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Friday, June 29, 2018

GENEVA, July 5 — "How do we collectively—as the hearing community—transform actions into concrete results at the country level for those who so much need it?" This was the challenge posed by Etienne Krug, MD, director of WHO's Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, at the 3rd stakeholders' meeting on the prevention of hearing loss and deafness. With the launch of the World Hearing Forum and mobilization of the World Hearing Report, among other critical outcomes, the meeting gave a new impetus to strengthen global collaboration and advocacy in ear and hearing care.

"Going forward, we want to develop a global movement that all stakeholders in this field can identify with and participate in," Shelly Chadha, PhD, technical officer of WHO's program on hearing care, told The Hearing Journal at the close of the two-day consultation. "The ultimate goal is to keep more and more people in civil society, general public, and policymaking aware about hearing loss to prioritize it in both their personal lives and in policies."

WORLD HEARING FORUM

Twhf.jpghe World Hearing Forum was officially announced to run from September 2018 through 2025. Input from the stakeholders' meeting will be reviewed and used to refine the forum outline. This a global network of stakeholders in ear and hearing care will include representatives from NGOs, academic institutions, organizations of disabled people, governments, professional societies, and others. ​​The members will have the mandate to ensure the implementation of the WHA70.13 resolution on hearing loss prevention through networking and sharing of knowledge, skills, and experiences from the field.

"The challenge is to take existing scientific evidence and translate it into something useful for professional bodies and civil societies to lobby with their policy makers," explained Dr. Chadha.

While making hearing health a political priority is at the forefront, Dr. Chadha noted an additional goal. "The aim is also to set a context—a cohesive and consistent narrative on hearing loss—and to have a uniform understanding of what we all mean by 'hearing care'."

​The forum will also bridge the critical gap between drawing a collective vision and transforming plans into concrete actions, such as raising awareness on safe listening and improving early identification and management of hearing loss in regions with limited human resources and inadequate health services.

WORLD HEARING REPORT

Central to the WHA70.13 resolution is the creation of a World Hearing Report, which will be released by March 2020. Dr. Chadha provided a glimpse of WHO's approach to developing this report sections outlines, including one on the challenges to hearing care access. This section will include key epidemiological data on people's access to hearing care services, assistive devices like hearing aids, and educational services for sign language. Each section will advance a key message, which in this case is that challenges can be fully addressed. The report will also present evidenced-based solutions to reduce the social and economic burden of hearing loss, as well as emerging issues including early detection, scientific and technological advancements, and preventable noise-induced hearing loss.

To set the stage for this report, organizers of the World Report on Vision shared some verified strategies in building optimal momentum for the report's launch and dissemination through relevant messaging, with clear instructions on where stakeholders can find certain information and how to use them.

Learn more about the WHA70.13 resolution here

Read Dr. Jackie Clark's commentary on the WHO stakeholders' consultation 

Friday, June 29, 2018

Harnessing the power of collaboration has been a proven strategy in addressing global health issues like vaccination and lead exposure, among many others. How can this strategy effectively work to promote safe listening habits and better hearing care across countries with varied resources and needs? This was one of the critical questions that stakeholders braved at this week's consultation on hearing health at the World Health Organization (WHO) headquarters in Geneva, Switzerland.

The Hearing Journal spoke with De Wet Swanepoel, PhD, president of the International Society of Audiology (ISA) and professor of audiology at the University of Pretoria in South Africa, to explore a practical and efficient approach to forming a global alliance in hearing health care. With his extensive research, clinical, and humanitarian work in audiology, Dr. Swanepoel reflects on the challenges and opportunities to achieving this goal.

HJ: How would you define or envision, in practical and actionable terms, an effective global alliance in hearing care?

Dr. Swanepoel: By its nature a global alliance should be a wide international platform representing all world regions and involve all stakeholders, including persons with hearing loss and their families, hearing health providers, industry, non-government organizations (NGOs), administrators and funders to convene and rally around the pressing priorities in global hearing care. Positioning such an alliance within an influential global organization like the WHO gives it the credibility and inertia to pull the right groups together and facilitate a global agenda that sees hearing care prioritized at the highest levels right through to implementation at grassroots.

HJ: On the goal of establishing a global alliance, what do you think is the biggest challenge(s) to forming this collaboration? And on the flipside, what are you most excited about as the WHO and various stakeholders move closer toward establishing and mobilizing this alliance?

Dr. Swanepoel: A major challenge in these alliances is to truly engage all stakeholders across world regions and organizations, allowing an equal opportunity to be heard whilst uniting them around a shared vision that is owned by all. On the flipside, this kind of shared vision and ownership is the only way in which to influence decision-makers across the globe toward an acknowledgement of and commitment towards global hearing health priorities.

