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UN Programme on Disability   Working for full participation and equality

Back to: Second Session of the Ad Hoc Committee
Documents of the Second Session

 

Ad Hoc Committee on a Comprehensive and Integral International Convention on Protection and Promotion of the Rights and Dignity of Persons with Disabilities
New York, 16-27 June 2003

Overview of Issues and Trends related to Advancement of Persons with Disabilities

Report of the Secretary-General

Executive Summary: towards progress in equalization of opportunities in the new century

The present report, which reviews and assesses 20 years of international cooperation related to the advancement of persons with disabilities in the context of development, should be read in conjunction with the report of the Secretary-General containing the findings of the fourth five-year review and appraisal of the World Programme of Action concerning Disabled Persons (A/58/61-E/2003/5). In his review, the Secretary-General discusses a strategic framework for the development and advancement of persons with disabilities, and presents recommendations on normative issues, policy options, and substantive planning and evaluation considerations for promoting the rights of persons with disabilities in the context of development.

The present report examines instruments and structures that have been developed to further implement the full participation and equality goals of the Programme of Action and to promote the Standard Rules on the Equalization of Opportunities for Persons with Disabilities. The report describes new initiatives related to persons with disabilities, particularly the proposal to elaborate a convention on the rights of persons with disabilities in the context of development, as endorsed by the General Assembly in its resolution 56/168. A basic lesson of the review is that a majority of reporting Governments have elaborated a national policy or legislation on persons with disabilities. An important task for policy development in the new century becomes reinforcing the disability perspective in mainstream development with reference to the “new universe of disability” and the emergence of policy concern with social inclusion, life sphere approaches to disability and the promotion of opportunities, on the basis of equality, to participate in social life and development. The review suggests that policy development would be facilitated by progress in elaborating a comprehensive and integrated international instrument to promote and protect the rights of persons with disabilities in the context of development. Policy development and evaluation from the disability perspective would be further strengthened through improvements in data and statistics on disability, which would also facilitate international comparisons of prevalence of disability in populations and with reference to social and economic data sets.

 

Contents

  1. Introduction
  2. Trends in Policies and Programmes from the Disability Perspective
    1. Disability perspective on development
    2. Developmental approaches to advancement of persons with disabilities
    3. Rights of persons with disabilities; the Standard Rules
    4. Rights of persons with disabilities: treatment in other international instruments
    5. Measuring, monitoring and evaluation of the situation of persons with disabilities
    6. Regional cooperation
    7. Universal design and equalization of opportunities for all
    8. Priorities to further equalization of opportunities

 

I. Introduction

1. In its resolution 56/115, the General Assembly endorsed the view that the fourth five-year review and appraisal of the World Programme of Action concerning Disabled Persons (A/37/351/Add.1 and Corr.1) should review and assess trends in instruments, policies and programmes from the disability perspective in the light of 20 years of international cooperation in the field of disability. The present report examines the extent to which structures are in place and identifies areas in which further action is required to further implement the goals of the Programme of Action— full participation, and equality — in the context of development. It examines trends in policies and programmes from the disability perspective. An additional report will review progress in furthering the equalization of opportunities by, for and with persons with disabilities with special reference to the priorities identified by the Assembly in its resolution 52/82, for action to equalize opportunities, i.e., accessibility, social services and safety nets, and employment and sustainable livelihoods. A further report will analyse issues and trends related to advancement of persons with disabilities in the context of development.

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II. Trends in policies and programmes from the disability perspective

2. With the adoption of the Programme of Action by the General Assembly in 1982, the international community obtained a policy framework for developmental approaches to the advancement of persons with disabilities. The goals of the Programme of Action, “full participation and equality”, reflect the strong commitment of the international community to the human rights of persons with disabilities. Trends in the implementation of the Programme of Action during the United Nations Decade of Disabled Persons (1983-1992) (see Assembly resolution 37/53) through the third review and appraisal of the Programme of Action, which was conducted in 1997, are reviewed below.

