Assistive Technology – Global Perspective

The United Nations and the World Health Organization are forging international collaboration to encourage research, public policy, health services, community education, technology, and support services for individuals with disability worldwide. Together, member countries work toward securing health maintenance, prevention, treatment, rehabilitation, inclusion and equal opportunity for all.

About assistive technology from a global perspective

The United Nations, or UN, and the World Health Organization, or WHO, are champions for the international rights and worldwide dignity of individuals with disability and impairment.

The United Nations is an international organization of over 192 member states, organized for the purpose of furthering worldwide economic development, human rights, international law, international security, social progress, and world peace.

WHO is a branch of the UN charged with directing and coordinating health initiatives within the UN.

These two entities understand the global magnitude of health, prevention, rehabilitation, and equal opportunity for those with disability. They encourage research, public policy, health services, community education, technology, and support services geared toward inclusion. They underscore the cost to society of exclusion and emphasize the benefit of inclusive environments.

WHO defines disability as a complex phenomenon that involves the interaction between an individual with impairment and the societal environment in which he or she lives.

In the simplest form, WHO first defines the key components of disability as:

Impairment – a problem in body function or body structure

Those with impairment encounter environmental challenges during activities of daily living that can be minimized or eliminated to allow those with disabilities equal access to opportunities. WHO categorizes the challenges into two areas:

• Activity limitations – a difficulty encountered by an individual in executing a task or action
• Participation restrictions – a problem experienced by an individual when trying to be involved in life situations

Activity limitations and participation restrictions occur when an individual with impairment encounters a cultural, physical, or social barrier that prevents participation on an equal opportunity basis in situations readily available to the masses. These limitations and restrictions then become barriers.

WHO is focused on limiting, or eliminating, barriers or obstacles experienced by those with disability so every individual can thrive, function, and contribute to their fullest capabilities in daily life and within society. They recognize that individuals with disabilities are important contributors to society and advocate allocating resources towards rehabilitation as a valuable investment.

WHO and the UN propose strategies, policies and procedures that member states can use as guidelines to improve the overall quality of life for individuals with impairments worldwide.

Following are key policy recommendations made by WHO and the UN which have greatly shaped barrier-free environments and accessibility worldwide:

World Health Organization

Community-Based Rehabilitation, or CBR

In the 1970s, WHO began collaborating with governments, educators, employers, the health industry, and social services. By the 1980s they were urging nations worldwide to embrace Community-Based Rehabilitation, or CBR, programs. They defined these as:

• Community-Based Rehabilitation involves measures at the community level to draw upon and build readily available community resources aimed at creating barrier-free environments. CBR focuses on meeting basic needs and ensuring inclusion and participation. These community resources require active participation and support at the local, state, national, and international level.

United Nations

World Programme of Action Concerning Disabled Persons

By adopting the World Programme of Action Concerning Disabled Persons on December 3, 1982, the United Nations initiated a global strategy to enhance disability prevention, optimize rehabilitation, and equalize opportunities for persons with disabilities. This program addressed disability from a human rights perspective. It advocates three defined areas for action:

• Prevention – measures to prevent the onset of mental, physical and sensory impairment. When impairment occurs, prevent the impairment from having a negative physical, psychological, or social consequence.
• Rehabilitation – providing a goal-oriented and time-limited process to enable the person with impairment to reach an optimum mental, physical, and social functioning level. This involves exposing the individual to methods of compensating or navigating limitations or restrictions in order to help facilitate adjustment.
• Equalization of opportunities – changing societal and environmental elements to accommodate the physical and cultural environment towards inclusion. Inclusion strategies are focused on designing equal opportunity access to housing, transportation, social environments, health services, education, public gathering spaces, recreation, and work opportunities.

United Nations

Decade of Disabled Persons with Disabilities (1983-1992)

The UN imposed a time frame, 1983 to 1992, in which the member states could implement programs to address the global strategies recommended in the World Programme of Action Concerning Disabled Persons - in particular, programs for participation, training, and employment in all levels of government, as well as equal opportunities in education and public employment.

In 1991, the General Assembly adopted the Principles for Protection of Persons with Mental Illness. This was a resolution containing 25 principles which defined the freedoms and basic rights of persons with mental illness.

United Nations

Standard Rules on Equalization of Opportunities for Persons with Disabilities – Resolution 48/96

On December 20, 1993, the UN adopted a resolution as a call-to-action for member states to create national legislation, economic policies, and support services for persons with disabilities to exert their human, civil, and political rights for equal opportunity.

The member states were urged to raise awareness; provide effective medical care and rehabilitation services; and supply support services – including assistive technologies – in the following areas to benefit those with disability:

• Accessibility
• Education
• Employment
• Income and social security
• Family life and personal integrity
• Culture
• Recreation and sports
• Religion

The measures were grounded in the belief that even after the Decade of Disabled Persons with Disabilities initiatives, obstacles remained for individuals with disabilities to exercise the same rights and obligations as those without disability. The Standard Rules on Equalization of Opportunities for Persons with Disabilities reinforced that it is the responsibility of the UN member states to take concrete action through legislation and economic policy to remove those obstacles. All resources must be employed to ensure every individual has equal opportunity for participation because the needs of each and every individual are of equal importance.

