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II. TRENDS IN POLICIES AND PROGRAMMES FROM THE DISABILITY PERSPECTIVE

C. Progress achieved and obstacles encountered in implementation of the World Programme of Action concerning Disabled Persons since the United Nations Decade of Disabled Persons

1. Progress that can be attributed to the Long-term Strategy to Implement the World Programme of Action concerning Disabled Persons to the Year 2000 and Beyond

The data available suggest that few countries have established the medium-term targets for the period 1997-2002 as envisioned by the Long-term Strategy. In this sense, the medium term for many countries has been postponed. Most countries still need to engage in the basic steps of establishing a task force, convening forums, reviewing the situation, formulating a long-term policy statement and setting medium-term targets.

What progress that has occurred as a result of the Long-term Strategy can probably be attributed to two of its characteristic. First, the Strategy focuses on establishment of concrete targets and indicators to measure those targets. Second, it provides a plan that allows countries flexibility in determining objectives and indicators.

In terms of establishing concrete targets, the increase in the number of countries measuring socio-economic variables for persons with disabilities is indicative of a change in thinking in relation to accountability for disability-related issues. In addition, the data available suggest that more countries now are collecting and publishing statistics on disability. There is evidence of a greater willingness to share this information with members of the public who are viewed as partners in monitoring and planning services related to persons with disabilities.

In terms of flexibility, the Long-term Strategy leaves to the Standard Rules the identification of particular target areas and allows countries to choose their own. While there is little evidence that this flexibility has played a role in the establishing long-term plans in countries, there is evidence that some countries are engaged in bottom-up approaches to establishing disability targets, within the context of their culture and traditions.

There are at least three potential obstacles associated with the Long-term Strategy and a scarcity of resources. First, the Strategy does not provide information on how to establish lead-in activities when resources are scarce. Second, it does not suggest mechanisms for prioritizing activities. Finally, the very flexibility that could make the Long-term Strategy attractive to countries focuses on process rather than concrete results.

In terms of establishing lead-in activities, many countries may not have national mechanisms - or coordinating bodies - to establish a task force or convene a forum. Even if such a task force is convened, its jurisdiction may be unclear. Without mechanisms to allow for the task force or some other body to engage in long-term monitoring, some countries may believe the establishment of such a body would result in only a short-term focus on disability issues and note establish capacities for the country to follow-through on its promises and proposals.

There is also a tendency for task forces as political bodies to be broad in their assessment of the areas that need improvement. Often, this may hinder the ability of countries to prioritize on targeting resources to those areas that would do the most to advance economic development and human rights. Without some guidance for prioritization, countries may feel they could be under attack if they establish goals for one area and not another. Moreover, countries may doubt whether such a task force would prioritize and, again, establish promises that cannot be kept.

The possible targets proposed in the Long-term Strategy emphasize an outcome goal for prevention of actually reducing causes of impairment, a systems output goal of establishing CBR in a number of rural areas and process goals of adopting policies in the area of equalization of opportunities. While this may be due to the fact that the fields of disability prevention and rehabilitation have a longer-term history, countries may still find the process emphasis of the Long-term Strategy too prescriptive. Indeed, they might welcome an emphasis on particular areas pinpointing priorities on where the gaps between those with and those without disabilities should be narrowed.

Three years perhaps is too short a time to determine conclusively those aspects of the Long-term Strategy that cause progress or create obstacles. Indeed, given the lack of progress prior to the establishment of the Strategy, it is unlikely that its adoption has in its short time created any obstacles. Indeed, if procedures could be established for setting priorities, the Long-term Strategy's emphasis on setting targets, on monitoring progress and on country flexibility could play an important role in implementing the Programme.

2. Progress that can be attributed to the Standard Rules on the Equalization of Opportunities for Persons with Disabilities

The Standard Rules are different from the Long-term Strategy in that the Rules were adopted by General Assembly - a negotiated intergovernmental text - while the Strategy is a document drafted by the Secretary General and which was endorsed by the Assembly.

The report of the Special Rapporteur on his monitoring mission for the period 1994 to 1997 [120] summarizes the background and framework for monitoring the implementation of the Standard Rules, as well as activities of the UN system and of the non-governmental community. His monitoring report notes that there are three points of distinction between the Rules and the World Programme of Action: the Rules are more concentrated and concrete in form, they directly address member States' responsibilities, and they include an independent and active monitoring mechanism. A "panel of experts" nominated by international non-governmental organizations consults with the Special Rapporteur to monitor implementation of the Rules.

