WHY IS THIS INVESTMENT IMPORTANT?
The UN Convention on the Rights of Persons with Disabilities, ratified by 167 countries, defines persons with disabilities as “those who have long-term physical, mental, intellectual, or sensory impairments, which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.” Article 25 of the Convention on the Rights of Persons with Disabilities reinforces the rights of persons with disabilities to enjoy the highest standard of health without discrimination on the basis of disability.
Persons with disabilities are the world’s largest growing minority. U.S. global health objectives, such as an AIDS-free generation and ending preventable child and maternal deaths, will not be met if persons with disabilities are unable to access health services. We are improving efforts to prevent deaths, but we are failing in addressing issues affecting quality of life. Disease management, disability, and inclusion (DMDI) is, however, recognized (though not extensively implemented) as part of the public health approach to addressing neglected tropical diseases and provides a good example for other sectors to follow.
A recent systematic review suggested that rehabilitation services may well be cost effective for many health conditions. Furthermore, a major review by the London School of Hygiene and Tropical Medicine highlighted the significant economic costs of excluding persons with disabilities and the gains of inclusion. Existing health financing and social protection systems frequently fail to protect persons with disabilities and their families from financial risks associated with using available health services – a key element of the mandate to provide Universal Health Coverage in the SDGs.
USAID does have a Disability Policy (1997), but it contains little specific language in relation to global health. The main USAID section supporting the needs of persons with disabilities is the Vulnerable Populations Programs within the Democracy, Human Rights and Governance section. This program houses a Disability Program, a Wheelchair Program, a Victims of Torture Program, a Displaced Children and Orphans Fund, and the Leahy War Victims fund. These have provided vital support across all dimensions of disability and development, including in health care, but are somewhat limited in their scope of work and programming budget.