March 28, 2024

Amplifying the global issue of hearing loss – The Lancet

Hearing aids will soon become available directly from retailers for adults with mild to moderate hearing loss in the USA, thanks to a long-awaited Food and Drug Administration rule that establishes a new category of over-the-counter (OTC) hearing aids. The agency’s announcement emphasised the expectation that the legislation would lower the price of hearing aids without sacrificing their safety and effectiveness. This overdue move represents a welcome step forward for people with hearing loss in…….

Hearing aids will soon become available directly from retailers for adults with mild to moderate hearing loss in the USA, thanks to a long-awaited Food and Drug Administration rule that establishes a new category of over-the-counter (OTC) hearing aids. The agency’s announcement emphasised the expectation that the legislation would lower the price of hearing aids without sacrificing their safety and effectiveness. This overdue move represents a welcome step forward for people with hearing loss in the USA, and should provide impetus for the global community to address what is often a neglected disability.Hearing loss, which currently affects 20% of the global population, has risen from the 11th leading cause of years lived with disability in 2010 to the third in 2019. A complex web of determining factors impacts hearing at different stages of life, including genetic characteristics, health conditions, living and working environment, and age-related degeneration. Many causes of hearing loss are preventable through public health measures. But it can become a chronic condition and worsen over time if not managed.Over 80% of the population with hearing loss lives in low-income and middle-income countries (LMICs), where access to health care—especially hearing care—remains limited. Many people with hearing loss do not actively seek hearing care for various reasons including limited awareness, high cost, and stigma. People with uncorrected hearing loss can experience difficulties with communication, mental health problems, social isolation, and a high unemployment rate.In the World Report on Hearing published in 2021, WHO recommended a comprehensive set of interventions (H.E.A.R.I.N.G.) covering prevention, management, rehabilitation, and environmental factors. A modelling study published earlier this year in The Lancet Global Health used data from 172 countries to examine the cost-effectiveness of the interventions recommended by WHO. It estimates that 90% implementation of the core interventions will avert 130 million DALYs—ie, a monetary gain of $1·3 trillion—in 10 years, corresponding to a return of $15 for every $1 invested. Hearing aids are one major component of this set of cost-effective interventions, serving as first-line clinical management.

Nonetheless, for hearing aids to truly aid, some challenges must be tackled. First and foremost, cost. The global supply of hearing aids is mainly controlled by manufacturers headquartered in high-income countries, whose current pricing strategies seem to overlook affordability in LMICs. Therefore, to bring down the price of hearing aids, investments and infrastructural support should be directed to new manufacturers located in LMICs to develop safe and low-cost hearing aids with features that satisfy local needs. In addition, national universal health coverage plans should consider including hearing aids and other hearing care to reduce out-of-pocket payment.

Affordable devices remove the financial barrier, yet other factors influencing people’s willingness to use hearing aids still stand in the way. A second challenge would be to mobilise people. Raising awareness of hearing loss and the harm of untreated hearing impairment is …….

Source: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00390-4/fulltext