NGOs have been actively involved in the elaboration of the Standard Rules, helped to establish the panel of experts and have assisted in the dissemination of the Rules through publication and placing the issue of implementing the Rules on the programme at important events. NGOs also have played active roles in ensuring that disability issues are raised at all recent global conferences of the United Nations.

To promote the implementation of the Standard Rules, the Special Rapporteur met with Governments, participated in conferences and actively engaged in correspondence and communications. To monitor their implementation, he conducted surveys with Governments and with the non-governmental community from November 1994 to August 1995. While first round of his survey to Government had only 38 replies, the second generated 83 responses - a response rate of 45 per cent. Summarized below are salient findings from the second survey:[121]

A. General Policy. Seventy out of 82 Governments responding stated they had a disability policy, with 60 actually having the policy in law. The survey indicated that Governments place more emphasis on individual support (prevention or rehabilitation) than on accessibility. This would suggest that Governments are more traditionally welfare oriented than human-rights oriented on the issue. Sixty-four of 79 Governments indicated they were supporting information campaigns.

B. Legislation, Rule 1. Fifty-six out of 83 Governments responding indicated they had passed specific amendments referring to disabled persons' rights within general legislation while ten reported protection only by special legislation. The majority of Governments reported judicial mechanisms to protect the rights of disabled persons. Of 82 countries, 55 reported that disability is not used as the basis for differential treatment while 27 reported that persons with disabilities are not considered full-fledged citizens in all areas:

1. no guarantee of the right to education and to employment - 10 countries;
2. no guarantee of the right to marriage - 17 countries;
3. no political rights - 14 countries.

In most countries, one or more of social security and welfare services are not within the legal framework guarantee to all, as follows:

1. no benefits guaranteed - 4 countries;
2. no guarantee of the right to health/medical care - 10 countries;
3. no guarantee of the right to training, rehabilitation and counseling - 14 countries;
4. no guarantee of the right to financial security - 24 countries;
5. no guarantee of the right to employment - 27 countries;
6. no guarantee of the right to independent living and participation in decision-making - 34 countries;
7. all benefits guaranteed - 33 countries.

Governments are thus more advanced in establishing laws guaranteeing civil and political rights than in establishing laws guaranteeing social and economic rights. The more specific the guarantees, the stronger the protections for persons with disabilities. Since the adoption of the Rules, 47 per cent of the Governments reported adopting legislation protecting the rights of persons with disabilities.

C. Accessibility, Rule 5. Twenty-three of 83 Governments reported no laws or regulations establishing standards for the built environment. In only 42 per cent of the countries (35 of the Governments responding) are there accessible means of public transportation. Eighteen reported no measures at all to facilitate accessibility to the built environment. No special transport arrangements were provided by 26 out of 82 Governments reporting. There was no disability awareness component in the training programmes of planners, architects or construction engineers in 42 of 78 Governments. In terms of communication, 26 out of 80 countries do not employ sign language in the education of deaf people while 34 provide sign language interpretation for any purpose. The results show that 71 of 81 countries do provide literature in Braille or on tape, 45 provide news magazines in those formats and 25 provide large print readers. Services for blind people are more available than for those who are deaf or mentally disabled.

D. Organizations of persons with disabilities, Rule 18. Sixty-three of 81 Governments reported that a national umbrella organization exists. In 31 of 80 countries - or 39 per cent - there are no legal provisions for mandating the participation of representatives of such organizations in policy-making. In 65 of 80 countries, such organizations receive financial support from Government.

E. Coordination of work, Rule 17. Sixty-two of 83 Governments reported that a coordinating committee or similar body had been established. Organizations of persons with disabilities are represented on a majority of these committees.

UNESCO conducted a survey in the 1993-94 period providing information related to Rule 6 on Education. The questionnaire was sent to 90 governments, of which 63 responded, with information on the following issues:[122]

A. Legal representation of the right to special education. Forty-four of 65 Governments responding reported that general legislation applied to children with special educational needs. Thirty-four reported that children with severe disabilities were excluded from education with 18 of those 34 reporting legal exclusion from public education.

