Disability inclusion and Covid-19. What future do we want
People with disability are no strangers to risk. The everyday risks and barriers that people with disability face are heightened in health emergencies, disasters and conflict. Covid-19, however, stands out. The virus and response is disrupting all of our lives and creating uncertainty in communities and households across the world. Yet, for people with disability the effects can be wider, deeper and, judging from recent reports, downright sinister at times.
The United Nations’ Global Humanitarian Response Plan for Covid-19 recognises people with disability are at higher risk of illness and death from Covid-19. This acknowledgement is vital, but it is not only the direct health impacts of Covid-19 that matter. The response does too. Globally, people with disability have higher unmet health needs, lower educational attainment, and are more likely to live in or near poverty than people without disability. Stigma and prejudice also negatively impact on social participation and health seeking behaviour. None of this is new.
We know people with disability are often the last to be included in response. We also know that response and recovery processes that are not inclusive reinforce pre-existing inequities and negatively impact on health and well-being. The World Bank estimates that quicker and more inclusive recovery following disasters could reduce losses to well-being by US$65 billion a year. The figures this estimate were based on are likely to be blown out of the water in 2020, but that only makes the message more important. While the current command and control response to Covid-19 is understandable, we can expect it to become increasingly untenable. Response and recovery processes designed with wide stakeholder participation and that include people with disability tend to be more effective and sustainable.
Last week, ONG Inclusiva in collaboration with the International Disability Alliance released preliminary findings from an international survey of people with disability and Covid-19. In a time of lockdowns, isolation and social distancing, over 70% of respondents reported requiring assistance for daily living. The same week, the BBC reported a doctor’s surgery in the UK asking patients with underlying health conditions to complete a do not resuscitate form. This and similar reports have sent shockwaves through the disability community.
The health impacts of Covid-19 on people with disability are immediate. The economic impacts on people with disability, who are disproportionality represented in insecure work and poverty, are not far behind. The impacts on the services that many women, children and men with disability rely on are starting to become apparent. The reality is: global data on disability is so poor, we may never know the true impacts of Covid-19 on people with disability. But we know enough.
In 2012, the United Nations Conference on Sustainable Development asked what future do we want? In 2015, the 2030 Agenda committed to transform our world and we agreed we want a future that leaves no one behind. Covid-19 has shown much remains to be done. At the same time, disasters present windows of opportunity. It is time again to ask what future do we want? Hopefully, when we emerge the other side it is to live in a world that is safer, more equitable and inclusive of all.
Dr Alex Robinson, Head of Disability Inclusion for Health and Development Unit, The Nossal Institute for Global Health