Policy Brief: A Disability-Inclusive Response to COVID-19

Policy Brief:

A Disability-Inclusive

Response to COVID-19

M AY 2 0 2 0

1. Executive Summary

The global crisis of COVID-19 is deepening

pre-existing inequalities, exposing the

extent of exclusion and highlighting that

work on disability inclusion is imperative.

People with disabilities—one billion people—

are one of the most excluded groups

in our society and are among the hardest

hit in this crisis in terms of fatalities.

Even under normal circumstances, persons

with disabilities are less likely to access health

care, education, employment and to participate

in the community. They are more likely to live

in poverty, experience higher rates of violence,

neglect and abuse, and are among the most

marginalized in any crisis-affected community.

COVID-19 has further compounded this

situation, disproportionately impacting persons

with disabilities both directly and indirectly.

An integrated approach is required to ensure

that persons with disabilities are not left

behind in COVID-19 response and recovery.

It calls for placing them at the centre of the

response, participating as agents of planning

and implementation. All COVID-19 related

action must prohibit any form of discrimination

based on disability and take into consideration

the intersections of gender and age, among

other factors. This is necessary effectively

and eciently to address and prevent barriers

that may arise during response and recovery.

Disability inclusion will result in a COVID-

19 response and recovery that better

serves everyone, more fully suppressing

the virus, as well as building back better. It

will provide for more agile systems capable

of responding to complex situations,

reaching the furthest behind rst.

This Policy Brief highlights the impact of COVID-

19 on persons with disabilities and in doing so,

outlines key actions and recommendations

to make the response and recovery inclusive

of persons with disabilities. While the brief

contains specic recommendations focusing

on key sectors, it identies four overarching

areas of action that are applicable for all.

1. Ensure mainstreaming of disability in all

COVID-19 response and recovery together

with targeted actions. A combination of

mainstream and disability-specic meas-

ures are necessary to ensure systematic

inclusion of persons with disabilities.

2. Ensure accessibility of information,

facilities, services and programmes in

the COVID-19 response and recovery.

Accessibility is fundamental to the inclusion

of persons with disabilities in the immediate

health and socio-economic response to

COVID-19. If public health information, the

built environment, communications and

2 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

technologies, and goods and services are

not accessible, people with disabilities

cannot take necessary decisions, live

independently and isolate or quarantine

safely, or access health and public

services on an equal basis with others.

3. Ensure meaningful consultation with

and active participation of persons with

disabilities and their representative

organizations in all stages of the

COVID-19 response and recovery.

Persons with disabilities have important

contributions to make in tackling the

crisis and building the future. Many

persons with disabilities have experience

of thriving in situations of isolation and

alternate working arrangements that

can offer models for navigating the

current situation. Perspectives and lived

experiences of disability contribute

to creativity, new approaches and

innovative solutions to challenges.

4. Establish accountability mechanisms

to ensure disability inclusion in the

COVID-19 response. Ensure inclusive

investments to support disability-inclusive

outcomes. Governments, donors, UN

agencies and other actors need to establish

mechanisms to monitor investments

to ensure it is reaching persons with

disabilities. Disaggregating data by

disability is key to ensure accountability.

Inclusion of persons with disabilities in the

COVID-19 response and recovery is a vital part

of achieving the pledge to leave no one behind,

and a critical test of the global commitments

of the Convention of the Rights of Persons

with Disabilities (CRPD), the 2030 Agenda

for Sustainable Development, the Agenda for

Humanity and the United Nations Disability

Inclusion Strategy. It is also central to the

UN’s commitment to achieve transformative

and lasting change on disability inclusion.

POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19 3

2. How COVID-19

impacts persons

with disabilities

Persons with disabilities are

disproportionately impacted by the COVID-

19 outbreak. An estimated 46% of older

people aged 60 years and over are people

with disabilities.

One in every ve women

is likely to experience disability in her

life, while one in every ten children is a

child with a disability.

Of the one billion

population of persons with disabilities,

80% live in developing countries.

They represent a diverse population of people

with different impairments and support

requirements, who face signicant barriers

in exercising their rights throughout the

lifecycle. Some groups face even greater

marginalization—for example persons with

intellectual and psychosocial disabilities,

persons who are deafblind—who are more

likely to be excluded from services, live or

be detained in institutions, and experience

higher rates of violence, neglect and abuse.

As the report ‘Shared Responsibility, Global

Solidarity’ on the socio-economic impact

of the pandemic reects, COVID-19 is

not simply a health crisis—it is attacking

societies at their core.

The response is

feeding on pre-existing social and economic

inequalities associated with disability and

threatens to exacerbate them further.

