Global Disparities in Access to Assistive Technology
- Sam Shepherd
- Aug 8
- 5 min read
By Joshua Lee
Assistive technology (AT)—including wheelchairs, hearing aids, prosthetics, eyeglasses, communication apps, and cognitive aids—is essential for enabling people with functional limitations to live independently and participate in society. According to the WHO & UNICEF Global Report on Assistive Technology, approximately 2.5 billion people worldwide need at least one assistive product, yet nearly one billion are denied access, especially in low and middle-income countries where coverage can be as low as 3 percent of need [1]. This article explores the scale of unmet need, the stark inequality in access, the causes behind disparities, the social and economic consequences, and promising strategies to enable universal access to AT as a human right.
The 2022 WHO-UNICEF Global Report reveals that while 2.5 billion people require assistive products today, that figure is projected to climb to around 3.5 billion by 2050 due to population ageing and rising chronic disease burdens [1]. Access disparities are profound as access levels range from just 3 percent in the poorest nations to approximately 90 percent in high-income countries [1]. A scoping review of AT-related guidelines found that most originate from high-income settings and focus on products for mobility, vision, hearing, and self-care, while AT for cognition and communication remains underrepresented [2]. Longitudinal datasets tracking AT use are rare. While a global review identified 81 cohorts and 202 surveys addressing functional limitations, nearly half were from high-income countries. Most capture simple AT use only sporadically, limiting evidence based policy-making in underserved regions [3].
The PURE study, a prospective cohort encompassing over 175,000 adults across 25 countries, demonstrates glaring discrepancies in both disability burden and AT adoption. In low and middle-income countries, walking limitations are twice as common and visual impairment five times as common compared to high-income settings. Yet use of basic devices such as canes, eyeglasses, or hearing aids is less than half that of richer nations [4]. Movement difficulties were also strongly linked to higher risks of death, cardiovascular disease, pneumonia, and falls [4]. This gap underlines not only unmet need, but deeper threats to health and longevity. National level surveys in countries like India reflect similar patterns: one study using WHO’s rapid Assistive Technology Assessment (rATA) tool found 24.5 percent of the population needed AT, yet nearly 8 percent had unmet need and rising to 52 percent among those with severe functional limitations. Females, the elderly, and rural residents were disproportionately affected, while affordability accounted for nearly 37 percent of access barriers [5].
Access barriers operate at multiple levels. In many low- and middle-income countries, AT must be paid out of pocket causing up to two-thirds of users self-funding their devices [1]. Low knowledge among users and caregivers about available AT, combined with cultural stigma—such as in China, where some users avoid devices to "save face"—suppresses demand [6]. Procurement systems are weak, trained personnel are scarce, and geographical distribution is uneven. Most WHO/UNICEF surveys show workforce and supply shortages across more than 70 countries [1]. Off the shelf AT often fails to suit local physical or socioeconomic settings. In China, DIY-modified AT, adapted by users or small providers, helps address this gap but lacks formal models and sustainability [7].
When people lack AT, the consequences extend beyond disability. Exclusion from education, employment, and civic life deepens poverty and isolation. WHO and UNICEF highlight that AT supports the right to equality, dignity, and participation—and failure to provide it undermines economic growth and social inclusion [1]. The PURE study further shows that mobility limitations are directly associated with worse health outcomes and increased mortality [4]. These insights align with the UN Convention on the Rights of Persons with Disabilities and Sustainable Development Goals, which recognize AT as a prerequisite for inclusive, rights-based development.
Multiple strategies offer pathways to change. WHO’s Global GATE initiative and its Priority Assistive Products List (APL), launched in 2016, aim to guide policy, procurement, and financing. The WHO-UNICEF Global Report outlines ten priority recommendations—from expanding AT into all development sectors to boosting data-driven policy [1]. At the 2023 World Health Assembly, member states adopted Resolution WHA 71.8 to enhance rehabilitation services globally, including AT [8]. Still, most countries lack cohesive AT policies integrated into national health and social systems. A 2024 initiative brought students, researchers, and people with disabilities together to co-design AT. Participants reported increased awareness, acceptance, and early prototypes extending into sustained innovation [9]. Co-design fosters locally relevant, culturally appropriate solutions. In China, user-modified AT tailored to local needs has boosted confidence and social inclusion, though sustainable models and broader scaling remain challenges [7].
