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Summary

  • People with disabilities are disproportionately represented amongst the world’s poor.  They suffer a range of barriers to improving their circumstances, including formal and informal patterns of discrimination, prejudice, and physical and financial constraints. As a result, they tend to have lower incomes and to have less access to employment, livelihoods, healthcare, education, adequate nutrition and transport than non-disabled people in the same societies.  
  • People with disabilities are at greater risk of violence and abuse, including being subject, in some cases, to involuntary sterilization. They are also more likely to be excluded from decision-making and therefore less likely to be able to exercise meaningful control over their own lives.  Some people with disabilities are denied autonomy – for instance when they are confined in institutions against their will or denied citizenship or equal status under the law as a result of their disability. 
  • Given that over 1 billion people (15 per cent of the world’s population) live with some form of disability, it is shocking that much mainstream development policy – pursued by national governments as well as bilateral and multilateral donors – has failed to give adequate attention to the rights and needs of people with disabilities. Most strikingly, the Millennium Development Goals (MDGs), agreed in 2001, made no mention whatsoever of disability, either in the headline goals or the accompanying targets and indicators.  This neglect of disabled people in much development policy and practice is a major explanation for the continuing levels of poverty, exclusion and disadvantage suffered by millions of people with disabilities across the world.
  • However in recent years, people with disabilities, supported by disabled persons’ organisations (DPOs) and allied NGOs, have worked tirelessly to put disability rights on national and international political agendas, and with some success.  The landmark United Nations Convention on the Rights of Persons with Disabilities (CRPD), which came into force in May 2008, was the culmination of sustained advocacy and campaigning efforts in many countries. The CRPD’s provision on international cooperation (Article 32) should be a guiding principle behind the UK’s development strategy.
  • It is commendable that DFID has committed to significantly enhancing its work on disability and development.  DFID should approach these issues from a rights perspective and with explicit reference to the obligations set out in the CRPD.  It should commit to publishing a comprehensive strategy on disability and development, with clear benchmarks by which progress can be measured, and it should fully integrate disability rights into its thinking, strategies and practice around development. It is concerning, for example, that many of DFID’s current 5-year country strategies do not mention disability or make any specific commitments around this issue.
  • DFID should press the issue of disability rights through its work in multilateral organisations, including the international financial institutions.  As multilateral development banks revise their policies, the UK should press for reforms to require that they undertake human rights due diligence, to ensure that they respect the rights of people with disabilities and other human rights. The UK government currently has on opportunity to do so as the World Bank reviews its safeguard policies.  
  • DFID should commit to work closely with disabled persons organisations (DPOs) and human rights groups in partner countries, drawing on their expertise and networks. 
  • DFID should also commit to press for specific goals and targets around disability rights to be incorporated into a post-2015 development agenda, and commit to disaggregate data on development, so that it is possible to measure the impact of development programmes on people with disabilities and other marginalised social groups.

About Human Rights Watch

1.       Human Rights Watch is an independent, international human rights organisation. We document human rights abuses in some 90 countries around the world. We expose these abuses through media work and other forms of communication. Through advocacy, we press for changes in policy and practice to better respect, protect and fulfill internationally-recognised human rights. 

2.       Human Rights Watch has been working on disability for four years.  This year, we established a separate division on disability rights, reflecting the growing importance of our work in this area. Further material on this work is available here: www.hrw.org/disability.

The exclusion of people with disabilities from services

3.       Human Rights Watch has documented many examples of where people with disabilities have been excluded from essential services.  In both Nepal and China, for example, we have documented extensive discrimination against children with disabilities in terms of access to education.  In our 2011 report on Nepal, Futures Stolen, we found that a large proportion of the estimated 330,000 Nepalese primary-school-age children out of school had a disability. Although Nepal has ratified the UN Convention on the Rights of the Child and the UN Convention on the Rights of Persons with Disabilities it was not doing nearly enough to ensure that children with disabilities were able to access school.  Barriers to education included inaccessible school buildings (no ramps or disability-friendly toilets), communication barriers (no sign language instruction or Braille teaching materials), negative attitudes from many teachers and other pupils and parents, and inflexible or inappropriate curricula that failed to take account of the needs of children with disabilities.  Our research revealed that this lack of access to education had other harmful consequences beyond the loss of educational opportunity: with some disabled children, who were unable to access school, locked up at home in a room or tied to a post while their parents went out to work.