GLOBAL POPULATION OF PERSONS WITH DISABILITIES

Figure 1 Global population of persons with disabilities (IASC Guidelines, 2019, Inclusion of Persons with Disabilities in Humanitarian Action)

4 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

1. Introduction

Why are the guidelines important?

W HO and World Bank,

World Report on Disability

(2011).

R eport of the United Nations Secretary-General for the World Humanitarian Summit,

One Humanity, Shared Responsibility

K atsunori Fujii, ‘

The Great East Japan Earthquake and Disabled Persons

’, in

Disability Information Resources

, Japan.

U NICEF,

Including children with disabilities in humanitarian action – General Guidance

(2017).

Sources: WHO and World Bank,

World Report on Disability

(2011); UN DESA,

Ageing and Disability

; UNICEF,

Children and Young People

with Disabilities

(2013).

Persons with disabilities are estimated to represent

15 per cent of the world’s population.

In humanitarian

contexts, they may form amuch higher percentage.

They are among the most marginalized people in

crisis-affected communities

and are disproportion-

ately affected by conﬂ ict and emergency situations.

In disasters, their mortality rate is two to four times

higher than that of persons without disabilities.

Persons with disabilities are not ahomogeneous

group. They are diverse in their experience, in the

ways that attitudinal, physical and communication

barriers impede their participation and inclusion in

humanitarian action, and in their identity, including

their age, gender, ethnicity, location and race. Due to

the intersectionality of these factors, persons with

disabilities face greater marginalization and discrim-

ination. During humanitarian crises, for example, chil-

dren with disabilities are at higher risk of abuse and

neglect, and women with disabilities are at higher

risk of sexual violence.

Diagram 2 | Global population of persons with disabilities

15%

An estimated 15% of the world’s population have adisability.

1 in 5

One in ﬁ ve women is

likely to experience

disability during her life.

46%

46% of persons aged 60 years

and over have adisability.

1 in 10

One in ten children is

achild with adisability.

Persons with disabilities are at greater risk of

contracting COVID-19. They may experience

barriers to implement basic protection measures

such as hand-washing and maintaining

physical distancing for several reasons: lack of

accessibility of water, sanitation and hygiene

(WASH) facilities; a reliance on physical contact

to get support; inaccessibility of public health

information; or being placed in institutional

settings which are often overcrowded and

unsanitary.

These barriers are exacerbated

for those living in informal settlements and/

or affected by humanitarian emergencies.

Persons with disabilities are at greater risk of

developing more severe health conditions and

dying from COVID-19. They have greater health

requirements and poorer health outcomes.

For example, they are more susceptible to

secondary conditions and co-morbidities, such

as lung problems, diabetes and heart disease,

and obesity, which can worsen the outcome of

COVID-19 infections.

The barriers to accessing

healthcare are further exacerbated during the

COVID-19 crisis, making timely and appropriate

care dicult for persons with disabilities.

Persons with disabilities living in institutions

are more likely to contract the virus and

have higher rates of mortality. Persons

with disabilities, including older people

with disabilities, represent the majority of

institutionalized people globally.

People with

disabilities are also overrepresented in the prison

population, particularly persons with intellectual

and psychosocial disabilities.

People in

institutional settings, such as nursing homes

social care homes and psychiatric facilities, as

well as detention facilities and penitentiaries

experience signicant barriers to implement

basic hygiene measures and physical distance,

and have limited access to COVID-19-related

information, testing and healthcare. Emerging

evidence indicates that people in institutional

settings are experiencing the highest rates of

infection and mortality from COVID-19.

The

percentage of COVID-19 related deaths in care

homes—where older persons with disabilities

are overrepresented—ranges from 19% to 72%

in countries in which ocial data is available.

Persons with disabilities are at greater risk

of discrimination in accessing healthcare

and life-saving procedures during the COVID-

19 outbreak. In some countries, health care

rationing decisions, including triage protocols

POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19 5

1 UN DESA Disability and Ageing

2 WHO and World Bank, World Report on Disability (2011); UN DESA, Ageing and Disability; UNICEF, Children and Young People with

Disabilities (2013).

3 United Nations Department of Economic and Social Affairs (UN DESA), Factsheet on Persons with Disabilities

4 United Nations, Shared Responsibility, Global Solidarity: Responding to the Socio-Economic Impacts of Covid-19, March 2020

5 WHO, Disability considerations during the COVID-19 outbreak, 2020; H. Kuper & P. Heydt, The Missing Billion, access to health services

for 1 billion people with disabilities, LSHTM, 2019; I. Mactaggart et al. (2018), Access to water and sanitation among people with

disabilities, BMJ open vol. 8(6), e020077.

