Having worked within the government, this question used to repeatedly surface before State Coordination Committee headed by the Minister in -charge of disability affairs in India. In some of the L/MICs , public transport services have been subsidized or provided free of charges. But persons with physical disabilities often find these services inaccessible due to barriers they face.
Given the fact that many LMICs are unable to allocate adequate resources to social protection for persons with disabilities on account of competing priorities, there has to be exemption /waiver of the cost of public services for certain ‘benchmark’ disabilities. Majority of persons affected by rare diseases experience disability resulting in limitations in Activities of Daily Living (ADL) and irrespective of their income level, struggle to meet medical expenses related to their treatment. For instance, some of the progressive provincial governments in India have created an exclusive health fund for persons with disabilities from low income group to access medicines and other health related services that are expensive in nature and associated with rare diseases.
While legislations in many low/middle income countries ( S.E. Asia) have subsidized education/health services for persons with disabilities , the provisions of the law often remain unimplemented and therefore there is a need for anti-discrimination commissions to be established and should function proactively to ensure social protection measures are disability-inclusive. I have meet families of persons with disabilities in S.E. Asia who were constrained to go to neighboring countries for rehabilitation services as the services were not available in their country and this ‘out of pocket expenditure’ had resulted in families falling back in poverty. The national govts need to take ownership of strengthening their health and rehabilitation services so that families of persons with disabilities do not have to incur out of pocket expenditure for health related services.
Tax exemptions such as Income tax/Profession tax for persons with disabilities and their families has been a significant step in some countries that has enabled families to meet disability related costs. Many countries have made provision for ‘Disability Fund’ and through public-private partnership to garner resources so that families of persons with disabilities with low income could be supported to meet additional expenses.
Social protection programmes result in enhancement of productivity and employability of persons with disabilities and thereby resulting in economic empowerment. National social protection policies should be fully disability- compliant with express provisions to support persons with disabilities and their families. Most importantly, through political will and leadership of the executive office in charge of disability affairs, governments in LMICs should ensure social protection policies and practices are able to address day-to-day challenges faced by persons with disabilities and their families.