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A. Disability perspective on development

3. The Programme of Action defines equality for persons with disabilities on par with opportunities available to the entire population. Parity is considered to be a dynamic concept, which changes as societies develop. The Programme of Action thus provides the basis for a “disability perspective” on development, in contrast with earlier approaches, in which persons with disabilities were characterized as “vulnerable” and disability as a problem to be addressed by medical care, rehabilitation and social welfare services. The value proposition of the social welfare approach is to effect changes in persons with disabilities so that they can better fit into “normal” social and economic structures. The disability perspective on development focuses on persons with disabilities as agents and beneficiaries of development of the societies in which they live. A key concern of developmental approaches to disability is promotion of environmental accessibility — in physical environments, in information and communication environments, and in institutional arrangements — to further equalization of opportunities for all.

4. The three objectives of the Programme of Action — prevention of disabling conditions, rehabilitation and equalization of opportunities — represent the attempt of the international community to blend traditional disability concerns with the emerging disability perspective on development. Equalization of opportunities is recognized as the process of enhancing accessibility to the general system of society. A key component of enhancing accessibility is promoting the full and effective participation of persons with disabilities in decision-making, which, as the Programme of Action notes, can be advanced by assisting in the establishment and development of organizations of disabled persons and by initiating direct contacts with those organizations and providing channels for them to influence governmental policies and decisions that concern them.

5. The Programme of Action represents movement towards both a broad human rights perspective and an environmental accessibility perspective. The Programme of Action recognizes the applicability of the Universal Declaration of Human Rights (Assembly resolution 217 A (III)) and the International Covenants on Human Rights (Assembly resolution 2200 A (XXI)) to persons with disabilities and provides guidance on promoting and protecting the rights of persons with disabilities. [1] While environmental approaches focus on physical, technical and institutional barriers, human rights approaches focus on rights to which all people, regardless of disability or non-disabled status, are entitled. [2]

6. The Programme of Action equates the equalization of opportunities with the promotion of accessibility in the environment in terms of facilities, communications and livelihoods. The first time access is mentioned in the Programme of Action is in conjunction with the definition of handicap, in the section entitled “Definitions”, as follows: “Handicap is therefore a function of the relationship between disabled persons and their environment. It occurs when they encounter cultural, physical or social barriers, which prevent their access to the various systems of society that are available to other citizens. Thus, handicap is the loss or limitation of opportunities to take part in the community on an equal level with others.”

7. Accessibility is central to the realization of equalization of opportunities and represents an approach to reversing exclusion; general systems of society become accessible to all by the removal of barriers and the promotion of human rights. Access is not an act or a state but freedom to enter, to approach, to communicate with, to pass to and from or to make use of a situation. [3] A review of the literature indicates that several approaches have been offered to assess systematically accessibility of environments in both the disability and health-care fields. [4] From the human rights perspective, ensuring accessible environments requires full and effective participation by persons with disabilities in both policy and programme-level decisions. It also requires the involvement of persons with disabilities in decision-making related to development, in contributing to development efforts and in equal sharing of the results of development. Disability issues are not the concern of a specific group; they are an essential prerequisite for advancing the human rights of all people and the comprehensive and integrated development of the societies in which they live. That is the approach of the Programme of Action and it has been reaffirmed in the outcomes of major United Nations conferences and summits in the economic and social fields (see A/52/351, para. 18; and A/56/169 and Corr.1, paras.24-26).

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B. Developmental approaches to the advancement of persons with disabilities

8. The proclamation by the Assembly of the period 1983-1992 as the United Nations Decade of Disabled Persons provided a time frame in which to promote the implementation of the objectives of the Programme of Action, i.e., prevention, rehabilitation and equalization of opportunities. Those three objectives reflect a blend of traditional disability concerns with environmental variables in a broad human rights framework. The decided focus of the Programme of Action is on development participation and equality, with special attention to policy, institutional and structural issues.