6 WHO, World Report on Disability, 2011; A. K. Singh et al. (2020), “Comorbidities in COVID-19: Outcomes in hypertensive cohort and

controversies with renin angiotensin system blockers”, Diabetes & metabolic syndrome 14(4).

7 OECD Health Statistics 2019, Beds in residential long-term care facilities, Long-term care beds in hospitals and Psychiatric care beds

in hospitals, available at https://oe.cd/ds/health-statistics; M. Luppa et al (2010), “Prediction of institutionalization in the elderly. A

systematic review”, Age Ageing 39(1).

8 Penal Reform International, Global Prison Trends 2020

9 United Nations, Policy Brief: Impact of COVID-19 on Older Persons, May 2020

10 United Nations, COVID-19 and Human Rights: We are all in this together, April 2020

11 A. Comas-Herrera et al. (2020), “Mortality associated with COVID-19 outbreaks in care homes: early international evidence”

6 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

(e.g. intensive care beds, ventilators), are

not being based on an individual prognosis,

but rather on discriminatory criteria, such as

age or assumptions about quality or value of

life based on disability.

Moreover, access

to healthcare, rehabilitation and assistive

technologies for persons with disabilities,

including with respect to accessibility and

affordability,

can also be curtailed due to the

increased pressure on healthcare systems.

Persons with disabilities are particularly

disadvantaged by the socio-economic

consequences of COVID-19 and measures to

control the pandemic. COVID-19 has both short-

term and far-reaching implications for people

with disabilities in many areas of life, which

may be further exacerbated in humanitarian

and disaster contexts and fragile settings:

•

Impact on employment and social protec-

tion. Already facing exclusion in employ-

ment

, persons with disabilities are more

likely to lose their job and experience greater

diculties returning to work during recov-

ery.

In most countries social protection

systems offer little support to persons with

disabilities and their families with much

less access to social insurance. Only 28%

of persons with signicant disabilities have

access to disability benets globally, and only

1% in low-income countries.

The increased

demand for unpaid care and domestic work

in the context of the pandemic is deepening

already existing inequalities

which may be

exacerbated for women with disabilities.

•

Impact on education. While reliable gures

on students with disabilities are not yet

available, it is likely that the current crisis

has exacerbated their exclusion from educa-

tion.

As detailed in the policy brief on the

impact of COVID-19 on children, students

with disabilities are least likely to benet

from distance learning solutions.

Lack of

support, access to the internet, accessible

software and learning materials is likely to

deepen the gap for students with disabilities.

Disruption to skills and training programmes

are likely to have far-reaching effects on

youth with disabilities who face a multitude

of barriers to entering the workforce.

•

Impact on support services. For many

people with disabilities, access to support

services is essential to lead safe, healthy

and independent lives. Measures to contain

the spread of COVID-19 have resulted in

12 A. Comas-Herrera et al. (2020), “Mortality associated with COVID-19 outbreaks in care homes: early international evidence”

13 S. Bagenstos (2020), “May Hospitals Withhold Ventilators from COVID-19 Patients with Pre-Existing Disabilities? Notes on the Law and

Ethics of Disability-Based Medical Rationing”, 130 Yale Law Journal Forum (Forthcoming)

14 Baart & F. Taaka (2017), “Barriers to Healthcare Services for People with Disabilities in Developing Countries: A Literature Review”,

Disability, CBR & Inclusive Development, 28(4).

15 United Nations, Disability and Development Report, Realizing the Sustainable Development Goals by, for and with persons with

disabilities, 2018

16 Mitra, S. and Kruse, D., 2016. Are workers with disabilities more likely to be displaced?. The International Journal of Human Resource

Management, 27(14), pp.1550-1579.

17 ILO 2017 World report on social protection Universal social protection to achieve the Sustainable Development Goals; page 66-73,

ILO 2019. Measuring nancing gaps in social protection for achieving SDG target 1.3 global estimates and strategies for developing

countries UN DESA, 2017, Promoting social inclusion through social protection, Report on the World Social Situation S. Kidd et al.,

Leaving No-one Behind: Building Inclusive Social Protection Systems for Persons with Disabilities, Development Pathways, 2019.

18 United Nations, Policy Brief: The Impact of COVID-19 on Women, April 2020

19 United Nations, Disability and Development Report, Realizing the Sustainable Development Goals by, for and with persons with

disabilities, 2018

20 United Nations, Disability and Development Report, Realizing the Sustainable Development Goals by, for and with persons with

disabilities, 2018

21 United Nations, Policy Brief: The Impact of COVID-19 on Children, April 2020

22 United Nations, Policy Brief: The Impact of COVID-19 on Women, April 2020

23 UN Women, COVID-19 and ending violence against women and girls, 2020

24 L. Jones et al. (2012), “Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of

observational studies”, The Lancet 380(9845); K. Hughes et al. (2012), “Prevalence and risk of violence against adults with disabilities:

a systematic review and meta-analysis of observational studies”, The Lancet 379(9826).

