also a growing recognition that social issues look increasingly similar across the North-South divide. Similar, but not identical – obesity may be on the rise in countries like Mexico and South Africa, but there, it coexists with hunger and malnutrition. Other issues that are bound to rise up the development agenda, especially if income poverty continues to fall, include mental health, ageing, reproductive rights, or discrimination on the basis of sexuality (think of the recent controversies over gay and lesbian rights in various African countries). They will join other social issues around gender, ethnicity or religion that have long been recognized as relevant to the development debate.
Another such topic is disability – most people who have travelled much will have been struck by both the number of people with disabilities in poor countries, and how often they are ignored, locked away or maltreated. But somehow this often failed to make it onto our priority list. Until now. The first ever World Report on Disability was published yesterday by the WHO and World Bank. Some highlights:
There has been a paradigm shift in approaches to disability. In recent decades the move has been away from a medical understanding towards a social understanding. Disability arises from the interaction between people with a health condition and their environment. The emphasis should be on removing environmental barriers which prevent inclusion.
There are over one billion people with disabilities in the world, of whom between 110-190 million experience very significant difficulties. This corresponds to about 15% of the world’s population and is higher than previous World Health Organization (WHO) estimates, which date from the 1970s and suggested a figure of around 10%. [did you get that? The first estimate in 40 years – now that’s what I call neglect].
The prevalence of disability is growing due to population ageing and the global increase in chronic health conditions. Patterns of disability in a particular country are influenced by trends in health conditions and trends in environmental and other factors – such as road traffic crashes, natural disasters, conflict, diet and substance abuse.
Disability is more common among women, older people and households that are poor. Lower income countries have a higher prevalence of disability than higher income countries. According to the Guardian’s coverage of the launch, 20% of the world’s poorest people have disabilities and nearly 80% of people with disabilities live in low-income countries.
The recommendations are based on the United Nations Convention on the Rights of persons with Disabilities (CRPD) and are pretty much what you would expect – governments need to spend more, have a national disability strategy and plan of action etc. The report talks about involving and consulting people with disabilities, but I didn’t see anything on supporting them to organize independently, at least in the summary materials, which is a worrying omission.
Possible wider implications for development agencies? Get out of your development comfort zone, look at the issues that are salient in the rich countries and try to understand them better, because albeit in slightly different forms, they are coming our way. We can get a headstart by supporting organizations and states in developing countries to learn about and adapt approaches in the rich countries, rather than starting from scratch.
And here’s one story from the billion – a powerful video about wheelchair users in Tanzania
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