Hearing – an underestimated topic
Global prevalence of hearing loss and consequences
The importance of good hearing and the consequences of hearing loss continue to be underestimated. Unaddressed hearing loss is among the three largest causes of years lived with disability (YLD) around the globe, and yet it remains an “invisible disability” with approximately 1.5 billion people – 20% of the global population – experiencing some degree of hearing loss, according to the World Health Organization (WHO) statistics.1
Over 5% of the worldʼs population – 430 million people – experience moderate or higher grades of hearing loss2; nearly 30 million have profound or complete hearing loss in both ears. The number of people with hearing loss continues to rise, due both to the aging of populations and to growing noise pollution in our environment. WHO estimates that by 2050, 2.5 billion people (1 in every 4) will experience hearing loss, and over 700 million people will require hearing care due to a moderate or higher grade of hearing loss1.
People with untreated hearing loss are often faced with serious consequences. These range from adverse effects on personal relationships to disadvantages at work and social isolation, which may even lead to depression. Especially severe are the consequences for children with untreated hearing loss, as the development of speech and language is fundamentally dependent on the sense of hearing. Untreated hearing loss also is often associated with academic underachievement, which can lead to lower job performance and fewer employment opportunities later in life.
In addition to the impact of hearing loss at an individual level, untreated hearing loss puts a heavy cost burden on society. Direct and indirect costs related to unaddressed hearing loss are estimated at USD 980 billion annually, of which more than 50% are borne by low- and middle-income countries in direct health costs, loss of productivity, and societal costs1. Todayʼs hearing solutions offer the opportunity to reduce this burden significantly.
Need for hearing solutions
The fundamental need for hearing solutions is driven by long-term socioeconomic factors. The number of people on our planet will continue to increase. Although populations in low- and middle-income countries are expected to grow the most, even high-income countries with stable populations will face a growing proportion of elderly citizens, who are likely to experience hearing loss. These developments increase demand for hearing care: a large unmet need remains.
According to WHO statistics, approximately 80% of people with moderate or higher grades of hearing loss live in low- and middle-income countries, with the most affected regions being the Western Pacific, South-East Asia, and the Americas1.People in such countries often have little or no access to audiological services, and the hearing care market is still relatively underserved. WHO estimates that total current hearing aid production worldwide would meet only around 3% of the need in low- and middle-income countries3. This situation presents substantial opportunities to increase access to hearing care.
- WHO, “World Report on Hearing” (2021)
- In 2021, the WHO has adapted its grading system on the severity of hearing loss. The threshold for moderate hearing loss is 35dB in the better hearing ear.
- WHO, “Factsheet: deafness and hearing loss” (March, 2020)
Innovative hearing solutions
Broad product portfolio
The hearing care market is highly diverse, requiring a broad range of technologically advanced solutions and versatile customer service channels. Our declared goal is to offer the most innovative hearing solutions and services available to consumers worldwide, continuously improving speech intelligibility, sound resolution and quality, and ease of use. The comprehensive, interdisciplinary knowledge that we acquire in the process is factored into each of our products. It also enables us to offer a broad spectrum of service and pricing levels for individual needs and different markets in countries of all income levels.
In 2020/21, 61 new patent applications were filed across the Sonova Group. By the end of March 2021, Sonova owned in total over 1,800 active granted patent and design rights.
In addition to improving audiological quality and ease of operation, Sonova continuously expands digital solutions that bring together the healthcare provider and the consumer in real time through all stages of the hearing journey. From online-based histories and customer support to remote adjustment and optimization under real-life conditions, digitally networked solutions offer consumers a higher degree of control and autonomy. Wherever users might be, their audiologist can be by their side online, directly capturing data on the specific audiological situation and providing immediate assistance. Continuous data monitoring and statistical analysis of listening situations allow user-specific fine tuning, as well as more targeted advice.
A key example is the myPhonak app, which gives wearers an enhanced and personalized hearing experience, including remote support, fitting, and control, as well as advanced customization options such as noise reduction and speech focus.
To complement our strong R&D hubs in Stäfa and around the world, we announced in November 2019 the opening of the Sonova Innovation Lab in Waterloo, Ontario, Canada, where we explore new digital capabilities in one of the leading consumer app development centers in North America, bringing together experts from our various specialties with people from the mobile industry to accelerate our app development.