25 J. Meaney-Davis et al., The impacts of COVID-19 on people with disabilities: a rapid review, Inclusive Features, Disability Inclusion

Helpdesk Query No: 35, 2020

POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19 7

signicant disruptions to services, support

systems and informal networks, such as per-

sonal assistance, sign language and tactile

interpretation, and psychosocial support.

The economic impact of COVID-19 may

also lead to even greater cuts within exist-

ing services in the post-pandemic period.

•

Impact of violence on persons with

disabilities. The policy brief on the impact of

COVID-19 on women documents early reports

which indicate a substantial increase of

domestic violence in the midst of lockdown

measures,

which has a particular impact

on women and girls with disabilities.

Given

that both children and adults with disabilities

are at much higher risk of violence than their

peers without disabilities,

it can be assumed

that they are disproportionately impacted.

Increased stigma and discrimination

against persons with disabilities within

communities has also been reported.

8 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

A human rights-based approach to

disability is required to ensure persons

with disabilities are not left behind.

Both the CRPD and the 2030 Agenda call

for placing persons with disabilities at

the centre of all our efforts, as agents

of planning and implementation.

A combination of mainstreaming and targeted

measures is necessary in all interventions.

Persons with disabilities share the same primary

needs as everyone else: health protection

and treatment, basic services, shelter and

income. The best way to address their inclusion

is through mainstreaming disability in all

plans and efforts. Targeted measures need

to complement disability mainstreaming by

addressing specic requirements that cannot

be met by making general responses inclusive.

NON-DISCRIMINATION

Non-discrimination is a core human rights

principle. COVID-19 response and recovery

must prohibit discrimination on the basis of

disability, as well as any criteria which could

have a disproportionate impact on persons with

disabilities. It is necessary to recognise and take

measures against disadvantage experienced

by persons with disabilities by taking

proactive steps, including through reasonable

accommodation, to ensure they equally benet

from COVID-19 response measures.

INTERSECTIONALITY

Persons with disabilities experiencing

intersectional and multiple discrimination as

a result of their gender identity, age, ethnicity,

race, sexual orientation, origin, location and

legal status, among other factors, will carry

a heavier burden of the immediate and long-

term economic and social consequences

of the pandemic.

COVID-19 response

and recovery needs to reect and respond

to the multiple and intersecting forms

of discrimination faced by persons with

disabilities to ensure that the most marginalised

groups among them are not left behind.

3. Foundations for a

disability-inclusive COVID-19

response and recovery

26 United Nations, COVID-19 and Human Rights: We are all in this together, April 2020

27 Reasonable Accommodation means “Necessary and appropriate modication and adjustments not imposing a disproportionate or

undue burden, where needed in a particular case, to ensure to persons with disabilities the enjoyment or exercise on an equal basis

with others of all human rights and fundamental freedoms” (CRPD Article 2)

28 United Nations, Disability and Development Report, Realizing the Sustainable Development Goals by, for and with persons with

disabilities, 2018

POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19 9

ACCESSIBILITY

Ensuring accessibility of facilities, services

and information is fundamental to a disability

inclusive COVID-19 response and recovery. If

public health information, buildings, transport,

communications, technologies, goods and

services are not accessible, persons with

disabilities cannot take necessary decisions, live

independently and isolate or quarantine safely,

or access health and public services on an equal

basis with others. Such measures do not need to

add greatly to overall cost especially if the needs

of the maximum number of users are considered

in the initial design.

Research shows that if they

are considered from the design stage, ensuring

accessibility can cost as little as 1% more.

PARTICIPATION

Persons with disabilities have the right to

participate fully and effectively in decisions

that affect their lives.

They are a diverse,

non-homogenous population who possess

unique knowledge and lived experience

of disability that others do not.

Close consultation and active involvement of

people with disabilities and their representative

organizations at all stages–from planning and

design to implementation and monitoring—

is key to ensuring inclusive response.

Partnerships and collaboration will improve

effectiveness and accountability, assist in

directly achieving inclusion and ensuring

that all action related to COVID-19 benets

persons with disabilities, and contributes to

longer-term development and recovery.

ACCOUNTABILITY

Accountability is essential for ensuring that the

COVID-19 response and recovery is inclusive

and respectful of the rights of persons with

disabilities. Governments, UN entities and other

actors are accountable to affected populations,

including persons with disabilities, and

mechanisms need to be established to engage

with communities to inform programming

and adjust it according to feedback.

