2 Why DFID needs a strong commitment
to disability |
Leaving no-one behind
7. Disabled people are among the poorest
of the poor. One witness observed: "If one goes into the
poorest urban slum or the most marginalized rural village and
asks "who is the poorest person in your community"?
one will almost invariably be directed to the household of a person
with a disability."
Disabled people experience disadvantage on many frontsfrom
a lack of access to lifesaving services, to violence and abuse
(Table 1). DFID's Permanent Secretary, Mark Lowcock, has described
this as a "key threat to reaching the Millennium Development
of our witnesses pointed out, if any country with one billion
people had such low employment, education and health outcomes
as the world's disabled population, it would probably be at the
top of international development priorities.
8. The Prime Minister has said hewants
to ensure "no-one is left behind" in future global development
work. The Minister
says this is already becoming an important guiding principle for
DFID.Table 1 illustrates
thatdisabled people have been left behind in progress towards
the Millennium Development Goals: if DFID is serious that no-one
should be left behind in future work, a strong commitment to disability
will be essential.
9. DFID's approach to disability is
important not only because of its direct impact on the ground,
but also because of the signal it sends to other donors. The US,
Australia, and Germany have all done some work on disability,
but their work only covers some countries and sectors, and is
not on its own enough to mitigate the substantial disadvantages
that disabled people face.
Galvanising support from other bilateral and multilateral donors
will be key. Witnesses
to the inquiry firmly praised the UK's statements on leaving no-one
behind, and said
DFID should now lead by example, "moving that commitment
Such a step could have a large multiplier effect:
That focus on disability could be
enormously influential, not just for those [...] people who you
are investing in, but for showing the others who have done nothing
on disability the impact that that can have. [...] You could then
get more from your money than you were anticipating.
Table 1: Key facts on disabled
people's progress towards the Millennium Development Goals
||Available evidence on disabled people in developing countries
|1.B Achieve full and productive
employment and decent work for all, including women
and young people
|- The unemployment rate is often 80%
- Any work is oftenlow paid, outside the formal labour market .
|2. Ensure that, by 2015,
children everywhere, boys and girls alike, will be able to
complete a full course
of primary schooling
|- One third of all out of school children have a disability
- Over 90 per cent of children with disabilities are out of schoolin Africa.
|3.2 Share of women in wage
employment in the
|- Women with disabilities are almost half as likely to have jobs as men.
|4. Reduce by two thirds, between 1990 and 2015, the under-five mortality rate
|| -Babies and children with disabilitiesmay not get adequate nutrition, may not be immunised, or may not be considered valuable enough for healthcare
|5.B Achieve, by 2015,
universal access to reproductive health
|- Inadequate access tosexual and reproductive health services
- Higher risk offorced sterilization, forced abortion and forced marriage
|6.A Have halted by 2015 and begun to reverse the spread
|- Many disabled people experience sexual assault or abuse during their lifetime.
- Healthcare services may beinaccessible, disabled people may be turned away from HIV education, or denied equal access to services that could prolong their lives.
|7.C Halve by 2015 the proportion of people without sustainable access to safe drinking water and basic
|- Disabled people face technical and social barriersto accessing clean water
In cooperation with pharmaceutical companies, provide access to affordable
essential drugs in
|- Disabled people are twice as likely to find health care providers' skills and facilities inadequate, thrice as likely to be denied health care, and four times more likely to be treated badly in the healthcare system.
version of table from Professor N Groce, Disability and the Millennium
Development Goals, UN, New York, 2011, pp 17-26
Getting value for money from UK
10. The Coalition Government has made
value for money a priority for DFID. DFID aims to "target
[UK aid] at people and places who will benefit most from our money".
We therefore sought evidence on whetherinvesting in disability
was good value for money.
11. Experts told us that the cost of
excluding disabled people from development work is much
greater than the cost of including them.
If disabled people are unable to participate in education and
employment, the impact on their communities and economies is severe.
A pilot study by the International Labour Organisation found that
countries could lose up to 5% of their GDP if disabled people
did not have equal access to employmentand this is before
taking into account indirect losses such as social security payments,
or caregivers' lost wages.
One witness described how an employment project for disabled people
work in Malawi had helped the whole community:
One community leader, completely
spontaneously, said to me, "It has made a huge difference.
