Progress report on improving access to assistive technology

Regional Committee for the Eastern Mediterranean Sixty-fifth session Provisional agenda item 3(d) EM/RC65/INF.DOC.3 August 2018 Progress report on improving access to assistive technology Introduction 1. In October 2016, the 63rd session of the Regional Committee for the Eastern Mediterranean adopted resolution EM/RC63/R.3 on improving access to assistive technology. This report summarizes progress in implementing that resolution and the regional situation regarding access to assistive technology. 2. In resolution EM/RC63/R.3, the Regional Committee requested the Regional Director, inter alia, to provide technical support to Member States in the development of national policies and programmes for assistive technology; conduct adequate needs assessment to inform service planning; advocate for unimpeded transfer of knowledge and information; strengthen collaboration among countries; and develop lists of priority assistive products. 3. In October 2017, during the 64th session of the Regional Committee in Pakistan, a high-level side event resulted in endorsement of the Islamabad Declaration on improving access to assistive technology, a further important commitment by Member States. 4. At the global level, with leadership efforts by the Government of Pakistan, the Seventy-first World Health Assembly in May 2018 endorsed resolution WHA71.8 on improving access to assistive technology. This resolution reinforces the commitment of Member States, WHO and partners to work together towards the common goal of improving access to assistive technology for everyone, everywhere. 5. Regional efforts are strongly linked to the WHO Global Cooperation on Assistive Technology (GATE) initiative. Member States can make use of the GATE initiative to address the core elements of any successful assistive technology strategy, namely: policy and financing; products; personnel; and provision of services. GATE emphasizes the need for Member States to change the way they have traditionally perceived, designed, produced, manufactured, distributed, serviced and financed assistive products or devices. A priority assistive products list has been developed by GATE as the first stage in supporting countries to implement their commitments to improve access to assistive products. Regional situation 6. Existing gaps in knowledge and scarcity of specific data make it difficult to accurately assess the situation in the Region regarding access to assistive technology for those in need. Nevertheless, available data on disabilities, visual and hearing impairments, ageing populations and the burden of noncommunicable diseases, mental health conditions and injuries, as well as data from emergency contexts, show an increasing need for assistive technology and rehabilitation services in the Region, with limited access to appropriate, affordable and quality assistive products. 7. Available data show that the proportion of older people within the population of the Region will progressively increase from about 6.6% in 2015 to almost 15% in 2050. Noncommunicable diseases are on the rise in the Region and prevalence of the main behavioural risk factors is among the highest in the world. Given that the regional road traffic death rate is one of the highest worldwide, the number of disabilities due to non-fatal road traffic injuries can be expected to be high. In addition, the implications of emergencies affecting many countries in the Region will create an even greater need for assistive technology. In view of the evolving needs of populations in the Region, access to assistive technology is as important as access to other technologies. EM/RC65/INF.DOC.3 2 Implementation of resolution EM/RC63/R.3 8. The Eastern Mediterranean Region has made progress towards improving access to assistive technology and ensuring its integration as an essential and inherent component of universal health coverage. In accordance with resolution EM/RC63/R.3, a rapid assessment survey was conducted on the status of assistive technology in the Region and a regional framework has been developed for advancing access to assistive technology in Member States. 9. The rapid assessment survey was undertaken in 17 Member States. It shows that policies, systems and service delivery for assistive technology are inadequate in many countries in the Region. Obtaining the relevant data and information to assess the situation represented a huge challenge as registry, tracking or monitoring systems do not exist in the majority of countries. 10. Results of the rapid assessment survey have been compiled in a report, which provides valuable baseline information on the regional situation. The regional report will be circulated during the 65th session of the Regional Committee, while country-specific profiles will be shared with respective ministers of health and delegations. 11. In May 2018, a regional framework on advancing access to assistive technology was developed in consultation with Member States during a meeting in Islamabad, Pakistan. The draft framework identifies four strategic objectives as key for improving access to assistive technology in the Region: • advancing the policy framework for progressive realization of universal coverage of assistive technology; • increasing the supply of high-quality, safe, effective and affordable assistive products; • expanding the coverage of services for the provision of assistive products; • improving the availability of qualified personnel at all levels. 12. For each strategic objective, priority actions have been identified with clear delineation of the roles of Member States, WHO and partners in implementation of the framework. The framework and its actions will assist countries in the development of country-specific road maps for advancing access to assistive technology. Results from the regional assessment survey and individual country profiles will also feed into the development of the national road maps. 13. In May 2018, the draft framework was shared with all WHO Member States during the Seventy-first World Health Assembly in Geneva. The framework will also be shared with Member States during the 65th session of the Regional Committee for the Eastern Mediterranean. Challenges 14. Despite ongoing efforts to improve access to assistive technology in countries of the Region, serious challenges remain. Government funding and programmatic action are inadequate to meet declared commitments. Mechanisms for coordination and/or referral between different sectors in relation to service delivery remain largely ineffective. National strategies or plans for assistive technology are generally not available, and when available, their enforcement and implementation are usually inadequate. Serious gaps in relevant information systems and research are coupled with underreporting of needs for assistive products in most Member States. Reliable information on the availability and affordability of individual assistive products is lacking. Systems for registration, market pre-approval and pricing regulation of assistive products are weak. Certain types of relevant personnel and local training opportunities are in short supply. Finally, systems for monitoring and regulation of assistive technology service delivery are virtually non-existent in the Region. The way forward 15. Political support in all Member States will be crucial to fulfil the collective commitment to improving access to assistive technology in the Region. EM/RC65/INF.DOC.3 3 16. The draft framework will be piloted in three Member States to ensure its effectiveness in helping to develop national action plans and road maps to improve access to assistive technology at country level. Results of piloting will be used to further refine the framework. The finalized version of the framework will be submitted to a future session of the Regional Committee for endorsement by Member States. 17. Technical assistance should be sought from international experts in the field of assistive technology, and networking and exchange of experiences between countries should be enhanced. 18. Development of a regional assistive technology centre for research, education and innovation as well as a data repository and information system should be explored to ensure that needs are met and that future efforts are based on accurate estimates of the required financing, products (and their availability and affordability), personnel and services.