DATA DISAGGREGATION

To understand the different ways in which people

with disabilities experience the impact of COVID-

19, and to monitor their inclusion in all phases

of the response and recovery, ensuring the

collection and availability of disaggregated data

by disability is essential. To that end, data should

be collected using internationally recognized

methods, such as the Washington Group tools.

More in-depth qualitative data can be collected

through needs assessments and surveys,

such as the WHO Model Disability Survey.

For planning purposes, where primary data

collection is not undertaken or secondary data

sources on disability is not available, the World

Bank/WHO 15 per cent estimate of persons with

disabilities in the population may be used.

29 Universal design means the design of products, environments, programmes and services to be usable by all people, to the greatest

extent possible, without the need for adaptation or specialized design (CRPD Article 2).

30 E. Steinfeld, Education for all: the cost of accessibility, World Bank Education Notes, 2005.

31 CRPD, Article 4.3.

32 Washington Group (WG) on Disability Statistics, Questions sets,

33 WHO and World Bank, World Report on Disability (2011).

10 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

The following section outlines key actions

to protect persons with disabilities from

contracting COVID-19 and the impact

of lockdowns, physical distancing and

isolation measures, and to achieve a

disability-inclusive response and recovery.

HEALTH

People with disabilities are more susceptible

to contracting COVID-19, and barriers to

accessing health services, including testing,

are exacerbated during the crisis. Lockdowns

can lead to restricted access to essential

goods and medicines, as well as limit access

to supports. The disruption of wider health

services puts persons with disabilities at a

disadvantage as they may require more frequent

access due to underlying health conditions.

Ensure accessible public health information.

An appropriate response requires measures

to ensure that information is accessible, up to

date, and keeps pace with the rapidly changing

knowledge evidenced during the pandemic.

For example, Inclusion Europe has produced

information and links on COVID-19 in Easy-to-

Read format in multiple languages. Through the

joint UN Partnership on the Rights of Persons

with Disabilities (UN PRPD) programme

in Nepal, information on COVID-19 included

accessibility features, including sign language.

Implement protective measures against

COVID-19. Access to appropriate WASH

facilities that make frequent hand-washing

possible is essential, as is the targeted provision

of protective measures for those providing

support to persons with disabilities either at

home or in institutions. The distribution of

personal protective equipment to persons

with disabilities needs to be tailored to their

impairment. For example, given that masks

make it impossible to read lips or see facial

expressions, deaf and hard of hearing persons

will benet better from face shields.

Ensure accessibility to services. Measures

need to be put in place to facilitate the

timely access to health services for persons

with disabilities, such as transportation to

healthcare facilities, access to sign language

34 WHO and World Bank, World Report on Disability (2011).

35 United Nations, Shared Responsibility, Global Solidarity: Responding to the Socio-Economic Impacts of Covid-19, March 2020

36 UN Partnership on the Rights of Persons with Disabilities (UNPRPD) supports joint programmes by UN agencies together with

governments and organizations of persons with disabilities at country level to advance CRPD implementation. In Nepal, the UNPRPD

project is jointly implemented by UNDP, UNFPA, WHO and UN Women and partners.

4. Sectoral actions and

recommendations for a

disability-inclusive COVID-19

response and recovery

POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19 11

interpretation in hospitals, as well as the

procurement of goods, medicines and services.

Essential health services, including sexual and

reproductive health, must be accessible—for

example, ensuring telehealth programmes are

accessible for persons with disabilities who

require different modes of communication.

By way of example, the United Arab Emirates

has launched a national programme to test

persons with disabilities in their homes,

and as of mid-April, had conducted 650,000

COVID-19 tests of persons with disabilities.

Ensure non-discrimination in the allocation

of scarce medical resources. It is important

to mitigate the risk of discriminatory

decisions in resource allocation that put

people with disabilities at a high level of

disadvantage

by applying ethical principles

that prioritize treatment for persons in

situations of particular vulnerability.

Make mental health interventions inclusive of

persons with disabilities. Anxiety, lockdowns,

isolation, and information consumption, loss

of livelihoods and support systems due to

the pandemic impact on mental health of all

people, including persons with disabilities. As

documented in the policy brief on the impact of

COVID-19 on older persons, physical distancing

measures that restrict visitors and group

activities in institutions can also negatively

affect physical, as well as mental health and

well-being.

Mental health and psychosocial

support needs to be accessible and not

discriminate against persons with disabilities.

37 R. D. Truog et al. (2020), “The Toughest Triage — Allocating Ventilators in a Pandemic”, The New England Journal of Medicine,

DOI: 10.1056/NEJMp2005689.