9. The experience of the Decade suggests that lead time is required to translate international normative considerations into country-level strategies, policies and programmes. The evaluation report of the Secretary-General at the mid-point of the Decade (A/42/561) [5] submitted recommendations on three principal issue clusters: (a) policy options and priority areas for further action; (b) institutional arrangements and coordination mechanisms; and (c) resources to support the implementation of the objectives of the Programme of Action. Based on its consideration of the findings and recommendations of the report, the Assembly adopted resolution 42/58, in which it invited Member States (a) to reinforce national committees on disability, or similar institutional mechanisms; (b) to incorporate projects related to persons with disabilities in national development strategies and plans and to encourage real involvement of persons with disabilities; and (c) to accord high priority to projects on prevention, rehabilitation and equalization of opportunities in bilateral and multilateral assistance activities.

10. Developmental approaches to the advancement of persons with disabilities were evident by the mid-point of the Decade in both policies and practice. Disability issues were being introduced in efforts aimed at the general population, with emphasis on equalization of opportunities. [6] Disability and rehabilitation efforts were moving beyond traditional medical concerns and were being incorporated in institutional development and capacity-building activities. [7] Resource scarcity remained a problem but resources involved not only finances but national personnel and appropriate technologies (see A/42/561, para. 47 (c)). Organizations of persons with disabilities as well as organizations concerned with disability had become important factors in promoting the Programme of Action and contributing to its implementation at all levels. Common concepts, practical tools for data collection and statistics on persons with disabilities, based on national censuses and surveys, had become available and were being used to identify and assess demographic and socio-economic trends concerning the prevalence of disability. [8] The availability of statistics on persons with disabilities contributed to the recognition of the need to establish international standards on disability statistics, which would reveal both commonalities and differences in national statistical work, and elaborate an appropriate set of indicators to monitor implementation of the Programme of Action and allow comparisons between the different situations of persons with disabilities and the non-disabled. [9] The handicapping facets of the environment — in terms of communications, movement and loss of opportunities to participate in social and economic life — were increasingly recognized as being critical to the elimination of barriers to the equalization of opportunity. [10]

11. In his evaluation report on the achievements of the Decade (A/47/415), the Secretary-General noted that the Programme of Action had provided a policy framework for the advancement of persons with disabilities in the context of development in a broad human rights framework. The experiences of the Decade had laid the foundations for disability-sensitive strategies, policies and programmes based on the principles of full participation and equality. The report also noted that disability was closely linked to social and economic factors, which had impacted on progress in furthering the objectives of the Programme of Action. Its objectives could not be reached in the foreseeable future in the absence of an expansion of international cooperation programmes — both multilateral and bilateral — beyond those available during the Decade. The report also suggested a need to reinterpret disability in the light of a number of significant developments during the second half of the Decade, including rapid technological changes in both information, communications and medical science, growing recognition that disability was of concern to the entire population, and the need to move beyond group-specific approaches based on care and protection.

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C. Rights of persons with disabilities: the Standard Rules

12. A particular — but not extensively documented — achievement of the Decade was the paradigmatic shift from the view that disability was a condition that required a cure, which had resulted in policies of exclusion and institutionalization. During the Decade, advocates had contributed to shaping a new understanding of living with a disability — which could affect anyone in the course of a “normal human life cycle” [11] — and the need for society to accept and accommodate that condition. Beginning with the adoption of the Programme of Action and its focus on the human rights of persons with disabilities, the emergence of concern with international norms and standards relating to disability carried with it the potential of law to transform an “almost universally pejorative” [12] cultural resistance to the equalization of opportunities for persons with disabilities.

13. The mid-Decade meeting of experts to evaluate its achievements recommended that the Assembly convene a special conference on the rights of persons with disabilities, with the mandate to elucidate such rights and to draft an international convention on the elimination of all forms of discrimination against disabled persons, to be ratified by States by the end of the Decade, in 1992 (see A/42/561, para. 14). Drafts of a convention were submitted to the Assembly at its forty-second and forty-fourth sessions, but summary records indicate that it was felt that more study was required (see A/C.3/42/SR.16, 17 and 19; and A/C.3/44/SR.16 and 20).

