19-05-2022

thurSDaY, MaY 19, 2022
5
neena BhanDari
Almost one billion children and adults with disabilities,
and older people, are unable to access the assistive
technology they need, according to a UN report, which
calls for more investment in these life-changing products.
Access to assistive technologies such as glasses, hearing
aids, mobility or communication devices is as low as three
per cent in some low-and middle-income countries,
according to the report by the World Health Organization
(WHO) and United Nations Children's Fund (UNICEF),
launched on 16 May.
It says more than 3.5 billion people will need one or
more assistive products by 2050 due to population ageing
and the increase in incidence of non-communicable
diseases. At present, the figure is 2.5 billion.
"Denying people access to these life-changing tools is
not only an infringement of human rights, it's
economically short-sighted."
WHO director-general Tedros Ghebreyesus
The report, which is the first ever global snapshot of the
need for and access to assistive technology, calls on
governments, industry and civil society to fund and
prioritise access to these products.
Almah Kuambu, technical advisor to the National
Orthotic and Prosthetic Services (NOPS) in Papua New
Guinea's (PNG) Department of Health, knows the
difference access to assistive technology can make to a
child's development, education, participation in sports
and community, and future employment prospects.
"I had lost my lower limb in an accident at the age of 11.
It was devastating for me and my family," Kuambu told
SciDev.Net. "It took nearly a year before I could be fitted
with a prosthetic limb. I remember feeling over the moon
to be able to stand on both legs again. It changed my life
and inspired me to work in this space and help destigmatise
disability in our communities."
There are globally 240 million children living with one
or more disabilities, according to UNICEF. "One of the
biggest barriers for children with disabilities is stigma
among peers and the non-inclusive school settings that
prevent them from accessing or using assistive
technology," Rosangela Berman-Bieler, UNICEF's lead on
disability, told a virtual media briefing on Friday.
"Children who are unable to access technology are even
less likely to access health care and other social services,
Access to disability aids
need to expedited
Majority of people who would benefit from assistive technology lack access
further exacerbating their disabilities and excluding them In developing countries, people have to travel long
from participating in everyday life. Their families are often distances to access assistive technology and the cost is
also affected due to reduced income as a result of often prohibitive, which can be a major barrier to access.
increased caretaking requirements," she added.
Around two-thirds of people with assistive products
reported making out-of-pocket payments for them.
Others reported relying on family and friends to support
their needs financially, the report notes.
When Anna Kwemeling, 39, lost her leg seven years ago
in a car accident in Kimbe, PNG's West New Britain
province, she had to quit her bank job. "I had two young
children. There were no assistive technology services
available nearby. It took a while before we could save
enough resources to pay for travel and accommodation to
access the service in Port Moresby. With the prosthetic
leg, I feel normal again and I am hoping to re-enter the
workforce," Kwemeling told SciDev.Net.
The report calls on governments to include assistive
technology as part of universal health care coverage
packages and employ a people-centred, rights-based
approach, actively engaging users in all aspects of assistive
technology.
"Denying people access to these life-changing tools is
not only an infringement of human rights, it's
economically short-sighted," said WHO director-general
Tedros Adhanom Ghebreyesus. "We call on all countries
to fund and prioritise access to assistive technology and
give everyone a chance to live up to their potential."
"This report gives us an understanding and some
evidence that to get the most efficient and effective
outcome, it's about more than just the assistive product.
As an occupational therapist, I see the power of the right
assistive product that enables people to do the
occupations of their daily life," said Natasha Layton,
senior research fellow at Monash University in Melbourne
and a board member of the Australian Rehabilitation and
Assistive Technology Association.
"The new data on the rapid Assistive Technology
Assessment (rATA) tool in the report, for the first time,
will tell us about unmet needs and where the most impact
can be had, particularly in developing countries. I am
hoping that it will change access to assistive technology
from a small charitable provision to a systematic scaling
and improving of in-country provision that is fit-forpurpose,"
Layton told SciDev.Net.
"There are many learnings from frugal innovation that
are culturally and environmentally appropriate and
worked very well in low-and-middle income countries,"
added Layton, who is also a contributing author to the
report.
Satellites chart unlit territory
and poverty hotspots
Dann OkOth
Almost one in five of the world's
settlements are entirely unlit at night,
according to satellite imagery which
researchers say can be used to target
development aid and infrastructure.
About 770 million people on the planet
live without electricity, mostly in Africa
and Asia, according to the International
Energy Agency. It says COVID-19 has
halted progress on access and worsened
energy purchasing power of households
in developing countries.
New analysis by the International
Institute for Applied Systems Analysis
(IIASA), published in Nature
Communications, used satellite data
from unlit areas to map poverty and
wealth levels in almost 50 countries.
Ian McCallum, a research leader at
IIASA who co-authored the study, told
SciDev.Net: "Africa and Asia tend to
show the least amount of human
settlement lighting.
"This is not unexpected, but we now
quantify this. As both regions have very
rural populations they tend to contain
significant portions of unlit settlements
infrastructure."
Africa accounted for 39 per cent and
Asia for 23 per cent of unlit settlements,
with these numbers rising to 65 per cent
and 40 per cent respectively when only
rural infrastructure was considered.
Several countries in the Middle East
were also found to have large areas of
unlit infrastructure.
Researchers have for decades used
satellite images of earth at night -
commonly referred to as nighttime
radiance or night lights - to map out
economic growth, poverty and
inequality, especially in places where
data is lacking. This has shown a link
between lit infrastructure and gross
domestic product.
But data analysis using this method
has traditionally focused on lit areas
while ignoring unlit areas, say the
researchers.
