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[new-pack] hearing-loss-care-access-global — 430M affected, 80% in LMICs, top-5 GBD YLD cause with no sub-national coverage data - #60
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Discovery mode: add public-health/hearing-loss-care-access-global as a scoped pack for verifying hearing care coverage and audiology workforce gaps in LMIC settings. The pack uses current WHO evidence for scale and cost-effectiveness, while framing the unresolved gap as unverified standardized sub-national coverage data rather than a global negative claim. Constraint: one discovery pack, public-health domain, all canonical files present, generated indexes rebuilt. Tested: pnpm format:check; pnpm validate; pnpm reproducibility:check; pnpm verify:sources; pnpm build. Confidence: medium-high; WHO scale figures are verified, while the neglectedness and allocation-wedge framing still require domain and field-reality review. Co-authored-by: OmX <omx@oh-my-codex.dev>
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Mode: Discovery
Problem Pack:
public-health/hearing-loss-care-access-globalRanking Table
Why This Problem
Hearing loss is a top-5 GBD cause of years lived with disability (YLDs). It affects 430 million people, 80% in LMICs, costs ~US$1 trillion annually, and has a documented cost-effective intervention (<US$1.40/person with 16:1 ROI). Despite this, the portfolio has a blindness/vision-impairment pack but no hearing loss pack. The evidence gap is precise: no standardized sub-national hearing aid coverage or audiology workforce density dataset exists for LMICs. Without it, health ministries cannot make evidence-based allocation decisions about including ear and hearing care in NCD budgets.
Files Changed
problem-packs/public-health/hearing-loss-care-access-global/(10 canonical files)agent-radar.json,tasks-available.json,docs/wiki/(regenerated bypnpm build)Evidence Added
5 evidence records in
evidence.json:who-deafness-fact-sheet-2026— 430M prevalence, 80% LMIC, $1T cost, $1.40/person, 16:1 ROI (primary-source, WHO fact sheet March 2026)who-hearing-loss-lmic-distribution-2026— 80% LMIC distribution (primary-source)who-hearing-loss-economic-burden-2026— economic burden and cost-effectiveness (primary-source)who-world-report-on-hearing-2021— strategic framework (expert-review, WHO 2021)who-childhood-hearing-loss-preventable-2026— 60% preventable childhood, 1B at-risk youth (primary-source)Validation Method
pnpm validate: passedpnpm reproducibility:check: passed (549 tasks)pnpm verify:sources: both evidence URLs verified 200 (WHO fact sheet, WHO World Report on Hearing)pnpm build: passed (106 packs, 103 scoped tasks)Known Limitations
Kill Condition (for the core pack thesis)
If sub-national hearing aid coverage data for at least three LMICs becomes available and shows coverage above 50% of need, the "coverage gap" framing of this pack is falsified and should be revised or deprecated.
Reviewer Type Needed
domain-reviewerfor evidence quality and pack structurefield-reality-reviewerfor whether the named decision-maker and allocation decision are realChecklist
pnpm validatepassespnpm reproducibility:checkpassespnpm buildpasses, regenerated files committedProtocol Notes
The
disability-access-barriers-globalpack uses["public-health", "education"]as its domain tags rather than a dedicateddisability-accessdomain. This pack initially tried usingdisability-accessas a domain tag but the validator correctly required a matching GitHub label. Since hearing loss is primarily a public-health access problem, using["public-health"]alone is sufficient and consistent with existing pack conventions. No schema change needed — the domain vocabulary is flexible enough to handle sensory-function issues under existing domains.