The World Health Organization estimates that more than one billion people globally require assistive products such as wheelchairs, prosthetics, or hearing aids. With longer life spans ensuring an increase in the aging population worldwide, and a rise in non-communicable diseases, there will be an unprecedented growth in demand. It is estimated that more than two billion people will need at least one assistive product by 2030.
The current reality however, is that in many low- and middle-income countries only 5-15% of people who need such products have access to them.
The reasons for this are multifarious and complex. Among the key issues:
• Most assistive products are manufactured for sale in high-income countries, contributing to the low availability of affordable, quality products in LMICs.
• For LMICs that import assistive products, limited financial resources and variety of available products mean buyers tend to procure from a single supplier with limited, often low-quality options.
• Even if product is available, few LMICs cover or subsidise the cost of assistive products under national insurance schemes, making products prohibitively expensive for low-income earners.
• This is exacerbated by insufficient distribution, referral and provision networks – meaning that getting products to the people who need them can be slow and expensive.
• Limited local availability of related services — such as technically trained professionals to prescribe and customise assistive products, teach people how to use them or conduct repairs — increases the problem, and means that many assistive products are abandoned over a small repair or maintenance issue.
Consolidated logistics solutions
It can be daunting and cost-prohibitive for donors and governments to identify and source multiple assistive products for the populations they serve. By consolidating complex logistics, CLASP helps buyers to procure an appropriate mix of assistive products efficiently, and at a more affordable price.
The USAID-funded CLASP initiative uses a consolidation hub that allows buyers to make big or small orders of mixed mobility devices from vetted suppliers in a variety of sizes and product types. To ensure the products meet global standards, a team of clinical, technical and wheelchair user experts reviews all products before they are offered and then recommends which wheelchairs, walking aids, cushions, spare part kits or modification kits should be part of the CLASP catalogue.
Greater focus on service provision
Wide-scale implementation of clinical wheelchair and mobility aid services in line with WHO’s Guidelines for the Provision of Manual Wheelchairs in Less Resourced Settings improves outcomes for users. The guidelines have proven health and functional benefits for users and help reduce wheelchair abandonment. CLASP actively seeks to support service organisations that are committed to delivering quality services.
Technology transforming product design and manufacture
Additionally, recent advancements in technology and materials are prompting transformations in the way assistive products are being designed and manufactured. Motivation, which produces several well-regarded, active, rough-terrain wheelchairs, and is a supplier to the CLASP catalog, has recently piloted the use of 3D printers to produce Postural Support Devices(PSDs) in India.
With support from Google.org, the Motivation Team has been printing PSD components and custom fitting them to individuals’ wheelchairs, enabling already prescribed and fitted wheelchairs to be even further refined for every user - empowering not only clinicians and other staff who fully understand the demands of the local environment, but also placing the wheelchair user firmly at the heart of the process.
Growing awareness of the global need for assistive products
The recent AT resolution adopted at the World Health Organization’s (WHO) 71st World Health Assembly in Geneva in May 2018 marks a growing awareness of the needs of the one billion people who currently do not have access to assistive products. The resolution urges member states “to develop, implement and strengthen policies and programmes, as appropriate, to improve access to assistive technology within universal health and/or social services coverage.”
In addition, the 177 countries that have so far ratified the UN Convention on the Rights of Persons with Disabilities are under scrutiny to uphold their pledges to facilitate access to assistive products. One thing is certain, as the world population ages and the demand for assistive products grows, the imperative to serve the needs of people with disabilities will only increase.