12The implant goes global

FThe first wave, and its ceiling

The manufacturers a clinician met for most of the implant's history were few and Western: Cochlear (Australia), MED-EL (Austria) and Advanced Bionics (USA), the lineages of Chapters within this story (Modules 7–8). Europe had one more contender — the French Neurelec line, whose Digisonic was the first fully digital cochlear implant (1992) and which carried the French thread begun by Djourno and Chouard. But that line was bought by the Demant group (Oticon Medical) in 2013 and, in 2024, absorbed into Cochlear — the end of an independent French implant industry, and a sign of how concentrated the established market had become.[2013]

That concentrated market had a ceiling: price. A device costing on the order of US$25,000 — and, in India, around ₹7–10 lakh for the implant alone — placed it far beyond the reach of most of the people who needed it. The first wave proved the cochlear implant could work; it did not make it affordable. The new manufacturers exist to attack exactly that.

TChina builds its own

China, with an enormous deaf population and a strong manufacturing base, built its own devices. Nurotron — developed through an academic-industry collaboration involving the University of California, Irvine — produced the Venus, a multi-electrode implant that became China's first domestically developed cochlear implant, approved for adults in 2011 and children in 2013. A second maker, Listent(from the lineage of Fudan University's Eye & ENT Hospital in Shanghai), had set China's first national cochlear-implant technical standard with its REZ-I device back in 2005.[2018, 2025]

The impact was not subtle. Driven by a government tender programme, the price of a domestic Chinese implant fell from roughly US$25,000 to about US$4,600within a few years, allowing tens of thousands of deaf children to be implanted who could never have been reached at the imported price. China's example showed that a safe, effective, far cheaper implant was achievable — and that a domestic manufacturer plus a public programme could close the access gap at scale.[2017]

CKorea's 32-channel newcomer

Korea contributed a different kind of innovation. The start-up TODOC, founded by an engineer formerly at Samsung, launched the Sullivan — described as the first 32-channel cochlear implant — in the Korean market around 2021. Its central idea was manufacturing: by automating the fabrication of the electrode array — the part whose hand-assembly makes conventional implants so costly — TODOC aimed to cut the price dramatically while increasing the channel count. It is a reminder that affordability can come from the factory floor, not only from the circuit design.[2022]

FTIndia — Kalam's bionic ear

India's entry into the story carries a particular weight. The former President Dr. A.P.J. Abdul Kalam — a scientist as much as a statesman — championed the idea that India should build its owncochlear implant, a “bionic ear” available at around ₹1 lakh rather than the ₹7–10 lakh of imported devices, so that an ordinary family could afford to give a deaf child hearing. It was an extension of his conviction that the know-how of national defence and science laboratories should be turned to the good of ordinary citizens.[2020]

That vision was taken up by the Defence Research and Development Organisation (DRDO), through its Society for Biomedical Technology (SBMT) — the same group whose earlier success was the Kalam–Raju coronary stent, which had already shown that an indigenous, low-cost medical device could displace expensive imports. Reports describe an SBMT effort to develop an indigenous cochlear prosthesis along these lines, aimed not at outperforming the global leaders on features but at bringing a safe, sufficient implant within reach of the Indian public.[2020]

It is important to be candid about the status of this effort. Detailed, independently verified information on the DRDO cochlear implant — its design, its trial results, its regulatory progress — is not publicly available, and no widely marketed indigenous device has emerged from it to date. The DRDO cochlear implant is, for now, best understood not as a finished product but as a national aspiration: a clearly stated intent, backed by a serious public laboratory and a revered scientist-president, to make hearing affordable. Whether and when it yields a device remains genuinely open.

Alongside the government effort, a commercial “made in India” device has appeared: the Neubio implant, Swiss-designed and Indian-manufactured, notable for a striking design choice — an electronic-free internal component, with all the sound- processing electronics kept in the external unit, which the makers argue improves safety and lowers cost. Between the DRDO/SBMT aspiration and actual made-in-India devices like Neubio, India is beginning to move from being purely a market for imported implants toward being a maker of affordable ones.[2024]

FTThe cost-and-access frontier

Put the new makers together and a pattern is unmistakable: the frontier of the cochlear implant's history has moved from capability to cost. The science of making a deaf ear hear is, in its essentials, solved; the unsolved problem is making that science reach the people who need it, the great majority of whom live in countries where the imported price is impossible.

None of this is finished, and none of it is guaranteed. The new devices must still prove themselves over years of outcomes; regulatory approval, clinical-trial timelines and manufacturing quality remain real hurdles (India's indigenous DRDO effort, for one, has yet to yield a publicly available device). But the directionis clear and, for the world's deaf majority, hopeful: a device once confined to wealthy health systems is becoming a global, and gradually more equitable, technology. That sets up the chapter's final reckoning — what the whole history has achieved, and what it still owes (Module 13).