B. Parents role. In 22 of 53 Governments providing information, the parent's role in decision-making concerning placement is fully recognized. In seven, parents have only the right to appeal; in 24 countries parents' involvement is limited.

C. Education forms and the issue of integration. In 33 of 48 Governments reporting, fewer than one percent of pupils are enrolled in special education programmes. Some progress towards the goal of integration in the educational system has been achieved over time.

D. Special education legislation. In 16 out of 52 Governments responding in a previous survey in 1991, special education was financed totally by the States and/or local authorities. Only in ten countries were students expected to follow the regular curriculum.

The ILO survey on ILO Convention Number 159 in 1996 provided information related to Rule 7 on Employment.[123] By the beginning of 1996, 54 countries had ratified Convention Number 159. In only 11 countries is the Convention considered by ILO to be applied in its entirety. The measures that are least implemented pertain to vocational rehabilitation in rural areas (10 countries), cooperation with organizations of persons with disabilities (7 countries) and availability of qualified staff (8 countries). The measure that is implemented in almost every country reporting concerns employment anti-discrimination provisions.

The Special Rapporteur concludes that no country has fully implemented the Rules. The Rules have been used as guidelines for new legislation, for national plans of action and for evaluating programmes and policies. Roughly 85 per cent of Governments responding indicate that the Rules have led to a rethinking of policies. The Rapporteur submits the following recommendations:[124]

1. "...that measures to make the Rules known must continue and be strengthened on both the national and international levels."
2. Although United Nations bodies and agencies are familiar with the Rules, a form of inter-agency mechanism should be established to improve coordination and identify areas for cooperation and joint action with the role of the United Nations Secretariat as the focal point in the implementation of the Rules strengthened.
3. Because disability measures are not integrated into development activities, such as the World Bank-assisted development activities, disability measures must be strengthened and integrated into the mainstream of technical cooperation.
4. Because most Governments still emphasize prevention and rehabilitation, advisory services and support to Governments on request to develop disability policies based on the Rules must be strengthened.
5. Because the protection of human rights is weak, the cooperation between United Nations bodies and agencies and NGOs in the disability field should be continued and developed.
6. Although the "Salamanca Statement" and the "Framework for Action" are promising developments for education, conditions should be created for UNESCO to give more vigorous support to governments in this area.
7. Governments are urged to ratify ILO Convention Number 159 and those which have should strengthen their efforts to reflect the provisions of the Convention.
8. ILO, in cooperation with other concerned United Nations bodies and agencies, should take the lead in assisting States to formulate policies to promote equal job opportunities.
9. To achieve the goal of full participation, information exchange and cooperation drawing on the experience of industrialized countries should be encouraged to assist all Governments to develop accessibility measures.
10. Governments are urged to strengthen their support to the work of organizations of persons with disabilities.
11. Because of a common lack of monitoring and evaluation procedures under Rule 20, the United Nations is urged to take measures to assist Governments on request to build their own monitoring and evaluation systems.
12. Because there is no "Rule" in the area of shelter and housing, a Rule on accessible housing and shelter could be redressed in a subsequent Standard Rules document.

In summary, the Special Rapporteur concludes that although the Standard Rules should continue to play a significant role in policy development, the overall human rights perspective should be more developed in the context of the Rules. Both the needs of the child and the gender perspective should receive more attention in future implementation studies.[125]

In addition to the Special Rapporteur's summary, an additional report on human rights and disability was prepared in 1996 by the Commission on Human Rights' Special Rapporteur for the Sub-Commission on Prevention of Discrimination and Protection of Minorities.[126] The report provided information from the Committees on the Rights of the Child, on Economic, Social and Cultural Rights and on the Elimination of Discrimination against Women, as well as on activities of the Special Rapporteur on Disability of the Commission for Social Development, and UNESCO. The report notes that the Committee on the Rights of the Child and the Committee on Economic, Social and Cultural Rights were particularly critical of the lack of progress concerning disabled persons.

What seems clear is that there has been a focus on process as opposed to outcomes. As a result, progress is being made in the legislative areas but it is unclear how much progress is being made in terms of improving the lives of disabled persons with regard to the target areas. This is ironic, given that unlike the Long-term Strategy, the Rules place emphasis on achieving targets.

