For the first time, the World Health Summit held a high impact session centering health equity for disabled people. The enthusiasm of leaders from around the world underscored the need to address disability justice in all future health summits. I had the honor of moderating this historic session in Berlin on October 13, 2024.
Key takeaways:
- Encourage health organizations to adopt the WHO Global Report on Health Equity for Persons with Disabilities.
- Recognize that many advocates are calling for a shift from person-first language to identity-first language.
- Civil rights laws and policies protecting disabled people should also include psychiatric disabilities and other non-apparent disabilities.
- Prioritize funding for accessibility. Many Deaf people have to pay for sign language interpretation during medical visits, which many can’t afford. Deaf/disabled people should not have to shoulder these costs.
- Health organizations should take ownership of accommodations for disabled people just as they provide accommodations to nondisabled people.
Our wonderful speakers:
- Dr Jérôme Salomon (Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases, World Health Organization)
- Dr R. Vensya Sitohang (Director of Productive and Elderly Age Health, Ministry of Health, Indonesia)
- Hon María José Plaza (Former Member of Parliament, Ecuador)
- Ms Haben Girma (Disability Rights Advocate & First Deafblind Graduate of Harvard Law School, USA)
- Ms Hellen Anurika Beyioku-Alase (Executive Director, Deaf Women Aloud Initiative, Nigeria)
- Mr Jarrod Clyne (Deputy Executive Director, International Disability Alliance, Switzerland)
- Ms Rachel Veldkamp (Health Messenger, Special Olympics, Suriname)
- Ms Natasha Smith (Australian Ambassador to Germany, Department of Foreign Affairs and Trade, Australia)
Watch and share the YouTube video recording of the session. It has English captions and International Sign Language interpretation, and a transcript is below.
Thank you to the World Health Organization, ATscale, Clinton Health Access Initiative, CBM, London School of Hygiene and Tropical Medicine, Missing Billion Initiative, SightSavers, and the Special Olympics for co-sponsoring this event.
Video
Descriptive Transcript
It starts with colorful triangles rotating to form three pyramids around a circle. A small World Health Summit logo is on the left, which is a triangle inside a square inside a pentagon inside a circle. Text reads: “World Health Summit October 13 – 15, 2024 Berlin, Germany and Digital. Building trust for a healthier world.” The video alternates between close-up footage of speakers with a title slide providing their name and title, and long-distance footage showing some of the audience. A podium stands in front, flanked by two long tables. Behind them is a blue backdrop and a monitor showing the text: “Health Equity for Persons with Disabilities to Achieve Health for All.”
Haben Girma: Welcome! We have such a full house today. I am really excited you chose to be here. This is Health Equity for People with Disabilities at the World Health Summit 2024. Now, I want to talk about communication. Traditionally, we are told that to listen, you have to sit still, be quiet, and listen with your eyes. But not everybody listens that way. Some people listen with their ears. Some people are not comfortable making eye contact or can’t make eye contact. Some people need to move and stretch to process what is going on. So, we are going to roll model accessibility, and you do what you need to do to feel comfortable listening. If you need to get up and leave the room to go to the restroom, this is being recorded, so you could catch the rest later.
My name is Haben Girma. I am Deafblind. I have limited vision and hearing. My older brother is also Deafblind. And he grew up in Eritrea, and the doctors told him, “We can’t help you.” And the schools told him, “We are sorry, we can’t help you.” And my parents were very worried. What can we do for a Deafblind child? I was born in California. And when my parents found out I was blind from the doctors, the doctors told them, “Don’t worry. She will find other ways to do things. She can learn to read Braille. She will get a white cane, a guide dog. She’ll have teachers instructing her, and she can do anything she wants to do when she grows up.” And getting that kind of message from our healthcare system was profound for my parents. And my older brother also soon got access to assistive technology, training, and sign language.
In the United States and around the world, that is very rare. Most doctors just feel uncomfortable or don’t know all about disability culture, like how to schedule sign language interpreters for visits. How do you weigh someone who has a wheelchair? Those are a lot of things healthcare systems struggle with. Today, we will talk about how do we get to the dream where everyone has access to healthcare. Whether you are disabled or nondisabled, whether you live in Eritrea or the United States, you should all have access to healthcare.
I got really good access to health and school and graduated from Harvard Law School as their first Deafblind student. I worked as an attorney and we sued some hospitals that were discriminating against disabled people. So it is a civil rights issue. And I am now a commissioner with the World Health Organization Commission on Social Connection, part of the health is access to connection. Community groups, communication access and for this presentation I am using a Braille computer and keyboard. I will read what speakers say in Braille. My typist is typing that. You will notice a delay between when someone speaks and when I respond. That’s because the communication is coming through.