38 WHO, Guidance for Managing Ethical Issues in Infectious Disease Outbreaks, 2016.

39 United Nations, Policy Brief: Impact of COVID-19 on Older Persons, May 2020

Figure 2 Percentage of persons with disabilities who report that health-care facilities are hindering or not accessible (United Nations,

Disability and Development Report, 2018)

WHO has produced guidelines on Disability

considerations during the COVID-19 outbreak.

12 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

PROTECTING PEOPLE IN

INSTITUTIONAL SETTINGS

Institutional settings have become COVID-19

hotspots, highlighting systemic challenges

in these settings. People with disabilities in

institutional settings face heightened risk of

contracting and dying from COVID-19. Their

situation is compounded by greater risks, such

as abuse, restraint, isolation and violence.

Prepare institutions to prevent and respond to

potential infections. This includes prioritising

testing and preventive measures within

institutions to reduce infection risks, addressing

overcrowding, isolation and physical distancing

measures among residents, modifying visiting

hours, ensuring use of protective equipment is

mandatory, and improving hygiene conditions.

It is important to guarantee that those who

contract the virus receive adequate treatment

and health care and, when needed, are

transferred to hospitals and/or emergency

care units. In Canada, for example, priority

testing guidelines have been issued with

specic measures for institutional settings.

Reduce the number of people within

institutions. It is important to take immediate

action to discharge and release persons

with disabilities from institutions, whenever

possible. Deinstitutionalization strategies

need to be accelerated and reinforced with

clear timelines and concrete benchmarks.

Reduce the number of persons with

disabilities in prisons. Whenever possible, it

will be important to explore early release and

probation or shorten or commute sentences.

Other possible measures would include

reducing the use of pre-trial detention, and

promptly ensuring support in the community

through family and/or informal networks.

In a number of countries around the world

prisoners with disabilities have been released.

SUPPORT SERVICES

Many persons with disabilities rely on

support services for daily living and to

participate in their communities. These

include personal assistance, sign language

and tactile interpretation, in-home services

and peer support, amongst others.

Ensure the continuity of support services.

It is important to develop and implement service

continuity plans, particularly for people with

disabilities with high support needs, as well

as measures to reduce potential exposure to

COVID-19 during the provision of services.

This

includes practical guidance and updated advice

to informal carers on how to support persons

with disabilities in a manner safe for everyone.

Expand community support for persons

with disabilities. The growth in demand for

support services in the community without a

corresponding supply of services can increase

pressure on families to provide unpaid,

informal care, with negative consequences

on both persons with disabilities and

family members, particularly women.

In Argentina, Peru, Spain and other countries,

for instance, persons who provide support

to people with disabilities are exempted

from restrictions of movement and physical

distancing.

Community support networks

40 OHCHR, Covid-19 and the Rights of Persons with Disabilities: Guidance, May 2020

41 WHO, Disability considerations during the COVID-19 outbreak, March 2020

42 C. Devandas, UN Special Rapporteur on the rights of persons with disabilities, Access to rights-based support for persons with

disabilities, UN Doc. A/HRC/34/58, 2016.

43 Argentina, Decree 297/2020, Article 6.5.; Spain Real Decree 463/2020; Peru Supreme Decree No 044-2020-PCM.

POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19 13

have also developed in Colombia and other

countries which recruit volunteers that support

persons with disabilities and older persons

with their groceries and other purchases.

SOCIAL PROTECTION

AND EMPLOYMENT

Social protection has already proven a key

element in the immediate relief to be provided

to persons affected by the socio-economic

impact of the crisis.

It is particularly relevant

for persons with disabilities out of work, who

have lost their job or their income resulting

from the informal economy, all of which are

at risk of poverty and extreme poverty.

Expand mainstream and disability-targeted

social protection and adapt delivery

mechanisms to provide adequate relief and

support to persons with disabilities and their

families. This can be done by: advancing and/

or increasing payments of disability benets;

extending coverage to persons with disabilities

already registered but who were not previously

eligible, and through (online) registration of

persons with disabilities; providing disability

top-ups to beneciaries of mainstream social

assistance schemes, including to family

members who have to stop work to support

persons with disabilities; and establishing

electronic payment and home delivery for

cash and essential food and non-food items.

Employment and working conditions need to

be responsive to accessibility and inclusion.

Persons with disabilities who continue working,

whether essential workers or others, may

need specic protection or adjustments to

stay safe during the pandemic. At all times it

is important that employers and workplaces

provide accessible environments and

reasonable workplace adjustments based

on individual needs. Persons with disabilities

who own businesses or work in the informal

economy may need particular support to

be able to maintain their livelihoods.

Alternate working arrangements and conditions

made accessible and inclusive. Platforms and

new ways of meeting must be accessible to all,

and adequate adjustments put in place to allow

persons with disabilities to work from home.