What progress that has occurred as a result of the Rules can probably be attributed to the three characteristics of them cited by the Special Rapporteur. First, the Rules are concise and concrete, which makes them understandable and accessible to both Governments and people with disabilities. Second, their direction towards countries creates a pressure point where disability advocates can push for their implementation. Finally, the monitoring mechanism reinforces desirable directions for interested countries and assists in advocacy for the Rules.

There are several potential obstacles that could be attributed to the Rules. First, although they establish targets, the Rules generally focus more on process than outcomes. Second, by establishing specific Rules, which are not well integrated with each other, countries may encounter difficulties in designing comprehensive disability programmes. Third, the Rules do not provide much guidance on implementation in the context of an overall development strategy and, hence, may not receive much consideration in countries' development plans. Fourth, unlike the Long-term Strategy, the Rules do not suggest country flexibility. Fifth, like the Long-term Strategy, the Rules do not suggest mechanisms for prioritizing activities. Finally, the Rules do not suggest mechanisms for coping with scarce resources.

Similar to the Long-term Strategy, four years is too short a time to determine conclusively those aspects of the Rules that cause progress or contribute to obstacles. Again, it is unlikely that the Rules have created obstacles, particularly given the enthusiasm they have generated in many quarters. However, as in the case of the Long-term Strategy, if procedures could be established for setting priorities, the Rules could be examined for their potential guidance in determining outcome measures for implementing the World Programme.

3. Factors influencing the implementation of the World Programme of Action

a) Resources framework: knowledge, people, skills and finances

In recent years, the global movement towards freer markets, information exchange and movement of persons has had major impacts on all persons, including those with disabilities. This movement has reduced somewhat the boundaries between the national, regional and international levels. One result is increased contact between persons with disabilities, regardless of country of residence. These changes offer flexibility in the placement of programmes at the most advantageous level, whether it be international, regional, national or sub-national, to produce the most positive changes in the involvement of persons with disabilities in major areas of life.

As noted earlier, the first five year review of progress in implementing the World Programme of Action, issued ten years ago, focused heavily on the issue of resources, particularly finances. Resources remain a critical issue. Certainly, knowledge about disability issues has increased during the past ten years. As disability has received more attention, the availability of people with skills in disability-related areas has increased. However, the increases in skilled people may have been outstripped by increases in the number of people with disabilities as the world's population has increased. Moreover, finances continue to remain a problem, particularly in a time when there is an increased emphasis on conserving resources. This emphasis contributes to the need to set priorities concerning disability issues.

b) Policy framework

As noted earlier, the policy framework for the World Programme of Action encouraged a tripartite approach to its implementation. In recent years, the interactions between prevention, rehabilitation and equalization of opportunities have been recognized and contributed to better programme design and implementation. By placing equalization of opportunity on a par with prevention and rehabilitation, the Programme created the climate for the current movement towards human rights approaches as stated in the Rules.

It should be noted, however, that many of the trends noted in this report, such as the integration of disability issues into general human rights and development concerns were all included in the World Programme. The Programme urged that the participation of disabled persons in decision making be promoted by assistance to organizations of disabled persons, by proactively fostering the development of such organizations and by the establishment of direct contacts with such organizations. The situation of the following special groups was noted - women, children, older persons, victims of crime, victims of torture, refugees and displaced persons and migrant workers. Other important elements of the Programme were a community-based approach to communication and staff training, as well as a coordinated information and public education campaign accessible to all.

The general policy framework of the Programme continues to be applicable to disability issues. Virtually all of the trends that have occurred since its passage were anticipated in the original text of the Programme. Thus, there is no compelling need at this time to revise either the World Programme or the two major international instruments adopted subsequently, namely the Long-term Strategy and the Standard Rules. Problems in the implementation of these three policies do not appear to be a function of their design but are rather, as noted by Commission for Social Development at its thirty-fifth session (1997), a function of budgetary constraints.[127]