"We found that it actually works the
other way around and that focusing on
the unlit areas is a good indicator of
poverty," McCallum said.
"In this study we turned attention to
those areas using the most accurate
dataset available of building footprints.
In particular we wanted to quantify the
amount of human settlements that do
not have associated lighting."
The researchers used a geospatial
wealth index compiled by the
Demographic and Health Surveys
programme to map out the economic
status of around 2.4 million households
for 49 countries across Africa, Asia and
the Americas.
They combined this data with satellite
images of global nighttime lights and
found that 19 per cent of the total
settlement footprint had no associated,
detectable artificial radiance.
Overwhelmingly, there was a clear link
between increasing percentages of unlit
communities in a country and decreasing
economic wellbeing, according to the
study,
"We have to caution here that it does
not mean these communities don't have
any light," McCallum said. "Just that
they're not detectable via satellite. Solar
power, kerosene, generators may all be
providing light in these settlements, but
will likely be shut off when satellite
passes overhead after midnight, or
One fifth of settlements globally emitted no nighttime radiance.
simply not generate enough light to be
detected.
"Nonetheless, it is important to try to
demonstrate in numbers the amount of
infrastructure that has no or little
associated lighting."
Low-income countries suffer
disproportionately from lack of access to
electricity and clean energy for cooking,
heating, and lighting. And access to
electricity is seen as vital to achieving
many of the UN's sustainable
development goals.
The researchers say their findings
could be useful to non-profit
organisations and aid agencies to
strengthen their cause for funding for
rural regions, as well as governments and
industry to prioritise areas for
development.
But Alexander Valeton, director at
Yielder, an information communication
and training platform for agribusiness in
East Africa, says governments and power
suppliers already know where the
coverage gaps are.
He believes the problem goes beyond
power supply. "Electricity does not mean
being connected. Connectivity is the big
game changer and that comes with cheap
power and cheap access to the web and
understanding how to use [the]
internet," Valeton said.
"Power is expensive so people with
ambitions will move to places where
power is cheap. Hence rural-urban
migration, especially among the youth."
This trend is making wealth creation
and development in rural areas all the
more difficult, says Valeton. "There is
now a deep divide between the poor and
old up-country and [the] relatively rich
and young in cities," he added.
Photo: naSa
a new study reports that a four-month-long childhood tuberculosis treatment works just as well as a sixmonth
course.
Photo: j P Davidson
Childhood TB course can be
Sanjeet Bagcchi
Short duration treatment -
four months instead of the
standard six - is as effective
in combating most cases of
childhood tuberculosis
(TB), says a study carried
out in India and some
African countries.
Shortening the treatment
duration could reduce the
burden on families and
health systems around the
globe, note the researchers
in a study published March
in the New England
Journal of Medicine, and
released in time for the
World TB Day observed
annually on 24 March.
Anna Turkova, an author
of the study affiliated with
the Medical Research
Council Clinical Trials Unit
at University College
London, says that of the
more than one million
children who fall ill with TB
each year only half are
diagnosed.
"We know that the
majority of those who are
diagnosed have non-severe
TB," Turkova tells
SciDev.Net. Non-severe TB
includes features like
confinement of TB to one
lobe of lungs with no
cut to four months
formation of cavities.
According to the study,
TB, in its not severe form,
could be treated with a
shorter duration course,
although the data is
limited. The World Health
Organization has now
updated its guidance to
recommend the fourmonth
regimen for
children and adolescents
with non-severe forms of
drug-susceptible TB in line
with the said study.
In the study, researchers
from various countries
looked at 1,204 children
aged two months to 15
years with TB which was
not severe and responded
to standard drugs. The
children were from India,
South Africa, Uganda and
Zambia, and South Africa.
They were randomly
assigned to two equal
groups, one of which was
placed on specific anti-TB
drugs for four months
while the other group
underwent the same
treatment for six months.
All children were followed
for 18 months after
enrolment to see whether
their treatment had been
successful.
The researchers found
that four months of anti-
TB treatment was as good
as the six months of
treatment among the
children, discounting their
country, age group and
HIV status as 11 per cent of
the children in the study
had HIV infection along
with TB.
Turkova said that the
trial showed that treatment
for children with nonsevere
TB can be safely
reduced from six months
to four months. "Reducing
the length of treatment
makes treatment easier for
children and carers and
improves treatment
completion, as well as
reduces costs to patients
and the health system," she
said.
According to Turkova,
saving US$17 per child
from the shorter course
translates into substantial
cost-saving on a country
scale which can be used to
improve TB screening and
diagnosis.
Madhukar Pai, associate
director of McGill
International TB Centre, in
Montreal, Canada, tells
SciDev.Net that the trial is
welcome news for children
with TB. "Since most
children have non-severe
TB, it is great that
treatment duration can be
reduced from six to four
months in such
individuals," he said.
"However, greater access
to molecular TB tests and
chest X-rays will be needed
to implement this regimen
in the real world."
Swapan Jana, secretary
of the Kolkata-based nongovernment
organisation
Society for Social
Pharmacology, says
reducing the treatment
duration for childhood TB
is welcome if implemented
properly. He tells
SciDev.Net that the study
supports a basic teaching
point in pharmacology that
if a disease is optimally
treated through a shorter
duration of drug therapy it
may be beneficial.
"Longer duration of
treatment with anti-TB
drugs - apart from other
problems like motivating
children to take the drugs
and complete the full
course and more visits to
treatment centres - is
associated with more
adverse effects, compared
to shorter duration of
treatment," Jana said.