EDITORIAL
The World Health Organization Disability Action Plan
S
ince the publication of the World Report on Disability (WRD) by the World Health Organization and the World Bank in June 2011, disability has become a prominent topic on the health agenda of the United Nations as well as in many countries around the world.1 This level of attention is excellent news for persons with disabilities as well as for rehabilitation professionals. The WRD explored, for the first time, the magnitude and scope of disability in the world. This landmark document reported that approximately one billion people in the world (approximately one in seven) live with a disability; more than 100 million are with moderateto-severe disability. Perhaps more importantly, the report concluded that persons with disabilities have poorer health, are two times more likely to find healthcare provider’s skills and facilities inadequate, are three times more likely to be denied care, have lower educational achievement, participate less in the economy, and have higher rates of poverty.1 The importance of this report for the field of PM&R, including academic organizations, was highlighted in an editorial that the author wrote in 2012.2 In January 2014, a special issue of the AJPM&R3 was dedicated to the implementation of the WRD in several countries representing the different geopolitical areas of the World Health Organization. That issue included an analysis of the WRD, a discussion of the challenges of implementing the report’s recommendations, and articles that analyzed the response of several countries to the report including (in alphabetical order) Argentina, Ghana, Indonesia, Mexico, Saudi Arabia, South Korea, Sweden, and the United States. It is evident from these articles that disability, in all its dimensions, is an important issue in all countries and is not limited to certain areas, demographic facts, or environmental conditions. Recently, in May 2014, the World Health Assembly approved an action plan to address the issues raised by the WRD.4 This new document titled BBetter Health for all People with Disability[ is an action plan developed with the active participation of many individuals, groups, and organizations including the International Society of Physical and Rehabilitation Medicine. The vision of the action plan is Ba world in which all persons with disabilities and their families live in dignity, with equal rights and opportunities, and are able to achieve their full potential.[ The action plan describes the strategies that all countries of the world should implement during
the next 7 yrs (2014Y2021) to achieve the following three main objectives: a. Remove barriers and improve access to health services and programs b. Strengthen and extend rehabilitation, habilitation, assistive technology, assistance and support services, and community-based rehabilitation c. Strengthen the collection of relevant and internationally comparable data on disability and support research on disability and related services A detailed analysis of each of these objectives including specific actions and the identification of metrics of success is included in the plan. With an emphasis on developing and expanding services, improving access, conducting research, and an implicit commitment to education and training, this action plan is simultaneously a challenge and an opportunity for physical medicine and rehabilitation. A challenge because it is an ambitious plan that attempts to address a very complex situation. For example, the range of impairments include mobility limitations to dysfunction of the senses such as visual and hearing loss. Furthermore, the nature of the interaction between the impairment and the environment varies from country to country, and solutions have to be adapted to local factors and the availability of resources. On the other hand, it is an opportunity because our agenda as a field of practice and inquiry is very similar to that of the World Health Organization as outlined in the plan. The plan promotes the integration of rehabilitation services at all levels including the traditional healthcare systems and the community. Furthermore, it highlights the importance of education and research in achieving these goals. The report strongly encourages PM&R to be part of the solution, and we should be! Walter R. Frontera, MD, PhD Editor-in-Chief Vanderbilt University Medical Center Vanderbilt University School of Medicine Nashville, Tennessee REFERENCES 1. Available at: www.who.int/disabilities/world_report/2011/en/ 2. Frontera WR: The world report on disability. Am J Phys Med Rehabil 2012;91:549
0894-9115/14/9309-0737 American Journal of Physical Medicine & Rehabilitation Copyright * 2014 by Lippincott Williams & Wilkins
3. Gutenbrunner C, Stucki G, Nugraha B, Bethge M: The world report on disability: A challenge for rehabilitation medicine (supplement). 2014;93:S1Y72
DOI: 10.1097/PHM.0000000000000183
4. Available at: http://www.who.int/disabilities/actionplan/en/
www.ajpmr.com
Editorial Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
