London School of Hygiene & Tropical Medicine

An argument I often hear when I talk about including people with disabilities in health services goes something like this - “Yes, that would be good/nice/worthwhile, but it is too expensive/impractical/unrealistic”.

Essentially, there is a widespread belief that providing good healthcare for people with disabilities is a luxury, which we will get to once services are provided for the majority.

Let me try to dispel this myth.

Access to healthcare for people with disabilities is not a niche issue. There are one billion people with disabilities globally – equating to one in seven people overall. On average, people with disabilities have higher healthcare needs, both because of their underlying health condition or impairment, as well as their vulnerability to poverty and exclusion. As a consequence, more than one in seven people needing healthcare will have a disability.

People with disabilities often face many barriers to accessing healthcare, whether through inaccessible transport, lack of money, or negative attitudes of healthcare providers. These barriers mean that while healthcare needs are greater for people with disabilities, coverage of services will be lower. Altogether, there are large gaps in healthcare facing a large group.

Access to healthcare is also a fundamental right for people with disabilities, enshrined in the UN Convention on the Rights of Persons with Disabilities and in the laws of most countries. The issue is also a critical one in this Sustainable Development Goals (SDG) era.

The SDGs make a commitment to Leave No One Behind, and SDG3 aims to ensure healthy lives and promote well-being for all at all ages. Universal Health Coverage implicitly includes those with disabilities, so if we don’t ensure people with disabilities have access to healthcare, we will be violating international law and fail to reach the SDGs.

Maximising access to healthcare matters to people and is fundamental to achieving good health and wellbeing. If people are healthy, then other benefits follow like having a job, going to school or having friends – basically the things that are needed to live a good life.

What does it mean to improve healthcare for people with disabilities? It means a health service that is physically accessible and affordable, with healthcare staff that have positive attitudes about disability and diversity and the ability to communicate well with people, regardless of whether they have difficulties seeing, hearing, speaking or understanding.

These changes will improve health services  overall make them better able to treat other diverse groups – whether in terms of age, minority language, sexuality and ethnicity. It also means that rehabilitation services are integrated into the health system – as these services are often needed by people with disabilities, but also by other groups such as those recovering from injuries or surgery, pregnant women, cancer survivors and so on. Essentially, a focus on people with disabilities will make the healthcare system for all.

These arguments are the cornerstone of the new report The Missing Billion. Access to health services for one billion people with disabilities. Our ambition is that this report will persuade the global community that people with disabilities must be recognized as a key population that requires a long-term strategic approach, but also immediate action.

We must join together to close these healthcare gaps.