To mitigate this global inequality, governments should adopt national AT policies aligned with the WHO Priority Products List, with dedicated funding, workforce development, and supply chains [10]. Investments in trained personnel including rehabilitation specialists, orthotists, technicians are critical. AT should be integrated into health, education, and employment systems. Promoting user-centered co-design, social inclusion, and local adaptation of technologies will ensure contextually appropriate solutions. Longitudinal datasets such as rATA and national cohort studies should be expanded to track access, outcomes, and equity [3,5]. Additionally, embedding digital inclusion strategies is crucial to ensure that software-based AT, such as screen readers and communication apps, is affordable and accessible, particularly for marginalized groups [11].
The disparity in access to assistive technology is striking and unjust. With billions in need, but only a fraction receiving the support required, urgent action is essential. Coordinated global and national policy, scalable innovation, user-driven design, and investments in workforce and data infrastructure can reposition AT from a marginal priority to a cornerstone of inclusive development. Achieving equitable access to assistive technology means not only honoring human rights—it is a powerful investment in global wellbeing and economic participation. The time to bridge the gap is now.
References
[1] World Health Organization. (2022, May 15). Global Report on Assistive Technology. Retrieved from www.who.int website: https://www.who.int/publications/i/item/9789240049451
[2] Google Books. (2018). Retrieved August 3, 2025, from Google.com website: https://books.google.com/books?hl=en&lr=&id=qEygJkO-Y_wC&oi=fnd&pg=PP1&dq=Schere r
[3] Danemayer, J., Mitra, S., Holloway, C., & Hussein, S. (2023). Assistive technology access in longitudinal datasets: a global review. International Journal for Population Data Science, 8(1). https://doi.org/10.23889/ijpds.v8i1.1901
[4] Joundi, R. A., Hu, B., Rangarajan, S., Leong, D. P., Islam, S., Smith, E. E., … Yeates, K. (2024). Activity limitations, use of assistive devices, and mortality and clinical events in 25 high-income, middle-income, and low-income countries: an analysis of the PURE study. The Lancet, 404(10452), 554–569. https://doi.org/10.1016/s0140-6736(24)01050-x
[5] Suraj Singh Senjam, Manna, S., Kishore, J., Kumar, A., Kumar, R., Praveen Vashist, … Kamath, R. (2023). Assistive technology usage, unmet needs and barriers to access: a sub-population-based study in India. 100213–100213.
[6] Franklin Mingzhe Li, Di Laura Chen, Fan, M., & Truong, K. N. (2021). “I Choose Assistive Devices That Save My Face.” ArXiv (Cornell University).
[7] Yang, K., Wu, J., Xin, H., & Gong, J. (2024). “I see it as a wellspring for my positive and upward journey in life.”: Understanding Current Practices of Assistive Technology’s Customized Modification in China. Retrieved from arXiv.org website: https://arxiv.org/abs/2406.09467
[8] SEVENTY-FIRST WORLD HEALTH ASSEMBLY WHA71.8 Agenda item 12.5 Improving access to assistive technology. (2018). Retrieved from
[9] Schmermbeck, K., Ott, O., Ralfs, L., & Weidner, R. (2024). Fostering Inclusion: A Regional Initiative Uniting Communities to Co-Design Assistive Technologies. Retrieved from arXiv.org website: https://arxiv.org/abs/2403.12263
[10] de Witte, L., Steel, E., Gupta, S., Ramos, V. D., & Roentgen, U. (2018). Assistive technology provision: towards an international framework for assuring availability and accessibility of affordable high-quality assistive technology. Disability and Rehabilitation: Assistive Technology, 13(5), 467–472. https://doi.org/10.1080/17483107.2018.1470264
