Impaired Millennium Development Goals?
In September heads of state met in New York to discuss progress of the UN Millennium Development Goals (MDGs). But are disabled people included in the MDGs? In this article a plea is made for an inclusive approach to the MDGs.
Impaired Millennium Development Goals?
Why the Millennium Development Goals will fail if they are not inclusive … The UN Millennium Development Goals (MDGs) were declared by the United Nations (UN) in 2000 as a policy approach for combating poverty. Five years later, last September in New York, the UN members’ heads of state met to make up the balance: are we on track to reach the goals set for 2015?
The problem with the MDGs
Few people expect the UN Millennium Development Goals (MDGs) to be reached, especially after the presentation of the first data from 2000-2005 and the UN’s lukewarm response to it during the New York Summit (September 2005). In spite of the optimistic tone of the reporters, who emphasised the great progress made in Asia, scepticism generally dominates. Life expectancy has actually gone down in most African countries and in most former Soviet countries too, clearly illustrating a health situation which is deteriorating. The question is, whether one can expect to achieve the MDG goals just by setting policy targets, without ensuring full political commitment, funding and the inclusion of people in their own development processes. If people are excluded from development processes, then MDGs will only be words on paper. If development included disabled people too, then the world would have a much better chance of reaching the goals that have been set for 2015.
Disability in the MDGs?
Disability and/or disabled people are not mentioned in any of the 48 indicators of the MDGs. Ten percent of the world's population is disabled (WHO) but where are their interests included in the MDGs? Poverty is first and foremost about exclusion and not just about economic issues. Those who are excluded from their own society are the ones who are really poor. Yet the issue of exclusion is hardly addressed. The MDGs should address issues of exclusion and marginalisation in order to make real progress to achieve any of the MDGs. But the MDGs today tend to be de-politicised and technocratic.
Are MDGs inclusive?
Disability was not properly addressed in the New York Summit declaration made last September (*) nor in the strategies designed for achieving the MDGs. It is, however, wrong to assume that disabled people will benefit pro-rata from general poverty reduction policies. When policy makers say they ‘mainstream’ disability in policies, benefits for disabled people remain invisible. In reality, people with disabilities today are a disproportionately larger group in the poorer parts of all societies. An inclusive approach only works when it gives specific attention to people whose position or circumstances make them more vulnerable. In the MDGs there are several areas where specific measures are needed. For example, in realizing educational goals there is a lot of attention given to how girls progress but, in absolute numbers, there are just as many children with disabilities who are excluded from primary schools. Recent research suggests that people with disabilities run a higher risk of HIV infection, yet in prevention campaigns disabled people are not accounted for. Information campaigns targeting deaf or blind people are rare. In Box 1 the most relevant MDGs and their relationship with disability are described.
The problem of not being heard
Disabled people are economically excluded from pro-poor growth, there is social exclusion from education and health and they have a weak political voice. The weak political voice of disabled people is of great concern. Disabled People Organisations (DPOs) are consulted in only a few cases…and when they are consulted, experience from the PRSPs studied shows that the narrow social focus of disability policy on social protection measures decreases and the broader, empowering economic focus increases. The role of disabled people is analysed more in terms of listing human potential. Disabled people have the potential of contributing to development processes if specific aspects of their disability are recognised and if their capacities and abilities are accounted for. Ignorance, neglect and - even worse - denial of this make disability a human rights issue. In the majority of development programmes, statements referring to disabled people (if any consideration of disability is made at all) often classify all disabled people as being unable to work and in need of social protection, welfare and medical rehabilitation. In the worst cases, people with disabilities are classified as groups that cannot or do not contribute to the economic labour force. This language and classification is unjust, stigmatising and discriminating. It should be replaced with language that recognises specific needs, capabilities and the role of society in breaking down barriers. If disabled people are mentioned at all, they are almost always subsumed under the general category of “vulnerable groups” – usually as an illustrative example. The danger of this categorisation is that there is little or no engagement with disabled people or disabled people's organisations and thus this could create potentially more barriers to achieving inclusion.
Dutch development co-operation and MDGs
In Johannesburg, in 2004, NGOs met to work together in a campaign against poverty, ‘Make poverty history’. Dutch NGOs also participated in this campaign within the Nederlands Platform Millenniumdoelen (Netherlands Platform Millennium Goals *). The worldwide campaign was quite successful in raising the profile of the MDGs and making poverty a media issue in Western countries. But here again, disability is a not an issue that is focused upon. The Dutch government emphasizes a human rights approach in the MDGs and, for example, stresses the need for qualitative indicators besides quantitative indicators in the measuring process, which we can agree to. But the government was not willing to put disability on the agenda of the New York summit, because, according to the answers given by the Minister for Development Cooperation in response to parliamentary questions, there are no or insufficient data about disability.
