Global Disability Context and Wheelchair Mobility

Introduction

Over a billion people in the world today are estimated to live with some form of disability, which corresponds to about 15% of the world’s population or one in seven people. Between 110 million (2.2%) and 190 million (3.8%) people 15 years and older have significant difficulties in functioning, while some 93 million children, or one in 20 of those under 15 years of age live with moderate or severe disability. Furthermore, the rates of disability are increasing in part due to ageing populations and an increase in chronic health conditions, while national patterns of disability are influenced by trends in health conditions and environmental and other factors, such as road traffic crashes, falls, violence, humanitarian emergencies including natural disasters and conflict, unhealthy diet and substance abuse. Women, older people, and poor people are disproportionately affected by disability with children from poorer households, indigenous populations and those in ethnic minority groups also at significantly higher risk of experiencing disability. The prevalence of disability is also greater in lower-income countries than higher-income countries with an estimated 80% of people with disability living in developing or low-resource countries. Disability is extremely diverse. While some health conditions associated with disability result in poor health and extensive health care needs, others do not. ^[1]

Disability has been highlighted as a human rights issue in a wide range of international documents including the World Programme of Action Concerning Disabled People (1982), the Convention on the Rights of the Child (1989), and the Standard Rules on the Equalisation of Opportunities for People with Disabilities (1993) and more recently the United Nations Convention on the Rights of Persons with Disabilities (2006) which to date is the most extensive recognition of the human rights of persons with disabilities outlining the civil, cultural, political, social, and economic rights of persons with disabilities. ^[2]

United Nations Convention on the Rights of Persons with Disabilities

On 13 December 2006 the United Nations Convention on the Rights of Person with Disabilities (UNCRPD) and its Optional Protocol (A/RES/61/106) was adopted at the United Nations Headquarters in New York, opening for signature on 30 March 2007 and finally entering into force on 3 May 2008, becoming international law. While there are basic human rights that apply to everybody, the UNCRPD focuses on ensuring that everybody recognises that these rights also apply to people with disabilities.^[3] Intended as a human rights instrument with an explicit, social development dimension, the UNCRPD “adopts a broad categorization of persons with disabilities and reaffirms that all persons with all types of disabilities must enjoy all human rights and fundamental freedoms, clarifying how all categories of rights apply to persons with disabilities and identifies areas where adaptations have to be made for persons with disabilities to effectively exercise their rights and areas where their rights have been violated, and where protection of rights must be reinforced”. Its overall purpose is to “promote, protect, and ensure the full and equal enjoyment of all human rights and fundamental freedoms by people with disabilities and to promote respect for their inherent dignity”.^[3][4]

Disability has increasingly been recognised as both a human rights and development issue following the entry into force of the UNCRPD, with an increasing body of evidence highlighting that people with a disability experience worse socioeconomic outcomes and poverty than persons without disabilities. The UNCRPD advances disability reform legally through direct involvement of people with disabilities through use of a human rights framework. Its core message is that people with disabilities should not be considered “objects” to be managed, but “subjects” deserving of equal respect and enjoyment of human rights.

Despite this recognition scientific information and global awareness of disability continued to be limited, with no agreement on definitions of disability and little internationally comparable information on the incidence, distribution and trends of disability albeit a few documents outlining how individual countries have responded to and developed policies in relation to people with a disability. In response to this situation, the World Health Assembly (resolution 58.23 on “Disability, including Prevention, Management and Rehabilitation”) requested the production of a World Report on Disability based on the best available scientific evidence, which was then produced by the World Health Organization (WHO) in partnership with the World Bank, as previous experience has shown the benefit of collaboration between agencies for increasing awareness, political will and action across sectors.

To find out more detail about the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) click here or to access the United Nations Convention on the Rights of Persons with Disability in it’s entirety, click here.

World Report on Disability

The World Report on Disability, directed at policy-makers, practitioners, researchers, academics, development agencies, and civil society, published in 2011 by the World Health Organization and the World Bank, amassed a wide range of evidence that, across the globe, people with disabilities have poorer access to health care and poorer health outcomes than nondisabled people, with these disparities more prevalent in low-income contexts, within which most people in the world find themselves. The disparities relate to almost every aspect of health and health care and highlighted that disability may lead to a lower standard of living and poverty through lack of access to education and employment, and through increased expenditure related to disability, which is largely due to the barriers they face in their everyday lives, rather than their disability. ^[2]

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