HJ: You've done significant work in demonstrating the value of m-health in bringing hearing health care to underserved patients. What would you say is the place of m-health in this global alliance and its plan of actions?

Dr. Swanepoel: A global health alliance should provide a clear agenda for addressing global hearing care issues with clear recommendations on proposed solutions. mHealth is an important strategy that touches on a number of these priorities. For example, mHealth surveys and hearing tests are invaluable tools that can support population-based surveys in low- and middle-income countries (LMICs) to ensure accurate prevalence data is collected to inform national strategies around hearing care. Furthermore, mHealth solutions can support decentralized programs to detect hearing loss in underserved areas through the assistance of local community workers. Looking at the connected global community and the way in which technology and connectivity is changing industries such as banking and agriculture in LMICs, it is only reasonable to expect the same in hearing health care. 

Friday, June 29, 2018

World Hearing Day has become a global movement, with over 67 countries that participated in the 2018.  

"There was a window of opportunity in the World Health Assembly resolution [in 2017] to undertake an evidence-based advocacy through the World Hearing Day," said WHO consultant Karen Reyes-Castro, MD, at the 3rd stakeholders' meeting on hearing loss prevention. "The World Hearing Day has been evaluated as a successful advocacy campaign that raised awareness of the relevance of hearing loss as well as promote ear and hearing care across the world."

Since its launch in 2012, World Hearing Day has been observed on March 3rd with an annual theme developed through consultations with partner organizations and member states. The 2018 theme of "Hear the Future" drew attention to the dangers of unsafe listening and the importance of hearing protection—messages that can be taken at the individual, community, national, and global levels.

Participating groups conducted diverse activities, including free hearing screenings and distribution of hearing aids, workshops for health care professionals, and community awareness raising in outpatient clinics and neonatal wards. Social media campaigns reached over 1 million people on Facebook and gained over 1.8 million impressions on Twitter. In the United States, h. res. 740 was introduced to the House of Representatives by Reps. David McKinley (D-CA) and Mike Thompson (R-WV) in February 2018 to express support for World Hearing Day.

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Some notable campaigns include the downloadable Digital Toolkit prepared by the American Speech-Language-Hearing Association (ASHA), as well as The Hearing Journal's Twitter #HearingChat with Barbara Kelley, executive director of the Hearing Loss Association of America (HLAA) and Clifford Olson, AuD (see recap here). In Italy, the group "Nonno Ascoltami!" Udito Italia Onlus ("Grandfather, listen to me!), in collaboration with the ministry of health, conducted an experts' roundtable with over 60 hearing care specialists, and launched the #dica33 campaign to promote awareness through "Ambassadors of Prevention" that include actor Lino Banfi, musician Povia, and Beatriz Lorenzin, Italy's minister of health.

While the increasing outreach has been successful, the challenge now, noted Dr. Reyes, is how to keep the momentum growing. "Everyone has a role to play," she stressed, "and we need everyone to be part of the growth."

Ear and hearing care professionals across the world can get involved in various ways, such as organizing awareness activities in private audiology or ENT practices or hospitals. Individuals, advocacy groups, and professional organizations can lobby with policy-makers to improve access to affordable and quality hearing care services and assistive devices. Individuals and groups can collaborate to motivate local communities to get hearing tests and learn more about safe listening. Finally, WHO encourages everyone to share their activities and provide feedback to help improve upcoming themes and materials (send email to WHOPBD@who.int). 

Tuesday, June 26, 2018

GENEVA, July 3 — "The best way to predict the future is to create it," said Shelly Chadha, PhD, technical officer of World Health Organization's (WHO) programme on Prevention of Deafness and Hearing Loss at the opening of the 3rd stakeholders' meeting that started today. The meeting brought together experts from hearing professional groups, clinicians, and civic society, among many others, to promote and improve the implementation of the 2017 World Health Assembly resolution on hearing loss prevention (WHA70.13) through a shared vision for global action.

"The resolution clearly sets out the goal that ear and hearing care should be accessible to all as a part of health care service delivery," noted Etienne Krug, MD, director of the of WHO's Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention (NVI). "And this goal is very much aligned with WHO's overall priority."

Hearing loss affects over 460 million people globally, and 60 percent of childhood hearing loss cases are preventable. However, high-quality epidemiological data on hearing loss and access to hearing care services and technology remain limited. The WHA70.13 resolution was adopted to call upon governments and policy makers to address hearing loss through strategies integrated into health care systems.

