Assistive technology (A.T.) is an umbrella term covering the systems and services related to the delivery of assistive products such as wheelchairs, eyeglasses, hearing aids, prosthetics, and personal communication devices. Today, over 1 billion people require A.T. to achieve their full potential, but 90% do not have access to the A.T. that they need.1 This unmet need for A.T. is driven by a lack of awareness of this need, discrimination and stigma, a weak enabling environment, lack of political prioritisation, limited investment and market barriers on the demand and supply side. Narrowing in on the market shortcomings that limit the availability of assistive products, market shaping is proposed to address the root causes that limit availability, affordability and access of appropriate A.T. with the wider aim of ensuring improved social, health and economic outcomes for people who require A.T.. To accelerate access to A.T., the global community needs to leverage the capabilities and resources of the public, private, and non-profit sectors to harness innovation and break down market barriers.
Whether by reducing the cost of antiretroviral drugs for H.I.V. by 99% in 10 years, increasing the number of people receiving malaria treatment from 11 million in 2005 to 331 million in 2011,2 or doubling the number of women receiving contraceptive implants in 4 years while saving donors and governments U.S.$240 million,3 market shaping has addressed market barriers at scale. Market shaping interventions can play a role in enhancing market efficiencies, improving information transparency, and coordinating and incentivising the numerous stakeholders involved in both demand and supply-side activities. Examples of market shaping interventions include: pooled procurement, de-risking demand, bringing lower cost and high-quality manufacturers into global markets, developing demand forecasts and market intelligence reports, standardising specifications across markets, establishing differential pricing agreements, and improving service delivery and supply chains.
Market shaping interventions often require coordinated engagement on the demand and supply side (refer to Figure 1). Successful interventions are tailored to specific markets after robust analysis of barriers and look to coordinate action on both the demand- and supply-side. These interventions are catalytic and time-bound, with a focus on sustainability, and are implemented by a coalition of aligned partners providing support where each has comparative advantages.
FIGURE 1: ENGAGING BOTH DEMAND- AND SUPPLY-SIDE FOR MARKET SHAPING
| DEMAND SIDE ENGAGEMENT | SUPPLY SIDE ENGAGEMENT |
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Work with governments, D.P.O.s, C.S.O.s, others to:
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Work with manufacturers & suppliers to:
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Historically, A.T. has been an under-resourced and fragmented sector and initial analysis indicated that a new approach was required. A.T.scale, the Global Partnership for A.T., was launched in 2018 with an ambitious goal to provide 500 million people with the A.T. that they need by 2030. To achieve this goal, A.T.scale aims to mobilise global stakeholders to develop an enabling environment for access to A.T. and to shape markets to overcome supply- and demand-side barriers, in line with a unified strategy (https://atscale2030.org/strategy). While the scope of A.T. is broad, A.T.scale has prioritised to identify interventions needed to overcome supply- and demand-side barriers for five priority products.
Clinton Health Access Initiative (C.H.A.I.) is delivering a detailed analysis of the market for each of the priority products under the A.T.2030 programme (https://www.at2030.org), funded by U.K. aid from the U.K. government, in support of the A.T.scale Strategy. What follows is a detailed analysis of hearing aids, one of five priority products identified by A.T.scale to be evaluated.