing countries and hearing aid manufacturers are necessary.

WHO and key stakeholders recently came together to set up an independent, collaborative network, called WWHearing (World-Wide Hearing Care for Developing Countries), to gather information on provision and need in developing countries, encourage appropriate, affordable hearing aids and services, stimulate public–private partnerships and promote projects for fitting, follow-up, repair and training. Countries in four WHO regions are in the process of setting up pilot studies to test the approach for these partnerships.