44 Such practice is promoted by States, such as Colombia.

45 United Nations, Shared Responsibility, Global Solidarity: Responding to the Socio-Economic Impacts of Covid-19, March 2020

Figure 3 Employment-to-population ratios, for persons aged 15 years and over by disability status and sex, 2006-2016

14 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

Ensure disability-inclusive Occupational

Health and Safety (OSH) measures. New OSH

measures may apply particularly to persons

with disabilities. In such cases, different

arrangements may be required, such as priority

to work from home or placed in paid leave.

Approaches to coming out of lockdown need

to be sensitive to the particular situation

of persons with disabilities. Persons with

disabilities and their family members or

support services have different levels of

vulnerability to COVID-19. Some persons

with disabilities, including older persons

with disabilities, may need to isolate for

longer than other groups. Social protection

and working arrangements need to be

adaptive to support their ability to do this.

The International Labour Organization (ILO)

has developed a guidance note on socio-

economic actions for persons with disabilities.

Information is also available on: Disability

inclusion in COVID-19 and the world of work

and Social protection measures for persons

with disabilities in the COVID-19 crisis.

EDUCATION

Students with disabilities are likely to face

greater barriers in accessing distance learning

or rejoining classes once they are available,

and face increased risk of dropping out of

education during disruptions to learning.

Ensure distance learning is accessible to,

and inclusive of, students with disabilities.

Education actors need to take measures to

ensure continuity of learning for students with

disabilities and return to school programmes.

This may include providing specialized

equipment to support their learning, including

assistive technology and devices, and

support to caregivers/parents of children with

disabilities. UNICEF has produced a guidance

note for staff and partners on supporting the

learning of children in areas of school closures,

which includes guidance on making learning

accessible to children with disabilities.

Address impacts that go beyond learning. For

many children with disabilities, peer relations,

social perception and social competence are

signicant aspects of their Individual Education

Plans, all of which are challenged in the context

of school closures. School closings can also

mean that many children with disabilities will

not access complementary services,

such

as food and medical check-ups, or referral

mechanisms for abuse and neglect.

Ensure that return to school programmes

are inclusive. Education actors need to

ensure that return to school programmes are

inclusive of children and young persons with

disabilities, in recognition of the increase

in the learning/achievement gap. This may

include development of plans for accelerated

education, remedial, and catch-up programmes.

46 UNICEF, All Means All – How to support learning for the most vulnerable children in areas of school closures, 2020

47 United Nations, Policy Brief: The impact of COVID-19 on Children, April 2020

POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19 15

PREVENTION OF AND

RESPONSE TO VIOLENCE

Persons with disabilities often face incidents of

violence in situations of isolation, with women

and girls with disabilities at even higher risk.

Reporting and access to domestic violence

services and assistance are particularly

challenging, as these are commonly not inclusive

of, nor accessible to persons with disabilities.

Ensure inclusive and accessible victim

assistance services. It is important to ensure

that reporting mechanisms and access to

victim assistance services are accessible to

persons with disabilities.

Being proactive and

innovative in outreach to those who are isolated,

including through voluntary networks, has

proven to be a key measure, as well as ensuring

that online counseling and other technology-

based solutions are accessible and respond

to the diversity of people with disabilities.

Strengthen awareness raising and knowledge.

Building capacity of services and communities

to prevent disability-related violence is key, as

is promoting awareness-raising about violence

against persons with disabilities, particularly

women and girls. For example, UN Women

Papua New Guinea is working with partners

to integrate COVID-19 aspects to improve

quality and standards for counselling and case

management services that will particularly target

women with disabilities. Women with disabilities

are being supported to run campaigns on

ending violence against women in a pandemic.

HUMANITARIAN CONTEXTS

Persons with disabilities in humanitarian and

disaster contexts face specic and heightened

challenges in the COVID-19 outbreak: barriers to

implementing basic hygiene measures; physical

distancing limitations in high-density sites;

barriers to accessing health care on the basis

of both disability and legal status, which may

determine and restrict their access to health care

and other services.

The Inter-Agency Standing

Committee (IASC) Guidelines on Inclusion

of Persons with Disabilities in Humanitarian

Action provide detailed sectoral information for

stakeholders working in humanitarian contexts.

Ensure disability-inclusive humanitarian

assistance and disaster response. National

and local coordination mechanisms, as well

as Preparedness and Response Plans need

to be disability-inclusive. In particular, it is

important to ensure that Humanitarian Response

Plans factor in responses targeted towards

persons with disabilities, including in WASH,

health, and food and nutrition, with adequate

resourcing, monitoring and adjustment, as

required. Concrete adaptions in humanitarian

assistance could include, for example, improving

accessibility of WASH facilities; distribution of

additional or disability-specic hygiene items

and supplies; targeted shelter assistance

for at-risk individuals to allow for physical

distancing; in-kind provision of goods, cash and

voucher assistance, and direct service provision;

and providing alternative arrangements

for food and non-food items distribution to

households of persons with disabilities.

