Global Cooperation on Assistive Technology (GATE)
The vision of the GATE initiative: A world where everyone in need has high-quality, affordable assistive products to lead a healthy, productive and dignified life. The GATE initiative has only one goal: to improve access to high-quality affordable assistive products globally. To achieve this, the GATE initiative will focus on four interlinked activities below.
Following the successful model of the Essential Medicine’s List, GATE’s first priority is to develop a WHO Priority Assistive Products List (APL). The Essential Medicine’s List succeeded in raising awareness and creating more competition, which has made more medicines available at an affordable cost. The APL aims to achieve the same. The APL is not a restrictive list but aims to provide Member States with a blueprint from which to develop a National priority assistive products list; according to National need and available resources. National APL will give health and welfare systems, manufacturers and funders a framework with which to synergize their efforts to increase access. The APL will include the 50 assistive products that are most needed and affordable across the world. The process to identify these has included a scoping review, a Delphi exercise and global survey in 52 languages. The survey has been widely disseminated to all stakeholders, including user groups and disabled people’s organizations, to ensure that the voices of people with disabilities and older people are heard, including formal and informal caregivers.
The aim of the ATTP is to support Member States to develop the capacity of their health workforce in the delivery of assistive products from the National APL. The ATTP will be a comprehensive training package, which will create a new cadre of assistive technology service providers. It will also be modular, to enable existing health and welfare personnel to add to their skillset; so that they can meet the needs of a growing ageing population with gradual functional decline in multiple domains. With this training, rehabilitation, nursing and community health workers will be able to deliver priority assistive products at the primary healthcare/community level. The inclusion of people with disabilities or expert users, (women in particular) as service providers and peer trainers will be integral to the ATTP. The ATTP will include four essential steps of service delivery: 1. Assessment and prescription (including screening and specialist referral); 2. Fitting; 3. User training; 4. Maintenance, repairs, and follow-up.
The ATSP will assist Member States to deliver a National assistive technology service provision system. The ATSP will comprise of a National APL procurement hub (including bulk purchase) and a National AT centre, with branches or networks at all levels of health and welfare service provision. This will create a systematic change within the field of assistive technology service provision, by uniting currently fragmented infrastructure and services. It will further ensure widespread availability of appropriate, priority assistive products that can be accessed from a single point as close as possible to people’s own communities, including in rural areas.
The ATF will assist Member States to develop a National assistive technology policy and programme, which is essential to ensure the successful provision of high quality affordable assistive products across the country. The ATPF will support Member States to realize their obligation to the CRPD; and this is especially important for Member States who have ratified the CRPD, for whom it is a legal obligation. The ATPF will include tools for health workforce development (ATTP), for identification of priority products (APL) and a decentralized service provision system (ATSP). In addition to these, the ATPF will also give guidance on financing mechanisms to ensure sustainability of assistive product service provision. This will ensure people are protected from financial catastrophe because of out-of-pocket payments. WHO sees the proposed GATE initiative with its four practical tools as a concrete step towards realizing the goals of CRPD, Universal Health Coverage (UHC) and the Sustainable Development Goals (SDG).