Response to the WHO Consultation on the Assistive Products Priority List (APL)
The International Federation for Spina Bifida and Hydrocephalus (IF) welcomes the WHO Consultation for the updated version on the Assistive Products Priority List (APL), in particular that it acknowledges catheters, and related accessories, as essential assistive products for persons living with SBH. As global advocates for persons with disabilities, we deeply value the WHO’s commitment to promoting equitable access to assistive technology.
This issue has been brought to us directly by our members in the 80Â countries and 110 associations we represent, who consistently report that lack of access to catheters remains a barrier to their health, autonomy, and participation in daily life. We therefore bring this matter forward on their behalf.
The APL plays a crucial role in guiding national procurement policies, shaping essential health benefit packages, and influencing donor priorities. It is therefore vital that it accurately reflects the assistive products that are essential for daily life, health, and independence. Failure to do so undermines the purpose of the list and contradicts core principles of human rights and disability inclusion.
Catheters are a life-sustaining assistive product for many persons affected with disabilities and their consequences with bladder dysfunction. For people with spina bifida, cerebral palsy, spinal cord injury, and a range of other neurological and congenital conditions, catheters are not just an option. They are essential for safe and hygienic bladder management, preventing infections, kidney damage, and other severe health complications. Importantly, they support autonomy, dignity, and participation in education, employment, and community life.
Urological catheters (such as Foley-Tiemann urinary catheters) are already listed in the WHO Priority Medical Devices Project (PMD), recognizing their importance in clinical care. However, inclusion in the PMD list alone is not sufficient to ensure equitable and sustained access for people who rely on catheters as assistive technology for daily living. The PMD list focuses primarily on devices used in health facilities, while the APL addresses products that individuals use to maintain functional independence and participate fully in society.
Moreover, while catheters were recognized as an example of assistive technology in the WHO’s 2022 Global Report on Assistive Technology[1], their surprising lacking from the 2016 WHO APL creates a disconnect with WHO’s own guidance and undermines global and national efforts to ensure access.
The current omission:
- Limits recognition of catheters as essential assistive products within national health systems;
- Hinders the inclusion of catheters in health benefit packages and public procurement;
- Perpetuates inequities in access, particularly in low- and middle-income countries.
A recent joint publication produced in equal partnership between the European Association of Urology, European Society for Paediatric Urology, ERN eUROGEN, ERN ITHACA, ERN ERKNet, and the IFSBH[2], further underscores the urgent need for improved access to catheters as a matter of health, dignity, and rights for people with SBH and similar conditions. This publication provides additional evidence of the clinical necessity and social impact of access to urological catheters and can serve as a valuable resource for the WHO’s ongoing work.
We welcome further dialogue with the WHO technical team and would be glad to support this effort with user testimonies, clinical data, and policy perspectives. As representatives of global patient communities, we remain firmly committed to supporting the WHO in realizing its goal of universal access to essential assistive technology for all.
DOWNLOAD & READ THE IF STATEMENT HERE
[1] World Health Organization, & United Nations Children’s Fund. (2022). Global report on assistive technology. World Health Organization
[2] Abrahamson et al., EAU – ESPU -ERN eUROGEN – ERN ITHACA – ERN ERKNet – IFSBH Guidelines on spinal dysraphism in children and adolescents. Clinical Guideline. EAU Guidelines Office, Arnhem, the Netherlands, 2024