Now that disabled people are benefiting our community, the whole
community has come out of poverty. [...] Before, they were dependent;
they were drawing our resources. Now they are productive, it means
the whole community has a better potential." That, for me,
represents what we mean by value for money.
12. Not only does investing in disability
offer economic benefits, it also ensures these benefits reach
some of the world's poorest people. A strong commitment to disability
would ensure DFID's aid does indeed "target people who will
benefit most". Bob McMullan, who helped introduce a 'disability-inclusive'
aid programme during his time as a minister in the Australian
Government, told us:
The poorest of the poor are people
with disabilities in developing countries, and if our development
programmes are not targeting them, we are missing the point. [...]
In terms of improving the lives of the poorest people, this is
the value for money number one.
Delivering human rights objectives
13. The UK ratified the UN Convention
on the Rights of Persons with Disabilities (CRPD)a legally
binding convention summarising disabled people's rightsin
2009. States that
have ratified the Convention are required to "ensure that
international cooperation, including internationaldevelopment
programmes, is inclusive of and accessible to persons withdisabilities".
They must also"take all necessary measures to ensure the
protection and safety of persons with disabilities" in humanitarian
emergencies. UK performance
against the Convention is due for review in late 2014, and we
plan to submit our report as evidence to inform this review.
A strong commitment to disability, put into action, would help
demonstrate how the UK is meeting its objectives under the Convention.
14 Professor N Groce, Disability and the Millennium Development Goals,
United Nations, New York, 2011, p1 Back
Mark Lowcock, speaking in 2007 when he was Director General for
Policy and International Finance, quoted in DFID, How to Note - Working on Disability in Country Programmes,2007,
Bob McMullan, Tales from an Imaginary Country, Leonard Cheshire
Disability and Inclusive Development Centre, University College
London, Working Paper Series: No.22, 2013 Back
United Nations, A New Global Partnership: Eradicate Poverty and Transform Economies through Sustainable Development: the Report of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda,
New York, 2013, p7 Back
USAID (DIS0088), Australian Government Department of Foreign Affairs
and Trade (DIS0063), Q4 [Mr Chandrasekar] Back
Q92 [Prof Groce], USAID (DIS0088) para 11. For country/sector
coverage please refer to: USAID 'Where we work' and DIS0088 para
9; Australia Department of Foreign Affairs and Trade 'Where we give aid'
and Development for All: Towards a Disability-Inclusive Australian Aid Program 2009-2014;
German Federal Ministry for Economic Cooperation and Development,
Action Plan for the Inclusion of Persons with Disabilities (2013-2015),
2013, pp14-15. Back
Development Initiatives, Investments to End Poverty, 2013, pp
68-69, illustrates the diversity of bilateral donors and the important
role played by multilateral agencies. Back
For example, Vision Alliance (DIS0013) para 13, RESULTS UK (DIS0021)
para 8.1, AbleChild Africa (DIS0026) para 2.8.1 Back
Q127. See also the Joint National Association of Persons with
Disabilities (DIS0083) para 4. Back
Q32 [Ms Wapling] Back
Based on 2005 data. 57 million children are still out of school,
so disabled children probably still disproportionately affected,
and some estimates suggest the proportion has even increased (source,
World Vision, DIS0023, para 9 and 'Of all the world's children deprived of education, two fifths are disabled',
The Guardian, 18 March 2014) Back
Based on 2005 data. Back
Dr Tom Shakespeare (DIS0002) para 3.1 Back
World Health Organisation, quoted in Dr Tom Shakespeare (DIS0002)
para 3.2 Back
DFID, 'Increasing the Effectiveness of UK Aid', accessed 22 March
Q65. See also USAID (DIS0088) para 11 Back
International Labour Organisation, The Price of Exclusion: the Economic Consequences of Excluding People with Disabilities from the World of Work,
Geneva, 2009, Table 65 and p.4. Table 65 shows the result for
South Africa was as high as 7% - although this result involved
a large number of assumptions, so we have excluded this result
for caution. Back
Q30 [Ms Wapling] Back
Q22 and Q30 [Mr McMullan] Back
United Nations Enable, Convention and Optional Protocol Ratifications and Signatories,
accessed 22 March 2014 Back
United Nations Convention on the Rights of Persons with Disabilities,
New York, 2006, Articles 32 and 11. Back
United Nations Committee on the Rights of Persons with Disabilities,
'Sessions for Convention on Rights of Persons with Disabilities',
accessed 22 March 2014 Back