14. In response to that dialogue, the Assembly reiterated its view that the second half of the Decade should place special emphasis on the equalization of opportunities for persons with disabilities (see Assembly resolution 44/70, para. 2). In its resolution 1990/26, the Economic and Social Council authorized the Commission for Social Development to initiate work on the elaboration of non-binding standard rules on the equalization of opportunities for persons with disabilities. In its resolution 1991/9, the Council welcomed the initiative of the Commission to elaborate standard technical rules on the equalization of opportunities for disabled persons. The work, which was funded by voluntary resources and included technical meetings with the participation of experts from all regions, drew upon the experience of countries during the Decade and on both general international human rights instruments and those related to the rights of persons with disabilities. Those efforts resulted in the decision of the Assembly to adopt in its resolution 48/96 the Standard Rules on the Equalization of Opportunities for Persons with Disabilities.

15. The value proposition of the Standard Rules, as stated in Assembly resolution 48/96, annex, paragraph 15, is “to ensure that girls, boys, women and men with disabilities, as members of their societies, may exercise the same rights and obligations as others”. A basic premise of the Standard Rules is that States should “take appropriate action” to remove obstacles that prevent persons with disabilities from exercising their rights and freedoms and make it difficult for them to participate fully in the societies in which they live. The Standard Rules note that “Persons with disabilities and their organizations should play an active role as partners in this process”.

16. Although the Standard Rules are not a legally binding instrument, they represent the strong moral and political commitment of Governments to take action to attain equalization of opportunities for persons with disabilities. They serve as an instrument for policy-making and as a basis for technical and economic cooperation. They incorporate the human rights perspective developed during the Decade and provide practical guidance on the equalization of opportunities in four areas: (a)preconditions for equal participation, (b) target areas for equal participation, (c)implementation measures, and (d) a monitoring mechanism.

17. The aim of the monitoring mechanism is to further effect the implementation of the Standard Rules, to assist States in assessing their respective levels of implementation of the Standard Rules, and to measure progress. The purpose of monitoring is to identify obstacles and suggest measures that would contribute to successful implementation of the Standard Rules. Monitoring would recognize the economic, social and cultural features existing in individual States. The Standard Rules further note that a special rapporteur with relevant and extensive experience in disability issues and international organizations should be appointed by the Secretary-General, if necessary, funded by extrabudgetary resources, for three years to monitor their implementation. The first Special Rapporteur on disability of the Commission for Social Development, Bengt Lindqvist (Sweden), was appointed by the Secretary-General in 1994, initially for a period of three years. The activities of the Special Rapporteur are discussed below.

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D. Rights of persons with disabilities: treatment in other international instruments

18. In paragraph 175 (d), the Programme of Action called upon the United Nations system to assist efforts in meeting the needs of persons with disabilities. On 20 June 1983, the General Conference of the International Labour Organization (ILO) passed Convention No. 159, the Vocational Rehabilitation and Employment (Disabled Persons) Convention, 1983, which came into force on 20 June 1985 and has been ratified by 68 ILO member States. The Convention aims to ensure that appropriate vocational rehabilitation measures are made available to all categories of disabled persons and promote employment opportunities for disabled persons in the labour market. It urges equality of opportunity and treatment of persons with disabilities of both genders and applies to all categories of persons with disabilities. Based on the work of the United Nations Educational, Scientific and Cultural Organization (UNESCO), the Salamanca statement and framework for action on special needs education, which was adopted by the World Conference on Special Needs Education: Access and Quality (Salamanca, Spain, 7-10 June 1994), proclaims that every child has a fundamental right to an education, that education systems must take into account diversity and that those with special needs must have access to regular schools with an inclusive orientation. The statement urges that Governments adopt inclusive education as a policy or law. The framework for action defines special educational needs as needs arising from disabilities or learning difficulties; the guiding principle is that schools should accommodate all children within a child-centred pedagogy.

19. The World Conference on Human Rights, held in Vienna from 14 to 25 June 1993, considered new frameworks for planning, dialogue and cooperation to enable holistic approaches to promoting human rights and involve actors at all levels — international, national and local. In its chapter entitled “Equality, dignity and tolerance” the Programme of Action adopted by the Conference recognizes that all human rights and fundamental freedoms are universal, and thus should unreservedly include people with disabilities. The Declaration adopted by the Conference states, in paragraph 22, that special attention needs to be paid to ensuring non-discrimination and the equal enjoyment of all human rights and fundamental freedoms by disabled persons, including their active participation in all aspects of society. The international community affirmed its view that any discrimination, intentional or unintentional, against persons with disabilities is per se a violation of basic human rights.

