Hearing loss affects more than 1.5 billion people worldwide. Close to 80% live in low - and middle - income countries, where hearing care is out of reach for most. In Africa, an estimated 136 million people live with hearing loss, a figure expected to more than double to 337 million by 2050. Yet fewer than 2% of people on the continent who need a hearing aid have one.
This shortfall is not a minor inconvenience but a major public health crisis. Left unaddressed, hearing loss drives costs across healthcare, education and productivity, falling hardest on children, whose language development and schooling depend on being able to hear. A 2024 Lancet Commission report identified it as one of the largest modifiable risk factors for dementia. The World Health Organization puts the annual global cost of unaddressed hearing loss at close to a trillion US dollars (page 10).
Despite this, access to care remains scarce. There are too few audiologists (fewer than one for every million people in many African countries), hearing aids cost more than a year’s income for many households, services are concentrated in cities and a persistent stigma keeps people from seeking help even where it exists.
Our research team at the University of Pretoria, where I head the World Health Organization Collaborating Centre for the Prevention of Deafness and Hearing Loss – the only such centre on the continent – has spent the past decade pioneering ways to close this gap. Our latest study reviews a decade of evidence on whether hearing care can be delivered outside clinics, by people who aren’t specialists.