737
The World Health Organization Disability Action Plan
S
ince the publication of the World Report on Disability (WRD) by the World Health Organization and the World Bank in June 2011, disability has become a prominent topic on the health agenda of the United Nations as well as in many countries around the world.1 This level of attention is excellent news for persons with disabilities as well as for rehabilitation professionals. The WRD explored, for the first time, the magnitude and scope of disability in the world. This landmark document reported that approximately one billion people in the world (approximately one in seven) live with a disability; more than 100 million are with moderateto-severe disability. Perhaps more importantly, the report concluded that persons with disabilities have poorer health, are two times more likely to find healthcare provider’s skills and facilities inadequate, are three times more likely to be denied care, have lower educational achievement, participate less in the economy, and have higher rates of poverty.1 The importance of this report for the field of PM&R, including academic organizations, was highlighted in an editorial that the author wrote in 2012.2 In January 2014, a special issue of the AJPM&R3 was dedicated to the implementation of the WRD in several countries representing the different geopolitical areas of the World Health Organization. That issue included an analysis of the WRD, a discussion of the challenges of implementing the report’s recommendations, and articles that analyzed the response of several countries to the report including (in alphabetical order) Argentina, Ghana, Indonesia, Mexico, Saudi Arabia, South Korea, Sweden, and the United States. It is evident from these articles that disability, in all its dimensions, is an important issue in all countries and is not limited to certain areas, demographic facts, or environmental conditions. Recently, in May 2014, the World Health Assembly approved an action plan to address the issues raised by the WRD.4 This new document titled BBetter Health for all People with Disability[ is an action plan developed with the active participation of many individuals, groups, and organizations including the International Society of Physical and Rehabilitation Medicine. The vision of the action plan is Ba world in which all persons with disabilities and their families live in dignity, with equal rights and opportunities, and are able to achieve their full potential.[ The action plan describes the strategies that all countries of the world should implement during
the next 7 yrs (2014Y2021) to achieve the following three main objectives: a. Remove barriers and improve access to health services and programs b. Strengthen and extend rehabilitation, habilitation, assistive technology, assistance and support services, and community-based rehabilitation c. Strengthen the collection of relevant and internationally comparable data on disability and support research on disability and related services A detailed analysis of each of these objectives including specific actions and the identification of metrics of success is included in the plan. With an emphasis on developing and expanding services, improving access, conducting research, and an implicit commitment to education and training, this action plan is simultaneously a challenge and an opportunity for physical medicine and rehabilitation. A challenge because it is an ambitious plan that attempts to address a very complex situation. For example, the range of impairments include mobility limitations to dysfunction of the senses such as visual and hearing loss. Furthermore, the nature of the interaction between the impairment and the environment varies from country to country, and solutions have to be adapted to local factors and the availability of resources. On the other hand, it is an opportunity because our agenda as a field of practice and inquiry is very similar to that of the World Health Organization as outlined in the plan. The plan promotes the integration of rehabilitation services at all levels including the traditional healthcare systems and the community. Furthermore, it highlights the importance of education and research in achieving these goals. The report strongly encourages PM&R to be part of the solution, and we should be! Walter R. Frontera, MD, PhD Editor-in-Chief Vanderbilt University Medical Center Vanderbilt University School of Medicine Nashville, Tennessee REFERENCES 1. Available at: www.who.int/disabilities/world_report/2011/en/ 2. Frontera WR: The world report on disability. Am J Phys Med Rehabil 2012;91:549
0894-9115/14/9309-0737 American Journal of Physical Medicine & Rehabilitation Copyright * 2014 by Lippincott Williams & Wilkins
3. Gutenbrunner C, Stucki G, Nugraha B, Bethge M: The world report on disability: A challenge for rehabilitation medicine (supplement). 2014;93:S1Y72
DOI: 10.1097/PHM.0000000000000183
4. Available at: http://www.who.int/disabilities/actionplan/en/
www.ajpmr.com
Editorial Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
737