20. Development approaches to the advancement of persons with disabilities were also on the agenda of conferences and summits in the economic and social fields organized by the United Nations in the period following the Decade. In paragraphs 6.29-6.33, the Programme of Action of the International Conference on Population and Development considers the situation of persons with disabilities in a broad rights framework and, inter alia, urges Governments (a) to consider the needs of persons with disabilities in terms of ethical and human rights dimensions; (b) to develop infrastructure to address the needs of persons with disabilities with regard to education, training and rehabilitation; (c) to promote mechanisms to ensure the rights of persons with disabilities; and (d) to promote systems for the social and economic integration of persons with disabilities. The Copenhagen Declaration and Programme of Action of the World Summit on Social Development addresses the situation of persons with disabilities under each of the priority themes, i.e., the eradication of poverty, the expansion of productive employment and social integration. The Beijing Declaration and Platform for Action adopted at the Fourth World Conference on Women addresses the situation of women with disabilities in a broad rights context. In paragraph 32, the Declaration refers to the elimination of barriers to their advancement and participation in development. The chapter entitled “Strategic objectives and actions” of the Platform identifies actions for the advancement of women with disabilities with reference to education and training, health, the economy, human rights, and the girl child. The Istanbul Declaration on Human Settlements and the Habitat Agenda adopted at the United Nations Conference on Human Settlements (Habitat II), in its chapter entitled “Commitments”, discusses the need to direct special attention to the needs and circumstances of persons with disabilities; commitment A, “Adequate shelter for all” refers specifically to the need for accessible shelter and basic services and facilities, which are to be promoted in a manner fully consistent with human rights standards. [13]

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E. Measuring, monitoring and evaluation of the situation of persons with disabilities

21. The reviews of policy instruments provided above indicate that disability issues have been recognized as an integral component of the international development agenda. Rights-based approaches have obtained policy commitments in major United Nations conferences and summits on social and economic issues of international concern. However, progress on measurement, monitoring and evaluation of the situation of persons with disabilities as a mainstream issue has been slow. [14] The observed tendency has been to assess conditions relating to disability in persons at the individual and population levels.

22. In paragraph 185, the Programme of Action urged United Nations Member States to develop a programme of research on the causes, types and incidence of impairment and disability, and the economic and social conditions of disabled persons, and in paragraph 198 requested the United Nations Statistics Division to cooperate with countries in the development of practical systems of data collection with regard to disabilities and publish technical manuals on the collection of such statistics. However, prior to the adoption of the Programme of Action, in 1982, the World Health Organization (WHO) concluded that as acute disease conditions were brought under control there was a need to classify what WHO believed were the consequences of disease. WHO issued in 1980 the International Classification of Impairments, Disabilities and Handicaps (ICIDH) [15] for trial purposes to facilitate health-service planning in disability-related fields. Some criticized ICIDH for placing undue emphasis on the medical model of disability; many disability rights advocates noted that the concept “handicap” recognized that social factors placed persons at a disadvantage along a variety of circumstantial dimensions. In recognition of the potential uses of ICIDH and taking into account the criticisms of its underlying model, particular classifications and language, such as the traditional use of the term “handicap” in English, resulted in active and engaged worldwide participation in ICIDH implementation and revision processes after its initial publication.

23. By the mid-point of the Decade, technical monographs had been prepared by the United Nations Secretariat on the development of statistics related to persons with disabilities, and a pilot database on disability statistics — DISTAT — based on national census, surveys and administrative reporting data from 55 countries, was under development. [16] The general conceptual framework of DISTAT was the United Nations framework for integration of social, demographic and related statistics; [17] ICIDH was used to organize DISTAT at the impairment and disability levels. [18] A definite focus in DISTAT is on the identification of standards for disability statistics and the establishment of a common framework for the further development of statistics on disability. The experience of DISTAT suggests that measures of socio-economic issues and persons with disabilities are the same as for non-disabled persons; and DISTAT data on educational attainment demonstrate the devastating handicapping effects of disablement among children in terms of loss of opportunity to attend school. [19] In 1996, the United Nations Statistics Division, in cooperation with WHO, prepared the Manual for the Development of Statistical Information for Disability Programmes and Policies [20] to provide guidelines on production and use of data relevant to disability policies and programmes. In 1997, the Division provided recommendations for the year 2000 round of population and housing censuses on disability and measurement of the disability dimension in the Principles and Recommendations for Population and Housing Censuses, Revision 1. [21]

