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[Chapal Khasnabis]

Access to assistive technology is a human right, and a precondition for equal opportunities and participation- a basic need for most persons with disabilities. Need is rapidly increasing especially due to emerging again population but not the resources. There is a great inequity in terms of access to assistive technology among countries and even within the country. To improve access to assistive for everyone, everywhere WHO and UNICEF are coming with first ever Global Report on Assistive Technology with new data, evidence, case studies, testimonies and 10 key recommendations. Though CRPD outlined access to assistive products are a human rights issue and called for international collaboration (article 32) but very little progress has been made to improve access since the adoption of the CPPD. Assistive Technology gap between Global South and North is phenomenon and as the technology is advancing, the existing gap is widening. Recent COVID demonstrated the weakness of the Assistive Technology provision system across the world. Even in recent humanitarian crisis access, provision of life changing assistive technology is not a priority. A global movement led by the users and their friends/family members are needed right now to ensure no one is leaving behind.

[Peter Torres Fremlin]

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Great question Chapal Da! I’m afraid I’ve my response is more questions to you, to break down the different ways that it’s more of a priority or not.

First to separate out the difference in priority between organizations working on disability and those that don’t.

For organizations working on disability, how do you assess what the level of priority is, and the barriers that you’ve faced when you’ve tried to raise it further? I confess that, in my own work on disability, I haven’t raised this subject as much as it deserves. Part of that is the way our work gets silo’d into different areas; part of that is that I don’t know enough details of, say, how AT relates to the area I worked on, employment issues.

For organizations not relating to disability… how do you find the relevance they see in the framing of “assistive technology”? From the outside of the work, I do wonder what is the difference between “technology” (which is very fashionable) and “assistive technology” (which sounds niche).

Am sure you have lots of numbers that demonstrate this lack of priority – for instance size of investments in AT sector vs investments in disability-inclusive ODA. Or even, if you can estimate, the difference between investments in assistive tech that is articulated in many different places (such as glasses) and disability-specific services. It’s not clear to me which sector would be bigger.

I didn’t know that there was a movement of people in terms of being AT-users – I guess I will hear more about that and much more when the report comes out. Looking forward to it.

[Chapal Khasnabis]

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Thank you Peter.

We agree we need to unite AT users, their family members and caregivers and beyond.

Tragedy is many people who can benefit from accessing AT, do not know how AT can help them. They have not seen any role-models in their neighborhood either. Lack of awareness at every level, overpriced products cost and over-medicalized service provision approach do not help any one.

We need to change this trend and to do that, we need people like you in the forefront.

I am lucky I have friends and supporters like you – Chapal

[Pradeep Bagival]

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One of the reasons for AT not being a global priority is that it is yet to become a national priority for 80% of persons with disabilities living in developing countries . Access to assistive technology as a human right is an underlying factor for the realization of the twenty one articles of the CRPD ( Art, 5,6, 7,9,10,11,12,13,18,19,20,21,22,23,24,25,26,27,28,29 and 30) and  an enabling factor for persons with disabilities in enjoying fundamental rights and freedoms on an equal basis with others. UN entities such as WHO have a significant role in contributing to the AT from becoming a global and a national priority along with other entities such as ILO, UNDP, UNICEF, UNFPA , UNWOMEN and UNOHCHR. We would like to see more proactive role of UN especially in developing countries in prioritizing AT in the form of international cooperation as envisaged in art 32 of the CRPD.

Donor agencies who have been supported development programs need to consider the fact that  access to AT is a means to  achieve inclusive development and to transform the SDG principle  ‘leave no one behind’ from precept to practice. Access to AT should be an integral part of the national policy on disability in developing countries. Though majority of the national disability legislations uphold the right to assistive technology, national governments should under article 32 seek international cooperation in transfer of technology, exchange and sharing of information through training and research. When national governments become proactive, we will certainly see access to AT becoming a national and eventually a global priority.

We need more  individuals like Chapal to lead local , national  and global movements in making assistive technology a priority.  Before I conclude , I would like to recall accompanying Chapal and his team from Mobility India to the remote villages when I served as Assistant Commissioner for Disabilities in India and it was indeed a learning experience on how assistive technology can transform lives for persons with disabilities in developing countries.

[Chapal Khasnabis]

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Thank you Pradeep.

I still remember those old days.

Thank you for your continuous support.

We need leaders/champions at all level.

Honoured with your comments.

Regards – Chapal

[Daniel Mont]

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Building on what Peter said, at least from the perspective of people working on inclusive policies, the focus is usually on participation outcomes — going to school, going to work, starting a family, voting, etc. — AT is always mentioned as a necessary thing to achieve those ends, but often in a secondary way. “Hey, this is important, someone should do it” but right now we’re talking about building accessible schools, getting workplace accommodations or employment quotas, etc because we are education policy people or employment policy people, etc.  Clearly all this is needed, but people’s attention to policy is often siloed even though (obviously) people don’t live their lives in silos.

In our work on inclusive social protection we are trying to bring the focus on what supports — in-kind, cash, regulatory, etc. – are needed for full participation, which hopefully can put AT a but more in the center among people thinking about social protection policies. So they are not just focused on cash top-ups or things like that.

As an example, a study of the extra costs of disability in Indonesia as part of work done for the development of social protection policy showed that cost of AT was a barrier to participation, and so Indonesia is getting ready to pilot a program delivering subsidies for AT.

[Edward Winter]

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This is a great discussion and very important. I work for World Vision and we are a generalist NGO but looking to do better on supporting persons with disabilities. I am most familiar with the wheelchair sector, serving on the founding Board of the International Society of Wheelchair Professionals. I am shocked by how a wheelchair in many contexts is not seen as a medical service but as some kind of charitable donation. As a result, wheelchairs are often inappropriate, don’t last and don’t address mobility issues for that person. The chairs themselves are not maintained or replaced per guidelines. Even in countries like Colombia, that have approved payment for WHO assistive devices through medical insurance, they haven’t approved wheelchairs. You still need to complain to the court who will then grant you a chair. There seem to be several other constraints around improved wheelchair provision, largely stemming from the lack of a human rights understanding of the importance of access to wheelchair services:

1. A lack of wheelchair professionals embedded into health systems – this means that wheelchair provision is not seen as being part of the health system and this limits referrals from the health and rehabilitation providers to wheelchair providers. This also limits the quality of wheelchairs and the functionality of those chairs.
2. A failure to understand the cost-benefit of appropriate wheelchairs – by governments, NGOs and individuals. Wheelchairs are often cited as being too expensive but this calculation is not made against the cost of a child’s inability to learn or an adult’s ability to work or be productive. It may also lead to the provision only of the cheapest wheelchairs which don’t provide the mobility needed to enable school attendance or productivity.
3. Low supply and demand – because wheelchairs are not in high demand from government, NGO or private buyers, supply is limited and most countries don’t have a manufacturer or assembler of wheelchairs. This increases costs for manufacture and delivery.

Our current focus at World Vision is on supporting advocacy by organizations of persons with disabilities to national governments to enhance wheelchair provision, supporting referral to existing free assistive device provision where available and budgeting adequately for assistive devices in World Vision programs where free provision is not available. I am also pleased to support the ISWP’s work to train wheelchair professionals, promote wheelchair standards and to enhance the function of the industry as a whole.

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