Partnerships and collaborations
At Sonova, we consider interdisciplinary collaboration as the guarantor of progress – and essential for such a complex subject as hearing. A key area of our innovation strategy is therefore establishing and promoting international networks, which pool the expert knowledge of leading research bodies, hospitals, companies, and institutions, and bring it to fruition in new hearing solutions.
Long-term partnership and open exchange are the hallmarks of our collaboration with over fifty top-class universities and centers of excellence and technology. The focus of this interdisciplinary work is to leverage all potential for innovation: broadening understanding of auditory perception and cognitive processing, driving forward digital signal processing and miniaturization of electronics, improving material and implantation technologies, and researching the potential of bionics. We work especially closely with the international groups of experts from the Pediatric Advisory Board to develop hearing solutions that counteract hearing loss in early childhood and at the same time include and support the entire family.
Accessibility and affordability
Innovation is not limited to products – it also drives the way we approach the market, both through our wholesale companies and our audiological care network. Operating through many channels multiplies the potential paths to hearing in all markets, even in parts of the world where hearing care has been in short supply. Our Audiological Care business represents the second-largest store network in the industry, with a clear path to further growth. We operate a global network of about 3,300 stores and clinics in 20 key markets.
The severe COVID-19 related restrictions in many markets, aimed at slowing the spread of the virus, had an impact on the entire hearing care industry, including Sonova as a market leader. Audiology stores – the primary distribution channel for hearing care products and services to consumers – had their operating hours reduced or were temporarily closed. Senior citizens, who account for a large proportion of hearing care consumers, are part of the high-risk group for COVID-19 and were asked to stay at home to protect their health. Elective surgeries, including cochlear implants, were deferred in many countries.
Our utmost priority is to protect our employees, their families, our customers, consumers, and partners. At the same time, hearing remains a fundamental human need. Sonova has been working hard to ensure continued access to necessary hearing care and solutions in compliance with regulations. We are aware of our responsibilities, especially towards elderly consumers, and have therefore taken strict precautions. Employees supporting people who need hearing care all work compliantly while giving top priority to safety, health, and hygiene.
Access in remote areas
One example of Sonovaʼs efforts to increase access to hearing care for people living in rural areas is the TeleAudiology model, pioneered by Triton Hearing, a Sonova Group company in New Zealand. Despite Tritonʼs nationwide network of 70 clinics across the country, many New Zealanders still find seeing an audiologist difficult, especially in communities of indigenous people living in remote areas. Triton fitted out two buses with state-of-the-art diagnostic hearing equipment and turned them into mobile, full-service hearing clinics.
A hearing care professional provides the in-room support, including performing video otoscopy, positioning transducers, and handling hearing aids. Through TeleAudiology, clients are connected with audiologists over a high-definition teleconferencing system. It is possible to provide a full diagnostic assessment, hearing and communication needs assessment, impression taking, hearing aid fitting and verification, purchase, and follow-up services through a synchronous, live connection. Although the COVID-19 pandemic restricted the activities of the mobile hearing clinic buses during the past year, digital solutions, such as remote support, were strongly enhanced to maintain service to people in remote areas.
We develop dedicated products and services for underserved markets. For example, around 1.3 billion people around the world speak a Sinitic language such as Mandarin or Cantonese1. These are tonal languages, where the basic frequencies communicate the information content of words. To better understand the specific needs of Chinese people with hearing loss, we are working with Chinaʼs largest hospital, the Tongren Hospital in Beijing. The result is a specific prescription formula for the amplification/frequency curve shapes of tonal languages – or, to put it more simply, hearing aids offering significantly better speech clarity for millions of people in Asia.
- Ethnologue: Languages of the World, 22nd edition (2019)
Affordable hearing care is still a challenge for many people in low- and middle-income countries and for underprivileged social groups in high-income regions. Sonova is committed to increase accessibility and affordability of hearing care by expanding its presence in underserved markets.
We aim to increase the number of hearing aids sold in low- and middle-income countries by 50%. The global health and economic crisis resulting from the COVID-19 pandemic severely affected the hearing care market and with it our business activities. We therefore adjusted the target date for achieving the 50% increase by one year from 2022/23 to 2023/24. Progress is presented in the table below.