48 S. Hellum Braathen, P. Rohleder and G. Azalde, “Sexual and reproductive health and rights of girls with disabilities: a review of the

literature”, SINTEF, 2017.

49 United Nations, Policy Brief: Impact of COVID-19 on Women, April 2020

50 See also references to persons with disabilities in the UN-led COVID-19 Global Humanitarian Response Plan, March 2020

51 Inter-Agency Standing Committee, IASC Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, 2019

16 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

Everything we do during and after the

COVID-19 crisis must have a strong focus on

building more equal, inclusive and sustainable

economies and societies that are more

resilient in the face of pandemics and the

many other global challenges we face.

Countries’ immediate efforts towards social

and economic recovery will be crucial for

progress towards the Sustainable Development

Goals (SDGs), including addressing inequalities

and ensuring that no one is left behind

While building back better

, it is critical that

persons with disabilities are part and parcel

of the response which countries, often with

the support of the UN, are preparing. These

responses, if well designed, can address

the exclusion and discrimination faced by

persons with disabilities, thus creating more

resilient communities and systems.

To build equal, inclusive and resilient

communities it is important to:

1. Meaningfully engage persons with

disabilities at all stages of the response:

When supporting local initiatives,

governments, UN entities, international

donors and civil society organizations

need to promote, fund and monitor the

inclusion of persons with disabilities in

all stages of design and implementation

of the relevant measures.

2. Prioritize persons with disabilities in

the socio-economic response: National

and sub-national economic models and

assumptions need to be critically reviewed

to identify gaps that disproportionately

impact persons with disabilities and

take into account the cost of under-

investment in disability-inclusion.

3. Track inclusion and empowerment of

persons with disabilities in national

response and recovery plans: A long-term

inclusive response needs to be closely

tied to inclusive national development

planning and nancing processes.

Disability inclusion should be a requirement

in all COVID-19 actions and systems

to allow tracking and accountability

(e.g. OECD DAC disability marker).

4. Improve health outcomes for persons

with disabilities: This entails building

accessible health systems, rights-based

training of health personnel and ensuring

universal health coverage for persons with

disabilities as a cornerstone for achieving

the health-related SDG targets. Further,

improving the determinants of health

for persons with disabilities is critical.

5. Build sustainable and disability-

inclusive social protection systems:

Universal disability allowances across

the life cycle addressing disability-related

5. Delivering on the SDGs —

Building Back Better

52 United Nations, A UN framework for the immediate socio-economic response to COVID-19, April 2020

53 United Nations, Sendai Framework for Disaster Risk Reduction 2015-2030, 2015

54 OECD, Handbook for the marker for the inclusion and empowerment of persons with disabilities, 2019

POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19 17

extra costs should be designed so that

these are compatible with employment

and other social assistance schemes

aiming at basic income security.

6. Address the specic situation of workers

with disabilities in all sectors: Stimulus

packages, including those that will promote

training and jobs in the transition to a green

economy should explicitly include persons

with disabilities in general, as well as women

and youth with disabilities in particular.

7. Invest in community-based solutions

now: Particular attention needs to be

given to persons with disabilities living in

residential institutions and funds should be

used to initiate, accelerate and complete

deinstitutionalization strategies and

transition to community-based solutions.

This includes investing and developing

support services and implementing

inclusive services at local level, such as

education and primary health care, including

rehabilitation, as cornerstones for achieving

the SDG targets for persons with disabilities.

8. Initiate multi-stakeholder dialogue and

collaboration: Inter-sectoral linkage is

required to address the multi-dimensional

nature of disability and the inter-

sectoral response that is necessary.

Bringing together all stakeholders—

government, UN entities, private sector,

organizations of persons with disabilities

and broader civil society—in the design,

implementation and monitoring of the

long-term rebuilding plan will be critical.

18 POLICY BRIEF: A DISABILITY-INCLUSIVE RESPONSE TO COVID-19

6. Conclusion

COVID-19 has created a human crisis of

unprecedented scale, which is disproportionately

impacting one billion people with disabilities.

This requires an unprecedented response—an

extraordinary scale-up of support and political

commitment—to ensure that people with

disabilities have access to essential services,

including to immediate health and social

protection services, to tide over the crisis.

A disability inclusive COVID-19 response and

recovery will better serve everyone. It will

provide for more inclusive, accessible and agile

systems capable of responding to complex

situations, reaching the furthest behind rst.

It will pave the way for a better future for all.