International Trade and Market-Shaping Strategies to Promote Access to Assistive Products

Assistive technology is vital for upholding dignity and fundamental rights by promoting health, autonomy, economic participation, and social inclusion for hundreds of millions of people with functional limitations. Ranging from wheelchairs and hearing aids to digital tools and communication software, assistive products are recognized as essential for equitable access to education, work, and community life. Yet access remains highly unequal, with coverage in some low- and middle-income countries as low as 3%.
Barriers include limited funding, data, and professional capacity, as well as trade restrictions and weak local production. While high-income countries benefit from established markets and regulatory systems, many low- and middle-income countries face high taxation, bureaucratic hurdles, and reliance on imports or donations. Global trade in assistive products remains concentrated in a few wealthy nations, leaving poorer regions with limited access, fragmented supply chains, and difficulties maintaining and repairing them.

In many low- and middle-income countries, assistive technology supply relies on a mix of imports, local production of low quality, and donations, rarely aligned with population needs. Few studies have analysed how tariffs, tax regimes, customs and market entry barriers affect the access to assistive products, especially in these countries. Market shaping strategies have been successfully used to influence markets' dynamics and improve the availability and affordability of other health products, such as by reducing transaction costs, increasing market information, and balancing supplier and buyer risks. There is a potential for market building and shaping strategies to change the landscape of the global provision of assistive products. Strengthening evidence-informed decision-making is therefore essential to ensure that policy development is guided by robust evidence rather than political or sectoral interests.

This Research Topic invites contributions that strengthen the evidence base for policy in assistive technology. We welcome original research, systematic reviews, and policy analyses that address factors that shape equitable access to assistive technology at global, regional, and national levels.
Relevant themes include:
• Trade policies, strategies, facilitation and agreements
• Tariff reduction
• Customs procedures
• International regulations
• International supply chains
• Technology transfer
• Classification of assistive products (e.g., in the Harmonized System)
• Tax structures and fiscal coordination
• Public procurement
• Regulatory frameworks for acquisition, distribution, and logistics
• National or regional production
• Regional trade integration
• Inclusive social and technological innovation adapted to local contexts
• Investment in research and development

Manuscripts emphasising evidence-informed policymaking and cross-sectoral collaboration are particularly encouraged.