24. During that period, disability advocates raised concerns that efforts to measure disability had directed their emphasis to disability prevalence with a view to supporting prevention programmes. Some had argued that such a focus conflicted with a human rights perspective because disability was a subjective concept, while some measurement efforts attempted to view the concept in a rigid, objective manner. In recent years, others have argued that such efforts are required to assess the situation of persons with disabilities with reference to all persons. The United Nations Statistics Division and WHO have considered a variety of perspectives concerning data and statistics related to disability, and their activities have helped to build awareness and frame issues in the ongoing debate.

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F. Regional cooperation

25. In connection with the observance of the end of the Decade, both the Economic and Social Commission for Asia and the Pacific (ESCAP) and the Economic and Social Commission for Western Asia (ESCWA) organized regional reviews and formulated long-term strategies for regional cooperation in the field of disability. In 1989, ESCWA organized a conference on the capabilities and needs of the disabled in the ESCWA region (Amman, 20-28 November 1989), which formulated a planning framework for regional action. At the end of the Decade, ESCWA organized, under the patronage of Queen Noor Al Hussein of Jordan, a cultural event for disabled persons (Amman, 17 and 18 October 1992), whose substantive plenary endorsed a long-term strategy towards the year 2010 to promote the rights of persons with disabilities in the western Asia region as well as a framework for proclamation of an Arab decade of persons with disabilities. Preparatory work on a long-term strategy to promote the rights of persons in Asia and the Pacific began at the Fourth Asian and Pacific Ministerial Conference on Social Welfare and Social Development (Manila, 7-11 October 1991), with the adoption of a social development strategy for the ESCAP region to the year 2000 and beyond (E/ESCAP/824). With the ultimate aim of improving the quality of life for all, the regional strategy provided an effective policy framework for the forty-eighth session of ESCAP. In its resolution 48/3, ESCAP proclaimed the period 1993-2002 as the Asian and Pacific Decade of Disabled Persons, with the goals of full participation and equality of persons with disabilities.

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G. Universal design and equalization of opportunities for all

26. The third evaluation report of the Secretary-General on the implementation of the Programme of Action (A/52/351) examined a range of disability issues in the context of development, with reference to a broad human rights framework. The report documented progress in incorporating the disability perspective in the outcomes of major United Nations conferences and summits on social and economic issues of international concern. From a policy point of view, the report discussed the concept of a disability perspective in rights-based approaches to development since that contributed to realization of a society for all (see General Assembly resolution 48/99). The report also introduced the concept of universal design and its application in planning and development of environments [22] that were responsive and supportive of the diverse needs of populations.

27. The value proposition of universal design is to meet the needs of as many users as possible through inclusive solutions and open and democratic participation, which are the basic concerns of the Programme of Action and the Standard Rules. The seven principles of universal design reflect a set of values to further full participation and equality rather than technical planning and design standards on accessibility: (1) equitable use — the design is useful and relevant to people with diverse abilities; (2) flexibility in use — the design accommodates a wide range of individual preferences and abilities; (3) simple and intuitive use — the design is easy to understand regardless of the knowledge, experience, language skills or concentration level of the user; (4) perceptive information — the design communicates information effectively to the user, regardless of ambient condition or sensory abilities of the user; (5) tolerance for error — the design minimizes the hazards and adverse consequences of unintended actions; (6) low physical effort — the design can be used easily, efficiently and comfortably, with a minimum of fatigue; and (7) size and space for approach and use — the size and space for approach, reach, manipulation and use is appropriate, regardless of the body size, posture or mobility of the user (see E/ESCWA/H5/2000/1).