How can the vicious circle be broken?
Poverty and disability are locked together in a vicious circle and poverty reduction can only be successful if specific disability issues are addressed. We have no hope of achieving the MDGs if no specific attention is given to disabled people and development programmes are not made inclusive. How can we reach this goal of inclusiveness? I would like to open this article by discussing four strategies.
1) Raising awareness about practical issues
Development organisations and governments know little about disability; together with existing widespread prejudices and stigma this creates an important barrier. General agencies think working with disabled people requires skilled knowledge and expertise that they don't have, and so they forget about disabled people all together. Awareness-raising should, of course, focus on combating discrimination but, in the case of development agencies, practical information should be promoted too. Easy practical solutions that facilitate the participation of disabled people are effective in overcoming many barriers. A lot of the measures taken to reach the MDGs need only a little adjustment to be barrier-free and promote equal participation. Perhaps the disability movement should focus more on these practical solutions instead of the ethical arguments that currently dominate its discourse?
2) More disability advocacy is needed
The voice of people with disabilities is not heard at the level of decision-making about the MDGs. There are several initiatives and attempts to highlight disability issues but, in general, international disabled people organisations (DPOs) lack influential representatives, for example, at the UN summit in New York this September. In Box 2, a description is given of several of the initiatives. Lack of political power at decisive levels is a structural feature of DPOs; nationally and internationally they are not sufficiently empowered to have a say in (international) decision-making. Disabled people are the ones who have the knowledge and experience to share with development organisations about how best to facilitate their inclusion. But many disabled people themselves, especially in low-income and developing countries, have very low expectations of advocacy and struggle with low self-esteem and power, stemming from the lack of education and stigmatisation in their communities. There is an urgent need for donors to address the issue of mobilization and the emancipation of people with disabilities more effectively.
3) Recognition of disability as a ‘cross-cutting’ issue
Disability is actually a cross-cutting issue affecting all sectors, although most NGOs and governments are not convinced of this. Disability is, however, not something to be found only in social protection schemes or medical rehabilitation work. Disabled people have rights to education, employment, poverty reduction and environmental programs and positive contributions to make, if they are given the explicit opportunity of participating. Disabled people are also affected by developments in all sectors, although at present, this goes largely unnoticed. Erratic and small-scale projects targeting localised groups of disabled people will continually fail to make sustainable differences if disability is not recognised as a cross-cutting issue. DCDD advocates a twin track approach: a focus on inclusiveness by integrating disability into broad sector development policies, with tangible, measurable benefits for people with disabilities, and a specific focus on people with disabilities in disadvantaged situations when needed.
4) Data and monitoring
The progress of the MDGs is monitored by using indicators. Currently there are very few examples of programs where disabled people are included as potential stakeholders and/or beneficiaries, and yet almost all the programs may affect them. Future mapping exercises, stakeholder analyses and other program-monitoring systems should routinely include and involve disabled adults and children, their needs and potential.
First steps to getting disability into the MDGs? I hope it is clear from this article that disabled people are unlikely to benefit from all the efforts made to achieving the MDGs. Not only because they are not a part of it, but also because the designed development strategies for achieving the MDGs, are not an inclusive process. The MDGs are doomed to fail if large groups in every society are excluded from poverty alleviation policies and measures. Although I believe that disabled people organisations (DPOs) should manifest themselves more at higher political levels in order to gain influence on the global development agenda, the road towards effective lobbying is a long one and is not always effective. Results in the short term might be expected if advocacy is directed more towards the design and implementation of development programmes themselves both at local and national levels. Both development programme initiators (governments, NGOs) and DPOs share a joint responsibility here. DPOs should make sure they are included in the steering of programmes and should contribute in a more practical and result-orientated manner. Governments and development NGOs have the ongoing duty of consulting all stakeholders; only by consulting disabled people in particular and making participation a truly reciprocal process will the best contribution be made towards a sustainable and measurable development of the whole of society for each and everyone of its’ members.
Mark Raijmakers
DCDD director
Notes
(*) In article 129 of the draft resolution of the New York summit it is stated that it recognizes "the need for persons with disabilities to be guaranteed full enjoyment of their rights without discrimination". Also, in this same article, a new 'disability' convention is referred to: "We also affirm the need to finalize a comprehensive draft convention on the rights of persons with disabilities."