4.       In a 2013 report, As Long as They Let Us Stay in Class, Human Rights Watch documented similar patterns of disadvantage and discrimination experienced by children with disabilities in China.  The Chinese government has an impressive record in providing primary education for children without disabilities, achieving near-universal education for such children. However, 28 per cent of Chinese children with disabilities are not in school.  The barriers to education faced by these children include the outright denial of school enrolment (in some cases), pressure on parents to take their children out of school, and a wider lack of “reasonable accommodation” provided to these children to limit the effects their impairments have on their performance. Even where children with disabilities do attend school, they rarely stay there beyond the junior years; and for those who aspire to higher education, the choices are very limited.

5.       These barriers to education for children with disabilities are replicated in many other countries around the world. Of the 57 million children currently out of school globally, over a third have a disability.

Barriers to political participation for people with disabilities

6.       Across the world, people with disabilities face serious barriers to effective citizenship and political participation.  For example in our 2012 report on Peru, I Want To Be A Citizen Just Like Any Other Human Rights Watch identified a wide range of restrictions and forms of discrimination against persons with disabilities. We documented how restrictions on legal capacity – the right to make decisions about one’s life - impact on the ability of people with intellectual and psychosocial disabilities to enjoy a range of rights, including the right to own or inherit property, be employed or legally represent their children.

7.       Our research in Peru revealed that many people with disabilities had been stripped of their legal capacity or were at risk of being deemed as lacking capacity, a legal process provided for in Peru’s Civil Code (by which a judge declares a person either absolutely or partially incompetent to take care of oneself and property and imposes another person as guardian to act on their behalf), in effect suspending their civil rights.   This process is incompatible with the Peruvian government’s obligations under the CRPD. The CRPD Committee, which monitors the implementation of the treaty, has called on the government to abolish it.  While our research in this specific area focused on Peru, these kinds of practices and patterns of discrimination and disadvantage are present in many other countries, too.

Violence and abuse against people with disabilities 

8.       In many countries around the world, people with disabilities are subject to appalling levels and forms of violence and abuse.  In a 2012 report Like a Death Sentence, Human Rights Watch documented and exposed abuses against people with disabilities in Ghana.   An estimated 2.8 million persons in Ghana have mental disabilities. Of these, 650,000 are thought to have severe mental disabilities. Across Ghana, mental disability is widely considered as being caused by evil spirits or demons. Our research looked specifically at people with mental disabilities being held in prayer camps (spiritual healing centres) and psychiatric facilities. The abuses to which they were subjected included involuntary admission and arbitrary detention, prolonged detention, overcrowding and poor hygiene, chaining, forced seclusion, lack of shelter, denial of food, denial of adequate health care, involuntary treatment, stigma and its consequences, physical and verbal abuse and forced electroconvulsive therapy.

9.       According to the UN Office of the High Commissioner for Human Rights, men and women with disabilities are at increased risk of being abused, either physically or sexually. The World Health Organization estimates that children with disabilities are 4 to 5 times more likely to experience violence and sexual abuse than non-disabled children. Women and girls with disabilities face a heightened risk of physical and sexual violence, including rape, because of perceptions that they are less able to defend themselves or demand justice for violations. Other factors include social exclusion, limited mobility, lack of support structures and communication barriers. Women with disabilities are often trapped in abusive relationships because they may be dependent on caregivers and due to their very real poverty.

10.    Furthermore, according to HIV experts, women and girls with disabilities are less likely to receive information about HIV prevention and safe sex, and are less likely to have access to prevention methods such as condoms. Instead, they are often shut out of sexual health education under the assumption that individuals with disabilities are not sexually active.

11.    Women and girls with disabilities are also often stripped of their right to a family. In many countries, parents of girls with disabilities can apply for court orders to allow the involuntarily sterilization of their child with disability, even if she is legally an adult. The laws treat people with disabilities differently, and courts have the power to make decisions for them that have life-altering effects on their future.

