Drs Nieman and McMahon served as core members of the expert consultants for the World Health Organization's World Report on Hearing.
The World Health Organization's World Report on Hearing debuted at the 2020 World Health Assembly in direct response to the 2017 World Health Assembly Resolution.1 The Report is a first of its kind within the field of hearing care, and amplifies recent national and global efforts to both recognise and address hearing loss as a public health priority, including the US-based National Academies of Sciences, Engineering, and Medicine's 2016 report and the ongoing Lancet Commission on hearing loss.2,Reference Wilson, Tucci, O'Donoghue, Merson and Frankish3 The growing burden of hearing loss, across the life course and in diverse resource settings, equates to 466 million individuals worldwide, a number expected to grow to over 900 million by 2050.4 Access to effective communication is fundamental to the health, education, employment, and overall well-being of individuals, families and societies, and is a core component of personal and public health. As hearing care providers, we, alone, will not meet this burden and realise a world with affordable and accessible hearing care for all.
The World Report on Hearing and surrounding efforts present an opportunity to break through the traditional barriers that restrict hearing care to the domains of otolaryngology and audiology. The Lancet Commission's 2017 report on dementia identified hearing loss in mid-life as the largest potentially modifiable risk factor for dementia in older life, and it elevated awareness of hearing loss and its potential impact for the first time for many working outside of hearing care.Reference Livingston, Sommerlad, Orgeta, Costafreda, Huntley and Ames5 The expected debut of over-the-counter hearing aids in the USA by the end of 2020 is another example of translating national efforts into consequential policies that will fundamentally change the landscape of hearing care.Reference Warren and Grassley6 These advances push clinicians, manufacturers and policy makers to understand that change is needed and is possible. The increased attention to the role of ear and hearing care necessarily crosses sectors and disciplines, from maternal and child health, to consumer electronics, to ageing services and beyond. This is the time for leadership as hearing care experts, to serve as ambassadors, collaborators and advocates, and redefine service delivery models and technological innovations in ear and hearing care, in order to meet the growing burden.
As ambassadors, we must aim to do more than counsel patients and provide treatments within a clinical setting. Individually, we can model ear and hearing care, including preventive measures like the routine use of hearing protection and the limiting of noise exposure. We can serve as a resource within our communities to our local hospitals, schools, senior centres and governments, to increase screening, and, more importantly, increase access to treatment. In our roles as clinicians, educators and researchers, we must actively seek out new collaborations, and serve as open and enthusiastic partners with those outside our fields, including general practitioners, obstetricians, paediatricians, geriatricians, gerontologists and social entrepreneurs, among others. These allies can extend the reach of current stakeholders, and help solidify access to the effective communication that is essential to health. Finally, we must be advocates who champion public health driven approaches. For example, we should support: the integration of ear and hearing care within existing health services and screening programmes, inclusion in national health plans and programming, and the incorporation of task-sharing models that empower community health workers and paraprofessionals in community-delivered hearing care. The path ahead will not be without its tensions, and will require a shared vision and reimaging of our roles, not as providers and gatekeepers, but as partners and leaders, in realising a world where every person, at every age and circumstance, has access to the tools they need to engage and thrive.