(**) The Netherlands Platform Millennium Goals has its own website (in Dutch): www.maakhetwaar.nl
Box 1: Disability and the Millennium Development Goals
Part of the Millennium Declaration of the UN in 2000 were the Millennium Development Goals (MDGs) which consist of 8 goals. The overall goal is to halve absolute poverty (the proportion of people living on less than US$1 per day) by 2015. Below are listed some, but not all, of the main points regarding the relevance and importance of addressing disability in the attainment of each of these goals.
Goa1 1: Eradicate extreme poverty and hunger
• Of the estimated 600 million plus people with disabilities worldwide, 70% live in developing countries and, according to UN statistics, 82% live below the poverty line. The World Bank estimates that people with disabilities comprise about 17% of the poorest of the poor.
• Disability affects not only the individual, but also their families and communities, e.g. child carers of disabled family members who are not able to attend school. The lives of 25% of the population in poorer regions of the world are believed to have been impacted by disability - this represents a significant burden on the potential of productive human capital.
• As many as 50% of disabilities are preventable and directly linked to poverty.
Goal 2: Achieve universal primary education
• United Nations studies show that only 2-10% of children with disabilities in developing countries receive an education.
• The United Nations Centre for Human Rights estimates that only 2% of people with disabilities have access to rehabilitation and appropriate basic services.
Goal 3: Promote gender equality and empower women
• Women with disabilities are often doubly disadvantaged because of their status as women and as people with disabilities, and thus they represent one of the most marginalised groups in society.
• Women with disabilities are two to three times more likely to be victims of physical and sexual abuse than women without a disability.
Goal 4: Reduce child mortality
• The mortality of children with disabilities can be as high as 80%, even in countries where the overall under-five figure for mortality is below 20%.
• 1 in 10 children are born with, or acquire, a disability.
• For every child killed by armed conflict, three are injured or permanently disabled. Over 10 million children are psychologically traumatised by armed conflict.
Goal 5: Improve maternal health
• As many as 20 million women a year suffer disability and long term complications as a result of pregnancy and childbirth; hence, approximately every minute, 30 women are injured or disabled because of childbirth.
Goal 6: Combat HIV/AIDS, malaria and other diseases
• Disabled people run a higher risk of HIV infection because of their weaker socio-economic position; they also have less access to HIV-prevention information and run a higher risk of sexual abuse.
• The estimated annual global burden of malaria is 1.1 million deaths, 300-500 million cases. About 1 in 10 children suffer from neurological impairment after cerebral malaria, including epilepsy, learning disabilities and loss of coordination.
• Each year, 1% of the global population is infected with tuberculosis, and 5-10% of those infected become sick or infectious and can develop disabilities (e.g. epilepsy).
Goal 7: Ensure environmental sustainability
• Poor environmental quality is directly responsible for about 25% of all preventable ill-health in the world, with diarrhoeal diseases being the leading cause. Goal 8: Develop a global partnership for development
• The inclusion of people with disabilities into mainstream services is important, along with specialised interventions where necessary and would constitute a twin track approach to disability in all development activities.
Box 2: Make poverty reduction inclusive
Some initiatives that need support to make the MDGs more sensitive to disability
In May 2002, UNESCAP (United Nations Economic and Social Commission for Asia and the Pacific) adopted the “Biwako Millennium Framework”. This framework is structured to supplement the MDGs and its contents are a detailed description of how disability can be operationalized for the MDGs. More information is available at www.unescap.org/esid/psis/disability/bmf/bmf.html
Inclusion International (Global Federation of Family-based Organizations Advocating for the Human Rights of People with Intellectual Disabilities Worldwide) is committed to contributing to the achievement of the UN MDGs by identifying common objectives that will enable sustainable and comprehensive development, directed at realizing the human rights of all citizens around the world. Inclusion International has analysed the MDGs and reformulated the goals in such way as to make them relevant to people with disabilities. More information is available at www.inclusion-international.org/en/ii_priority_areas/mdg/index.html.
The Australian Council for Overseas Aid (ACFOA) in 2003 adopted a resolution about disability and the MDGs. The resolution recognises the integral link between disability and the achievements of the MDGs and is a call to strengthen development programming accordingly. The resolution is online at: www.acfid.asn.au/about/policies/disabilities.
Disability India Network (DIN) has launched a worldwide campaign to sign a “Petition for appropriate inclusion of disability in the MDGs”. At www.disabilityindia.org/mdg.cfm you can find the petition online.
This article was published in DCDD's newsletter 11, click here for the online contents of this newsletter.