28. Introduction of universal design considerations to the evaluation report responded to both an observed expansion of constituencies concerned with disability in the period since the Decade and the recognition that full and effective participation for all in the emerging global information economy required new thinking, accessible and inclusive approaches, and comprehensive development initiatives in a broad rights framework. By linking universal design considerations with the analysis of the political economy of disability, the report indicated that sustainable development required full and effective participation by all parties as agents and beneficiaries. The evaluation also recognized the link between environmental accessibility and the promotion and protection of human rights for all. The report noted that measures of whether persons with disabilities were empowered to take independent decisions in their lives, to exercise control over their use of time, to plan and decide on use of economic resources and to prepare for major life cycle changes represented the types of indicators that could predict whether desired outcomes were being achieved. It also noted that measures of environmental accessibility that affected the exercise of one’s rights, such as independence, uses of time, social integration, economic self-sufficiency and life cycle transitions, required further study.

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H. Priorities for the further equalization of opportunities

29. In its consideration of the third evaluation report of the Secretary-General (A/52/351), the Assembly identified, in its resolution 52/82, three priorities for action to further equalization of opportunities: (a) accessibility, (b) social services and safety nets, and (c) employment and sustainable livelihoods. It also urged bodies and organizations of the United Nations system to promote the rights of persons with disabilities.

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Notes

[1] The Programme of Action, para. 164, states: “Specifically, organizations and bodies involved in the United Nations system responsible for the preparation and administration of international agreements, covenants and other instruments that might have a direct or indirect impact on disabled people should ensure that such instruments fully take into account the situation of persons who are disabled.”

[2] See Marcia H. Rioux, “Disability: the place of judgment in a world of fact”, Journal of Intellectual Disability Research, vol. 41, No. 2; Michael Oliver, “Changing the social relations of research production”, Disability, Handicap and Society, vol. 7, No. 2; Jean-François Ravaud and Henri-Jacques Stiker, “Les modèles de l’inclusion et de l’exclusion à l’épreuve du handicap”, Handicap-Revue de Sciences Humaines et Sociales, vol. 87; Jean-François Ravaud and Henri-Jacques Stiker, “Inclusion/exclusion: disability, politics and recognition”, chapter 21 in Gary L. Albrecht, Katherine D. Seelman and Michael Bury, eds., Handbook of Disability Studies (Thousand Oaks, Sage Publications, 2001); Catherine Barral, “Typology of the forms of social exclusion”, paper presented at an expert meeting on the theme “Critical issues and trends related to disability and human rights: emerging issues and concepts”, Toronto, 17-19 June 2002.

[3] See Scott Campbell Brown, “Methodological paradigms that shape disability research”, chapter 5 in Albrecht et al., op. cit.

[4] See R. Pechansky and C. Thomas, “The concept of access: definition and relation to customer satisfaction”, Medical Care, vol. 19, No. 2; Rune J. Simeonsson, Donald B. Bailey Jr., Donna Scandlin, Gail S. Huntington and Marcia Roth, “Disability, health, secondary conditions and quality of life: emerging issues in public health”, chapter 11 in Rune J. Simeonsson and Lauren N. McDevitt, eds., Issues in Disability and Health: the Role of Secondary Conditions and Quality of Life (Chapel Hill, North Carolina Office on Disability and Health, 1999); Gale G. Whiteneck, Patrick Fourgeyrollas and Kenneth A. Gilbert, “Elaborating the model of disablement”, in Marcus J. Fuher, ed., Assessing Medical Rehabilitation Practices: the Promise of Outcomes Research (Baltimore, Paul H. Brookes, 1997).

[5] The report was based on the findings and recommendations of a global meeting of experts to review the implementation of the Programme of Action at the mid-point of the Decade, held in Stockholm from 17 to 22 August 1987 and generously supported by the Government of Sweden.

[6] At the policy level, the Nairobi Forward-looking Strategies for the Advancement of Women state that women constitute a significant number of people who are disabled. The Strategies also note that many factors account for rising numbers of disabled persons, including war, violence, poverty, hunger, and work-related accidents, and recommended that Governments adopt the Programme of Action (see A/CONF.116/28/Rev.1, chap. I, sect. A, para. 296).