ONE YEAR DOWN

Before WHA70.13, the last WHA resolution on hearing impairment prevention in 1995 (WHA48.9). Since the 2017 resolution's implementation, WHO has made strong headways in coordinating multi-stakeholder platforms and opportunities. Based on the WHA resolution, WHO has identified key action areas for 2017-2021, explained Dr. Chadha. These are evidenced-based advocacy, data, technical support, and the "Make Listening Safe" initiative. The WHO-ITU "Global Standards for Safe Listening Devices" is set to be released later in 2018, while the "World Report on Hearing," which aims to frame hearing within the public health agenda, by March 2020.

WHO also provides technical support through its comprehensive ear and hearing tool kit and regional workshops with partners in India, Pakistan, China, Philippines, among others. Maryam Mallick from WHO-Pakistan shared recent country-level efforts to address hearing issues, such as adding assistive technology to the prime minister's National Health Insurance program and conducting national need-based assessment surveys. Engaging various stakeholders and activating different communication channels have also been instrumental in advancing advocacy efforts such as the annual World Hearing Day.

MAKING HEARING CARE A PRIORITY

"We are not there yet, and we have a long way to go," said Alarcos Cieza, PhD, who oversees WHO’s work on rehabilitation and disability. "The need for hearing care is huge and this need will increase in the years to come."

At present, there's a gap between the high need for hearing care, low demand for hearing services due to low awareness, and low supply of health care resources and technology, particularly in low- and middle-income nations. "The question we need to really answer together is how we can turn this around so that we not only have a huge need but also a huge demand," Dr. Cieza added.

Moving forward, Dr. Chadha was prompt to identify immediate priorities. "What we really need is to define what kind of action we can take from the global level that can lead to changes at local level," she noted.

"It's important for us to keep driving this momentum that was provided by the WHA resolution and keep moving this issue forward in whichever country we work, whichever group we represent, and whichever section of society we come from."​

Tuesday, June 26, 2018

By Jackie Clark, PhD

WHOGeneva008.jpgFrom the outside, it may look as though a flurry of unorganized activities are taking place within the walls of the World Health Organization's (WHO) Prevention of Deafness and Hearing Loss (PDH) Division in Geneva, Switzerland as it hosts a trifecta of stakeholders' consultations from July 2 to 5. Since her entrance in 2011 to this division, Technical Director Shelly Chadha, PhD, has made significant inroads to raise awareness about the prevention and remediation of hearing loss. Dr. Chadha's consistent and proven formula has resulted in tangible and publicized outcomes, including the global recognition of World Hearing Day and the call by the World Health Assembly (WHA) for a World Report on Hearing. It's a simple formula of involving a broad, global breadth of subject matter experts—the stakeholders—in attaining a consensus on how the WHO can be most impactful.

Surprisingly, despite the disparate living conditions in very poor to very prosperous countries, these stakeholders hold similar abiding passions in bringing ear and hearing care to the poorest of the poor. Over the years, the stakeholder's have convened to recommend the following: promotion of hearing care in member states; preferred product profile for hearing aids; development of advocacy tools and resources to identify prevalence and causes of hearing loss to be used by ministers of health; primary, intermediate, and advanced ear and hearing training manuals for community workers, hearing technicians, and primary care physicians; promotion of World Hearing Day; and reinforcement and expansion of rehabilitation service, to cite a few.

So, who exactly are these invited subject matter experts or stakeholders? The typical stakeholder profile includes having an integral and uniquely focused knowledge about an aspect of ear and hearing health care. These stakeholders include experts from clinical practices, professional organizations, public health, ministers of health, publishing, philanthropic organizations, hard of hearing or deaf communities, and health communication, among others.

Yesterday, July 2, the first ad hoc consultation kicked off with a review of the latest draft of the Primary Ear and Hearing Care Training Manuals and the process for field testing. The final manuals will be deployed to many parts of the world to facilitate the training of health care professionals with little to no knowledge of ear and hearing care. The second ad hoc consultation, the 3rd Stakeholders' meeting for the WHO programme on prevention of deafness and hearing loss, started today, July 3, and continues tomorrow. The agenda includes developing the theme for next World Hearing Day and strategies to build a global alliance. Finally, on July 5, the final consultation will advance the goals of the April 2018 consultation to explore possibilities of resource mobilization for the World Hearing Report. 

From the perspective of a middle- or high-income country, these activities may appear superfluous. However, to a low-income country, these activities are critical in educating health officials and the public about the basics of ear and hearing care and interventions to address hearing loss. Ultimately, the rewards will be felt across the globe.

Photo credit: WHO/P. Virot