Melvin, John L, MD, MMSc

Sharma, Saloni, MD

Jefferson Digital Commons

Public Policy for People with Disabilities:the UN and WHO PerspectivesJohn L. Melvin, MD, MMSc                                                         Michie Professor and ChairmanDepartment of Rehabilitative MedicineThomas Jefferson UniversitySaloni Sharma, MD                                                               Chief Fellow, Pain ManagementDepartment of AnesthesiaMilton S. Hershey Medical CenterPennsylvania State UniversityLike other social issues, globalization has had an impact on governmental policiestowards disability. Legislation in one country can have a significant impact on international organizations – such as the United Nations (UN) and the World HealthOrganization (WHO) and on the policies of other countries. For instance, the UnitedStates (US) Americans with Disabilities Act (ADA) of 1990 provided an important modelto these organizations and many countries. The reverse can also be true; internationalapproaches can impact the legislation of individual countries. For example, the broaderdefinitions of disability included in the UN Convention on the Rights of Persons withDisabilities influenced advocates who sought passage of the US ADA Amendments Actof 2008, signed into law on September 25, 2008.Increasingly, awareness of international concepts related to social problems providesinsight into issues likely to be addressed in one’s own country. This paper reviewsrecent UN and WHO actions likely to influence the public policies of most countriestowards people with disabilities, including those of the US.Disability is a significant issue in the US. Based on the 2002 Survey of Income andProgram Participation, The United States Census Bureau News reported in 2006 that51.6 million Americans (18% of those responding) reported having a disability.1US public policy addresses both the rights and the financial needs of people with disabilities.2,3 The laws implementing these policies were largely the result of advocacyefforts of people with disabilities and their US organizations.Health Policy Newsletter Volume 21  •  Number 4 December 2008 Internationally, disability is an even greater problem than it is in the US. Approximately10 percent of the world population, which is equivalent to 650 million people, has a disability.4 Disability does not exist in isolation; it is linked to unemployment, poverty,reduced health status, lower educational levels and abusive behavior, particularly ofchildren and women. Globally, 10% of disabilities from injuries are from war; particular-ly from unexploded ordinance including landmines.5 The UN refers to disability as multisectorial, i.e. programs addressing disability require the involvement of multiplegovernmental departments dealing with these related social problems. Estimates arethat 25% of the world’s population is directly affected by disability when the impact oncaregivers and family members is considered.On a global scale, the UN General Assembly adopted the Convention on the Rights ofPersons with Disabilities and an Optional Protocol to the Convention (Convention) onDecember 13, 2006.6,7 This Convention entered into force on May 3, 2008, after itreceived its 20th ratification. This status requires that a Conference of Member Stateselect a Committee on the Rights of Persons with Disabilities in 6 months. TheConvention aims to ensure that persons with disabilities enjoy all human rights andfundamental freedoms on an equal basis with others. It lists the adaptations membercountries must make to enable people with disabilities to exercise their rights effectively.The need for these requirements is based upon an analysis of the rights that have beenviolated and those that need reinforced protection. Within the United Nations, theWHO is taking the lead in implementing the Convention, particularly its health aspects.8 One of its initiatives includes disseminating information on the Convention,emphasizing its importance and supporting Member States in their implementationobligations. Another initiative is appropriately incorporating disability issues withinWHO projects and programs, and assuring that WHO offices, information resources and employment opportunities are accessible.At the request of the World Health Assembly, WHO is developing a World Report onDisability and Rehabilitation to thoroughly discuss and examine the importance of disability, assess the current situation and determine what will be needed in the future.The report will investigate the current data and patterns in disability and rehabilitation,etiologies of disabilities, and key issues including rights, access and equality.Furthermore, it will develop a plan for change on the national and international levelsbased on the best available scientific evidence while promoting awareness on the stateof disability and rehabilitation.These mandates to protect the human rights of people with disabilities will affect all ofthe institutions of countries that incorporate them into their laws, much as the US hasdone with the ADA Amendments of 2008. They will have the same impact as the lawsthat protect the rights of women and underrepresented minorities. Organizations suchas Thomas Jefferson University and Thomas Jefferson University Hospital will need to consider these mandates as they examine policies related to employment andacceptance of students, as well as programmatic goals and competencies.References1. U.S. Census Bureau News. More than 50 million Americans report some level of disability. http://www.census.gov/Press-Release/www/releases/archives/aging_ population/006809.html. Published May 12, 2006. Accessed July 14, 2008.2. U.S. Department of Justice. A guide to disability rights laws. Http://www.usdoj.gov/ crt/ada/cguide.htm#anchor65610. Published September 2005. Accessed July 14, 2008.3. Social Security Online. Disability programs: benefits for people with disabilities.http://www.ssa.gov/disability/. Updated June 30, 2008. Accessed July 14, 2008.4. United Nations Enable. Rights and dignity of person with disabilities. Factsheet on persons with disabilities. http://www.un.org/disabilities/default.asp?id=18.Accessed July 14, 2008.5. World Health Organization. The world health report 1999. http://www.who.int/whr/1999/en/index.html. Accessed October 20, 2008.6. United Nations Enable. Rights and dignity of persons with disabilities. Convention on the rights of persons with disabilities. http://www.un.org/disabilities/ default.asp?navid=12&pid=150. Accessed July 14, 2008.7. United Nations Enable. Rights and dignity of persons with disabilities. Entry into force. http://www.un.org/disabilities/default.asp?id=210. Accessed July 14, 2008.8. World Health Organization. Disability and Rehabilitation Team (DAR). Policies.http://www.who.int/disabilities/policies/en/. Accessed July 14, 2008.Copyright © 2008 by the author. Health Policy Newsletter is a quarterly publication of Thomas Jefferson University, JeffersonMedical Center and the Department of Health Policy, 1015 Walnut Street, Suite 115, Philadelphia, PA 19107. jdc.jefferson.edu/hpn

Public Policy for People with Disabilities: the UN and WHO Perspectives

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Public Policy for People with Disabilities: the UN and WHO Perspectives

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