By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia
The WHO South-East Asia Region is committed to addressing hearing loss and ear diseases across the life-course. More than 400 million people in the Region live with hearing loss, accounting for just over 25% of the global burden. More than 100 million people in the Region require hearing rehabilitation services, which by 2050 is expected to total at least 185 million. Unaddressed hearing loss leads to reduced productivity and is estimated to cost nearly 1 trillion international dollars globally, including 110 billion in the Region. WHO will continue to support all countries in the Region to prevent and address hearing loss, in line with the findings of the first ever WHO World report on hearing, released today, on World Hearing Day.
Action is needed across programme areas to achieve the targets identified in the report, which include a 20% relative increase in the effective coverage of newborn hearing and screening services; a 20% relative increase in the effective coverage of adults with hearing loss that use hearing technology; and a 20% relative reduction in the prevalence of chronic ear diseases and unaddressed hearing loss in school-aged children, all by 2030. Hearing loss is preventable throughout the life-course through effective public health interventions. In children, almost 60% of hearing loss is due to causes that can be prevented through measures such as immunization, improved maternal and neonatal care, and screening for, and early management of, otitis media. In adults, legislation on noise control and safe listening, and surveillance of ototoxicity can help maintain hearing trajectories and reduce the potential for hearing loss.
Identification is the first step in addressing hearing loss and related ear diseases and must therefore be promoted as part of the Region’s primary health care approach to achieving universal health coverage, which since 2014 has been a Flagship Priority. Clinical screening at strategic points in life ensure that these conditions can be identified at the earliest possible stage. Recent technological advances, including accurate and easy-to-use tools, can identify ear disease and hearing loss at any age, in clinical or community settings, and with limited training and resources. Once diagnosed, early intervention is the key to successful outcomes. Medical and surgical treatment can cure most ear diseases, potentially reversing associated hearing loss. When hearing loss is irreversible, rehabilitation can ensure that those affected, and society at large, avoid adverse consequences.
Essential public health interventions for the provision of ear and hearing care services across the life course are summarized in the acronym “H.E.A.R.I.N.G”: Hearing screening and intervention; Ear disease prevention and management; Access to technologies; Rehabilitation services; Improved communication; Noise reduction; and Greater community engagement. The first four interventions can be integrated and delivered through strengthened health systems. Countries can determine which interventions best suit their needs by conducting an evidence-based consultative prioritization exercise. Region-wide, increased efforts are needed to enhance health worker capacity, especially at the primary level, and to expand access to high-quality hearing technologies, which can be achieved by including them in governments’ lists of essential devices.
Increased investments aimed at tackling the problem are needed. It is estimated that scaling up ear and hearing care during the next 10 years, through integrating the H.E.A.R interventions into health systems, will require an additional per capita investment of just US$ 1.33. The economic and social benefits will be immense, averting nearly 130 million disability adjusted life years globally and yielding a return of nearly US$ 16 for each dollar invested. To build a post-COVID recovery that is healthier and fairer, countries in the Region must prioritize investments in cost-effective interventions that will benefit people with hearing loss, and which will bring financial gains to all of society.
The choice is simple: act now or pay later. The World report on hearing provides a call to action that we must all get behind to avoid a Region and world in which nearly 25% of the population faces hearing loss. By integrating quality ear and hearing care into national health systems that are people-centred and accessible to all, we can sustain and accelerate progress towards the 2030 World report on hearing targets and Sustainable Development Goals. On World Hearing Day, WHO reiterates its support to all countries in the Region in their efforts to prevent, diagnose and treat hearing loss and ear diseases, for a healthier, fairer and more sustainable future for all.