Equitable access to cochlear implants: a perspective on social justice and international obligations

Hearing loss is one of the most prevalent sensory conditions worldwide, affecting over 1.5 billion people and is one of the main causes of disability. For individuals with severe to profound hearing loss, cochlear implants (CIs) are one of the most effective rehabilitation options as they can significantly improve speech comprehension, language development, quality of life and social inclusion. Despite their clinical value, however, access to CIs remains highly unequal between and within countries, with implantation rates disproportionately favoring wealthier nations and people with a higher socioeconomic status. Grounded in a human rights approach, this article develops a conceptual and policy-based reflection supported by a targeted review of scientific literature and international legal standards. From this standpoint, access to CIs must be recognized as an enforceable fundamental right. This recognition implies clear international obligations for states to translate their human rights commitments into tangible, inclusive national policies. Furthermore, this perspective emphasizes the ethical responsibility to ensure the real accessibility, affordability and adaptability of cochlear implants, overcoming barriers related to socioeconomic disparities, geography, race and systemic inequalities. This perspective article highlights the urgent need for comprehensive public policies based on international human rights law to ensure equitable access to cochlear implants, advocating a rights-based approach as a necessary strategy to achieve social justice, dignity and full social participation for people with hearing disabilities.