[7] The mid-Decade report of the Secretary-General on the implementation of the Programme of Action (A/42/551) noted that bilateral cooperation in the field of disability in the period under review had included support for drinking water and sanitation, as well as for health services and nutrition surveillance. The report also described institutional development and leadership training activities in such areas as community-based rehabilitation, appropriate technologies, sports training and cooperative development, supported by the United Nations Voluntary Fund on Disability, which also included co-financing support to a UNDP-assisted project on training and research in rehabilitation in Mauritania.

[8] See United Nations Disability Statistics Database, 1975-1986: Technical Manual (United Nations publication, Sales No. E.88.XVII.12); Elaboracion de estadísticas sobre los impedidos: estudios de casos; (United Nations publication, Sales No. S.86.XVII.17). The World’s Women 1970-1990: Trends and Statistics (United Nations publication, Sales No. E.90.XVII.3) discusses, briefly, the situation of women with disabilities, and notes that the care of persons with disabilities falls disproportionately on women.

[9] See Development of Statistical Concepts and Methods on Disability for Household Surveys (United Nations publication, Sales No. E.88.XVII.4); and Disability Statistics Compendium (United Nations publication, Sales No. E.90.XVII.17).

[10] The mid-Decade review (A/42/561) submitted recommendations, inter alia, on (a) recognition of sign language as a legitimate interpretation need in United Nations meetings, when required; (b)access to United Nations facilities and materials for persons with special needs; (c) national-level guidelines on the rights of persons with communications disabilities, and on education and training for socio-economic integration of persons with disabilities.

[11] See Robert I. Metts, “Planning for disability”, paper presented to a United Nations panel on independent living of persons with disabilities, 3 December 1998.

[12] See James I. Charlton, Nothing About Us Without Us: Disability Oppression and Empowerment (Berkeley, University of California Press).

[13] Commitment B, “Sustainable human settlements” (paras. 42-43), addresses provision of equal opportunities for a healthy, safe and productive life for those who belong to vulnerable and disadvantaged groups. Commitment C, “Enablement and participation” (paras. 44-45), expresses commitments for capacity-building in human settlements planning and management, based on dialogue among actors, especially women and persons with disabilities, for promoting equal access to information, and for facilitating participation in management of public and community-based housing by women and those who belong to vulnerable and disadvantaged groups.

[14] The 12 key socio-economic indicators related to the major United Nations conferences and summits on social and economic issues of international concern — elaborated by the system-wide former Advisory Committee on Coordination Task Force on Basic Social Services for All— did not include any measure of incidence of disability in persons. The indicators are: total population, access to health services, contraceptive prevalence, underweight prevalence among preschool children (under 5), maternal mortality ratio, mortality rate for infants and under-5 populations, life expectancy at birth (female/male), school enrolment (female/male), adult literacy (female/male), access to safe water, access to sanitation, and floor area per person. See Charting the Progress of Populations (United Nations publication, Sales No. E.00.XIII.6).

[15] Geneva 1980.

[16] See ESA/STAT/AC.18/7; Development of Statistical Concepts and Methods on Disability for Household Surveys (United Nations publication, Sales No. E.88.XVII.4); United Nations Disability Statistics Database, 1975-1986: Technical Manual (United Nations publication, Sales No. E.88.XVII.12).

[17] See Towards a System of Social and Demographic Statistics (United Nations publication, Sales No. E.74.XVII.8).

[18] See Disability Statistics Compendium (United Nations publication, Sales No. E.90.XVII.17), chap. I.

[19] Ibid., chap. II.

[20] United Nations publication, Sales No. E.96.XVII.4.

[21] United Nations publication, Sales No. E.98.XVII.8, paras. 2.258-2.277.

[22] Environment is used here in a broad sense and, as noted above, refers to the policy and programme environments for equalization of opportunities, the social and economic environments to pursue equalization of opportunities, accessible built environments, and information and technologies environments that provide reasonable accommodation.

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