Global Health Discussion on Hearing Loss Coming to Duke and Duke-NUS

Lancet Commission Heavy with Duke Expertise

A world map showing where American Sign Language is the primary language for the deaf.
A world map showing where American Sign Language is the primary language for the deaf.

Hearing loss may lack the dread of a deadly infectious disease like dengue or HIV, but it is a large and growing global health disability, affecting about 7 percent of the world’s population. A 2017 report estimated the global cost of untreated hearing loss at more than $750 Billion (in 2015 international dollars).

To address this health issue systematically and globally, a newly-formed international commission on hearing loss and health care will convene its first session at Duke University on Oct. 22 and 23.

This prestigious Lancet Commission on Hearing Loss brings together leaders from health care, public health, health economics and policy, and includes many Duke faculty.

“Lancet Commissions are selected very carefully by (the medical journal) The Lancet and are often highly influential, especially at the policy levels,” said Blake S. Wilson, co-founder of the Duke Hearing Center, whose recent work on hearing health policy helped launch the commission.

“The expertise at Duke is stunning and perfect for our project.”

The commission grew out of a 2017 review article Wilson published in The Lancet with Duke colleagues Debara Tucci and Michael Merson, and Gerard O’Donoghue of the University of Nottingham, which argued that the global health burden of hearing loss is large and growing, but that addressing it would be among the least expensive and most effective ways to improve human health and happiness.

The editors at The Lancet agreed, and enthusiastically approved a full Lancet Commission to create an urgent roadmap to do just that.

An engineer who greatly enhanced the capability of cochlear implants with improved signal processing, Wilson has devoted his career to the remediation of hearing loss.

“Recently, I’ve become keenly interested in global hearing health,” Wilson said. “It has been so exciting to broaden my scope to include all of these other aspects of the problem. I’ve learned so much about global health care and how to be respectful of the challenges faced by ministers of health and finance in different world regions.”

The commission’s advisory board is chaired by Gavin Yamey, professor of global health and public policy and director of the Center for Policy Impact in Global Health in DGHI.

“I’ve been fortunate to serve as a commissioner on three previous Lancet commissions,” said Yamey, “including on TB, global surgery, and investing in health, and in my experience  these can clearly be game-changers when it comes to global health improvement.”

Other Duke representatives on the commission include Wilson, former FDA Commissioner Mark McClellan, director of the Duke-Margolis Center for Health Policy, Eric Finkelstein, a professor of global health at Duke and Duke-NUS, and Debara Tucci, a co-founder with Wilson of the Duke Hearing Center who now heads the NIH’s National Institute on Deafness and Other Communication Disorders (NIDCD). It also includes Robert Califf, former FDA Commissioner, founder of the Duke Clinical Research Institute and vice chancellor for health data science, who recently announced his departure from Duke to head Google’s health care division.

Several more commission members also have Duke ties. Enis Baris of the World Bank is an adjunct professor at the DGHI, Osondu Ogbuoji of Nigeria is an assistant research professor and deputy director of Duke’s Center for Policy Impact in Global Health in the DGHI, and Muhammad Pate from Nigeria is a visiting professor at the DGHI. Dr. Pate, a former Minister of Health for Nigeria, is now the Global Director for Health, Nutrition and Population at the World Bank and leads the World Bank’s Global Financing Facility for Every Woman, Every Child.

Wilson is the chair for the commission and Tucci is one of the co-chairs with Shelly Chadha from the World Health Organization (WHO) in Geneva, Switzerland, and Bolajoko Olusanya from the Centre for Healthy Start Initiative in Lagos, Nigeria.

The commission includes an international group of experts, half of whom are from the low-and-middle income countries where more than 80% of the people with hearing loss live. Two commissioners have experienced hearing loss themselves.

“I think this new commission on hearing loss is going to have an enormous impact,” Yamey said. “The commission is addressing a highly neglected issue that causes a large burden of disability worldwide, it has marshaled world-renowned talent, and it has clear and achievable aims. I believe it will help catalyze a worldwide movement to prevent and treat hearing loss at all ages and in all parts of the world.”

The panel’s second meeting will be held at the Duke-NUS Medical School in Singapore, Feb. 21 and 22, 2020. The final two meetings will be held in Europe and the commission’s findings and recommendations will be published in a special issue of the Lancet, hopefully in conjunction with the separate meeting in Geneva of the World Health Assembly in late May 2021. “We will work hard to make that happen!” Wilson said.

Principal support for the Lancet Commission to address the global burden of hearing loss has been provided by the Duke University Provost's Office, the School of Medicine, the Chancellor for Health Affairs, the Pratt School of Engineering, the Duke Global Health Institute, the Duke Clinical & Translational Science Institute, and the Division of Head and Neck Surgery and Communication Sciences. Additional financial, in-kind support, or both has been provided by RTI International (a not-for-profit research institute in Research Triangle Park), the Duke–National University of Singapore (NUS) Medical School in Singapore, the National Institute on Deafness and Other Communication Disorders (NIH), the Fondation Pour l’Audition in Paris, France, and the World Health Organization.