c) Institutional framework, including coordination mechanisms

The World Programme of Action stresses the importance of integrating the Programme with other United Nations activities, such as interregional, regional and bilateral assistance, information and public education campaigns and research. Several United Nations bodies and agencies are designated in the Programme for particular responsibilities related to its implementation. UNICEF should promote prevention through maternal and child health services, health education, disease control and improvement of nutrition, as well as rehabilitation and equalization of opportunity by developing integrated education projects and supporting CBR. ILO is to promote vocational rehabilitation and occupational safety and health. UNESCO should promote the education of disabled children and adults while the World Health Organization is to promote both the prevention of disability and promote medical rehabilitation and FAO is to promote the improvement of nutrition. The (former) Centre for Social Development and Humanitarian Affairs, now the Division for Social Policy and Development the United Nations Secretariat is to coordinate and monitor implementation of the Programme as well as conduct its periodic review and appraisal. The Statistics Division of the United Nations Secretariat is to encourage a realistic and practical system of data collection. The major coordination mechanism that has been added since the Programme was adopted in 1982 is the Special Rapporteur on Disability of the Commission for Social Development who is to promote and monitor implementation of the Standard Rules.

The Statistics Division has played a critical role in coordinating its activities with other agencies. For example, in compiling DISTAT, the Division took care to employ WHO's ICIDH framework. In 1996, the Division produced the Manual for the Development of Statistical Information for Disability Programmes and Policies.[128] The Manual incorporates the guidelines of the United Nations High Commissioner for Refugees for monitoring the prevention of Handicap along the dimensions of integration, self-sufficiency, participation and opportunities. The Statistics Division is updating DISTAT and has provided recommendations on disability questions for the year 2000 round of censuses.[129] As a result of its coordination activities, the development of statistics is one of the most advanced elements of Programme implementation.

The role of the Division for Social Policy and Development as the coordinator of the Programme has been a critical factor in its successful implementation and wide-spread support. This mechanism could be further strengthened if other concerned United Nations organizations and bodies would routinely consult with the Division on major initiatives regarding disability and facilitate thereby effective and productive collaboration to promote a society for all.

d) Other factors

Other factors that may influence implementation of the World Programme of Action, include the world economy, the unique situations that may exist in individual countries and the advancement of technology.

However, two factors that should be addressed at this moment are United Nations initiatives related to advancement of women, and further development of the ICIDH framework.

The importance of links between disability initiatives and other United Nations initiatives for women and for specific social groups has been noted in earlier paragraphs. The emphasis on the gender perspective often stressing comparisons between women and men for women's initiatives lends support to a corresponding disability perspective stressing comparisons between disabled and non-disabled persons for disability policy development, programme planning and implementation, monitoring and data gathering practices. The linkage between advancement of women and disability issues means that, if traditional roles and behaviour of girls and young women are such that their disabilities go undetected, additional efforts must be taken to identify them and provide them with appropriate services. These services have to be appropriately designed, because women with disabilities are often placed in the most disadvantaged position in both the disability community and the community at large.[130]

In terms of the second area, the development of the ICIDH has played a critical role in providing a framework from which to implement the Programme. The Standard Rules notes that the term Handicap means the loss or limitations of opportunities to take part in the life of the community on an equal level with others. It describes the encounter between the person with a disability and the environment. Though the term Handicap has proven controversial, as noted earlier, those elements that Handicap within the Classification system seeks to identify, particularly independence, use of time, social integration and economic self-sufficiency, have proven beneficial in identifying the areas of involvement that the Programme must foster. In turn, implementation of the Programme has informed the ICIDH on the importance of the environment as the critical element in either enhancing or denying equalization of opportunities for persons with disabilities.

Notes:

[120] A/52/56, annex.

[121] Ibid., paras 17-103.

[122] Ibid., paras 104-116.

[123] Ibid., paras 121-128.

[124] Ibid., paras 133-152.

[125] Ibid., paras 152.

[126] Prepared pursuant to Sub-Commission resolution 1995/17; See United Nations Commission on Human Rights document E/CN.4/Sub.2/1996/27.

[127] Official Records of the Economic and Social Council, 1997, Supplement No.6 (E/1997/26), chap I, sect. A; subsequently adopted as Economic and Social Council resolution 1997/19 of 21 July 1997.

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

[129] United Nations, Principles and Recommendations for Population and Housing Censuses; revision 1 (United Nations publication, Sales No. E.98.XVII.8) paras 2.266-2.285.

[130] Margaret Snyder, "Issues in gender-sensitive and disability-responsive policy research, training and action", paper presented at the "Seminar on Employment and Sustainable Livelihoods of Persons with Disabilities; issues in technology transfer, microcredit and institutional development (United Nations, 26 April 1999) [http://www.un.org/esa/socdev/disrppeg.htm].

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