DFID and the rights of people with disabilities

12.    DFID’s new focus on disability is very welcome.  DFID Ministers are to be commended for stating so clearly and publicly that they will “put disability at the forefront of the world’s development efforts” and for their acknowledgement that we “will never solve the root causes of poverty unless we end the discrimination and prejudice that disabled people face every day”. DFID has also indicated that future DFID projects in areas like education will ensure access for people with disabilities.  The challenge and the opportunity for DFID is to translate this strong rhetorical commitment into practical action.

13.    There are a number of specific steps that DFID should take. First, it should agree a comprehensive new strategy on disability and development, including by designating disability as a cross-cutting issue, similar to gender. Second, through this strategy and DFID country strategies, it should set clear goals and targets around enhancing the rights of disabled people, in terms of access to health, education, nutrition and livelihoods, but also reforms to legal and informal practices that discriminate against people with disabilities. It is striking that many of DFID’s 5-year country strategies make no reference to disability and set no targets for improving the conditions of people with disabilities. Thirdly, DFID should disaggregate data, so that it is possible to assess the impact of its programmes on people with disabilities and other vulnerable social groups. Fourth, DFID could usefully designate a senior official within the Department as the lead on disability issues.  Fifthly, DFID should deepen its engagement with disabled persons organisations and human rights organisations working on disability rights, to draw on their expertise and networks when designing and implementing their development programmes. 

14.    UK government should also press the issue of disability rights through key international organisations like the World Bank and other international financial institutions. The World Bank’s ongoing safeguards review provides an important opportunity to do so. The UK government should support policy reforms to require the World Bank to respect international human rights law in all of its activities. This should include respecting the rights of persons with disabilities and working to make sure that all activities are disability-inclusive. More broadly, an essential element of such a human rights requirement would be ensuring that the World Bank does not discriminate against people on any grounds prohibited by international law and that it works to address inequality in its activities. To operationalize this human rights requirement, the World Bank should undertake due diligence to identify the human rights impacts of its activities, avoid or mitigate adverse impacts, and confirm that the rights of persons with disabilities are fully respected.

15. The UK government should also ensure that its own domestic laws are in compliance with the CRPD and all other human rights laws ratified by the UK relevant to persons with disabilities. This includes, in particular, laws governing legal capacity. At the same time the UK could consider sharing its decades of experience of implementing disability discrimination legislation, for example.

Disability and the post-2015 development agenda

16.    In 2001, the world’s government agreed the Millennium Development Goals, but these made no reference whatsoever to disability. This oversight in the MDGs and in much mainstream development policy and practice is a major explanation for the continuing levels of poverty, exclusion and disadvantage suffered by millions of people with disabilities around the world.

17.    The UN-led process underway to agree successor goals represents a crucial opportunity to address the rights and needs of people with disabilities.  The UK government is very actively engaged with this process. The Prime Minister was co-chair of the High Level Panel on the post-2015 agenda, which reported in May 2013. This was a strong report, which made a number of clear references to the rights and needs of people with disabilities.  The report said that new development goals should be set with the aim that “no one should be left behind” and that goals would “only be considered achieved if they are met for all relevant income and social groups”.

18.    In a recent report, Human Rights Watch has argued that the post-2015 development agenda and any new goals and targets should be rooted in human rights standards and principles We argue that new goals and targets should be set for tackling discrimination, reducing disparities and promoting equality of opportunity between different groups, alongside concrete targets for improving the conditions of the poorest and most marginalised, including people with disabilities.  We also believe that national and international data on development should be fully disaggregated, to make it possible to assess the impact of development interventions on different groups, including people with disabilities.

19.    With the process for formulating post-2015 goals and targets having now moved to the stage of inter-governmental negotiations, it is very important that the DFID and the UK government continue to press the case for integration and prioritisation of disability rights.  It would be an unacceptable missed opportunity for a post-2015 development agenda not to agree on specific targets relating to disability.  These should include access to services, but also action against discrimination and abuse, as well as pressure on governments to ratify and implement the full range of rights set out in the Convention on the Rights of Persons with Disabilities.

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