United Nations

Millenium Development Goals

Under an unprecedented global consensus to improve humanity worldwide, 189 Heads of State and governments from the north and south signed the Millennium Declaration at the UN Millennium Summit. Recognizing that over one billion men, women, and children were subjected to abject and dehumanizing conditions of extreme poverty; and admitting that disability remains both a cause and consequence of poverty that impacts over one-fifth of the world’s poor, the following Millennium Development Goals were created:

• Eradicate hunger and poverty – Disability and poverty are intertwined.
• Achieve primary universal education – Of the 115 million children not attending primary schools in developing countries, over 40 million have disabilities.
• Promote gender equality and employ women – Disabled women are more likely to be victims of abuse. Violence causes psychological disabilities and other stigmatizing disabilities.
• Reduce child mortality – Children with disabilities are at higher risk of dying, partly because of medical conditions, lack of access to appropriate services, and stigma associated with disability.
• Improve maternal health – Disabled women lack access to services and are more prone to abuse placing them at greater risk of pregnancies, disease, and forced sterilization.
• Combat HIV/AIDS, malaria and other diseases – Diseases can be disabling; therefore, efforts to halt epidemics among those with disabilities should be made.
• Ensure environmental sustainability – Environmental dangers cause disabilities. The cost of retrofitting environments for accessibility is higher and less satisfactory than designing, constructing, and maintaining proper urban designs.
• Develop a global partnership for development – A partnership implies inclusion, which means everyone.

United Nations

Fifty-Eighth World Health Assembly WHA58.23

On May 25, 2005, WHO adopted the Fifty-Eighth World Health Assembly WHA58.23. The report claimed approximately 600 million individuals worldwide were living with disability. Concerned by the sheer and growing magnitude of the health and rehabilitation needs, as well as the cost of exclusion within society, they urged the member states to adopt programs and policies towards prevention, rehabilitation, and management of disabilities.

WHO acknowledged the rapid increase in the number of persons with disabilities was due, in part, by:

• Population growth
• Increased numbers of aging population
• Prevalence of chronic conditions
• Malnutrition
• Injuries from war, violence, environmental degradation, disease, accidents, recreation, and occupation
• Environmental degradation
• Poverty-related causes such as malnutrition, limited access to health services, and rehabilitation

WHO urged member states to take measures, including:

• Strengthen national programs, policies and strategies for equal opportunities for persons with disabilities
• Increase awareness and educate on the importance of issues of disability, including prevention and inclusion at all levels and in all programs prevent disabilities
• Promote early intervention and identification of disability
• Ensure and strengthen access to an adequate, effective, accessible, affordable health care and integrated health system
• Facilitate access to appropriate assistive technology, including prostheses, wheelchairs, driving aids, and other devices which promote access to medical care
• Participate actively and constructively in the preparatory work for the United Nations to promote and protect the rights and dignity of persons with disabilities
  • Taking necessary steps for the reduction of risk factors that contribute to disabilities
  • Implementing family counseling programs and premarital testing
  • Research, develop and utilize community collaboration to implement the most effective measures to prevent disabilities

United Nations

Conventions of Rights of Persons with Disabilities

To date, the UN has 25 countries that have ratified the Convention of Rights of Persons with Disabilities and 120 who indicate an intention to ratify in the future. The Convention is a UN treaty that legally binds participating states to treat persons with disabilities with rights and dignities equal to those afforded individuals without disabilities. Ratifying countries are bound to adapt domestic legislation to international standards.

The Convention works to address barriers of persons with disabilities, including discrimination, and accessibility. The eight guiding principles of the Convention are stated as:

• Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons
• Non-discrimination
• Full and effective participation and inclusion in society
• Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity
• Equality of opportunity
• Accessibility
• Equality between men and women
• Respect for the evolving capacities of children with disabilities and respect for the right of children with disabilities to preserve their identities

United Nations

Disability and Rehabilitation WHO Action Plan 2006-2011

The Disability and Rehabilitation WHO Action Plan 2006-2011 is the WHO’s future plan of activities to be carried out by its Disability and Rehabilitation Team, or DAR. Their vision is that “All persons with disabilities live in dignity, with equal rights and opportunities.”

The Disability and Rehabilitation WHO Action Plan contains nine key activities:

• To produce a world report on disability and rehabilitation
• Advocate raising awareness about the magnitude and consequences of disability
• Facilitate data collection, analysis, and dissemination of disability-related data and information
• Support national, regional and global efforts to promote health and rehabilitation services for persons with disabilities and their families
• Promote Community-Based Rehabilitation
• Promote development, production, distribution, and servicing of assistive technology
• Build capacity among health and rehabilitation policy makers and service providers
• Contribute to the development of local, national, and international public health policies on disabilities and rehabilitation
• Foster multisectoral networks and partnerships