Sales growth in low- and middle-income countries
Increase in number of HI sold in low-and middle-income countries vs. 2018/19
Training and education
Many countries lack trained health personnel, educational facilities, and necessary data to address the needs of those living with hearing problems. These factors, and the lack of hearing care professionals and infrastructure in many markets, can impede efforts to raise the proportion of people receiving hearing care. Building local capacity worldwide and training hearing care professionals to the highest standards is very important to Sonova.
As an example, China faces the challenge of a rapidly growing number of people with hearing loss due to an aging population, which will put more strain on an already under resourced hearing care system. Sonova decided to tackle the significant lack of comprehensive, practical training for hearing care professionals and build a training center – the Global Hearing Institute in Suzhou. The center offers advanced audiology courses and practical training for hearing care professionals from the entire Asia-Pacific region; it features a soundproof room for hearing tests and workstations for fitting ear-molds. The uptake of training courses by hearing care practitioners from across China has been very strong since the center opened in May 2017. After the courses, participants keep in touch with their trainers via chat and can contact them if they need advice on issues back in the workplace. In 2020/21, the Global Hearing Institute provided around 40,000 online training sessions.
Sonovaʼs commitment to provide high-quality training for hearing care professionals applies to both developing and developed markets. The Swiss International Hearing Academy (SIHA), a Sonova Group initiative, runs a pioneering blended learning program in audiology for aspiring hearing care professionals (HCPs). The study program makes training courses viable in emerging economies where opportunities for vocational education are thin on the ground or non-existent. In 2020/21 we set a new target: to train and certify 250 HCPs in low- and middle-income countries through the SIHA 12-month HCP program by 2022/23. In 2020/21, already 150 HCPs have been enrolled in the 12-month program and are expected to graduate and become certified throughout the coming year.
In addition to the SIHA, we opened our first training center in Germany in 2019. Located in Dortmund, the Sonova Academy offers comprehensive training and development opportunities at the cutting edge of science and technology in ultra-modern training facilities. The program of in-person and eLearning modules complements Germanyʼs existing training offerings in hearing acoustics: The Sonova Academy cooperates closely with the German Academy for Hearing Acoustics and the German Vocational School for Hearing Acoustics.
Hear the World Foundation
Sonovaʼs philanthropic engagement at Group level has a strong focus on increasing access to hearing care in low- and middle-income countries, especially for children. We achieve this primarily by supporting the charitable Hear the World Foundation – initiated by Sonova in 2006 – with funding, expertise, and hearing solutions. In 2020/21, Sonova has committed to the following new target: We aim to increase the number of lives affected by the Hear the World Foundation by 10% year-over-year.
The mission of the foundation is to improve the quality of life of people in need with hearing loss worldwide and create equal opportunities by giving them access to hearing healthcare. The foundation makes essential contributions to the UN Sustainable Development Goal (SDG) 3 (good health and wellbeing) and SDG 4 (quality education) by investing in projects benefitting children in need with hearing loss, providing training, and building local capacity in countries that lack qualified hearing care professionals, and supporting prevention of hearing loss.
In 2020/21, the foundation supported 18 programs globally, in which over 640 professionals were trained, over 8,000 hearing screenings conducted, and around 900 parents of children with hearing loss were supported. Sonova employees conducted around 600 hours of volunteer work for the foundation. You can find more data in the foundationʼs Activity Report, which is published annually and available on the foundationʼs website and provides detailed information on the foundationʼs strategy, activities, goals and impact.
In the 2020/21 financial year, the total monetary value of Sonovaʼs contribution to corporate citizenship and philanthropic activities amounted to around 3.6 million CHF. Broken down by type of activity (see first table below), the vast majority (98%) of the monetary value of all contributions was in the form of community investments: long-term strategic involvement with community partner organizations by the Hear the World Foundation with the aim to improve quality of life and create equal opportunities. A total of 1% of the cost of all activities was in the form of charitable donations, and 1% was for commercial initiatives, e.g. research projects, sponsoring of community organizations, and other initiatives related to the topic of hearing supported by Sonova. Broken down by type of contribution (see second table below), the total of around 3.6 million CHF comprises 67% in-kind contributions (mostly hearing instruments and cochlear implants), 16% direct cash contributions, 16% management costs (e.g. staff salaries and overheads), and 1% time (e.g. employee volunteering).
Monetary value of philanthropic contributions by type of activities
1Only contributions at Sonova Group level included, does not include contributions at brand level.
Monetary value of philanthropic contributions by type of contribution
1Only contributions at Sonova Group level included, does not include contributions at brand level.