Part of accessibility is patience. Make time for different kinds of voices. Voices that speak, voices that sign, voices that use assistive technology. So, we need to change our cultures. At our health systems, at our medical schools, so that we are training doctors and care providers to treat disabled people with respect and make sure we have equal access to healthcare. We have a lot of amazing speakers today. Our first one is Doctor Jerome Salomon. He’s Assistant Director-General for the World Health Organization. Dr Salomon, the lectern is yours. (Applause)
Jerome Salomon: First of all, thank you. Thank you very much dear moderator, dear Haben for your inspiring words. Your Excellency, Ambassador Smith, Deputy Permanent Secretary Rumatila, dear colleagues and friends, good afternoon. It is a real pleasure to be here with you today. I will like, I would like to thank all the partner co-hosting organizations. Sight Savers, International Disability and Developmental Consortium, Clinton Health Success Initiative, Special Olympics, the Missing Billion and the London School of Hygiene and Tropical Medicine. It has been a great collaboration to organize this event together.
My presence here demonstrates the importance of this agenda for the World Health Organization. Just now, in the very next room, our Director-General Dr Tedros Adhanom Ghebreyesus is speaking at the women’s leadership and trust event, mentioning the importance of health equity for women and girls with disabilities. Today is the first time that an event entirely focussed on equity for persons with disabilities is held at the World Health Summit. It is our hope this will not be the last and that health equity for persons with disabilities will be featured in future World Health Summits.
This is important because we know that compared to the general population, persons with disabilities die up to 20 years earlier and have poorer health, due to unjust and avoidable factors. The health sector is not addressing these health inequities and persons with disabilities are left behind. As we show in our global report on health inequities for persons with disabilities. The good news is that we know what to do and we have already outlined it in the global report. Targeted disability inclusive actions, as part of our primary health care efforts, and as a part of every country’s journey towards universal health coverage is what is needed. Advancing Disability Inclusion in the health sector is not a choice any more.
There are 1.3 billion people with significant disabilities in the world and we know that investing in Disability Inclusion in the health sector has benefits for the economy and society. WHO estimates that every US dollar spent on disability inclusive noncommunicable disease prevention and care yields $10US of increases healthy life years and human capital. WHO is aware of the importance of making good investments. Tomorrow, the Director-General, Dr Tedros will be speaking on WHO’s investment round to anchorage and secure funding for the WHO to support countries to address global health priorities. Our investments need to be smart ones. Ensuring everyone has equitable access to healthcare, including persons with disabilities.
WHO is moving the Disability Inclusion agenda forward in three key ways. First, WHO is bringing stakeholders together under a common vision for coordinated action towards health equity for persons with disabilities. This will be done through our new global health equity and disability platform to be launched in 2025. In fact, in the last two days, we held the first global consultation meeting here in Berlin with experts working in the disability and health space. Second, we are mainstreaming disability in our own house, through the implementation of the United Nations Disability Inclusion strategy across our business operations and technical programs. Third, WHO is supporting ministries of health to develop national action plans to advance Disability Inclusion in the health sector through the WHO Disability Inclusion Guide for Action, a planning tool which will be launched soon.
However, WHO cannot do this alone. Every stakeholder has a role and links listening to and acting on the voices of people with disabilities is fundamental. I thank the International Disability Alliance for its close collaboration with WHO and of course the heavy lifting on health inequity for persons with disability should not be left to the NGO sector only. All stakeholders share this responsibility, which makes this event during this World Health Summit so important. If we want to achieve Health for All, we must prioritize health equity for persons with disabilities as part of the global health agenda. We look forward to continuing to work with you, thank you so much. (Applause)
Haben Girma: Thank you Dr Salomon. We now have with me here to my right Rachel Veldkamp from Suriname. She is the Special Olympics Health Messenger. Can you introduce yourself?
Rachel Veldkamp: Yes. Hi. Before I begin, I have some pictures. So, to remember me when I am talking with, ok… yes. My name is Rachel Veldkamp. I am from Suriname. When I was young, I found out I have a intellectual disability. I also found out that I love swimming. I want to… sorry… I went to a special school, where my support teacher told me about the Special Olympics. I competed in swimming for 15 years and I won 95 medals. Besides swimming, I have a small business, where I work with wood and painting, because I enjoy working with my hands. I work to earn money for my health and to take care of my house. I got married three months ago and now my husband and I pay for our health, and, yes for our health and bills together. I am also a Health Messenger for Special Olympics Suriname. As a Health Messenger, I teach other athletes, like me, about health, about healthy eating and exercises. Today, I am here to speak about the needs and the rights of people with intellectual disabilities, called ID&I.
Haben Girma: That was fantastic. You found your passion, swimming. You found joy through creating with your hands and you found love. Congratulations on your recent marriage. (Applause)
Rachel Veldkamp: Thank you.
Haben Girma: A lot of people in healthcare assume that disabled lives are worse than they actually are. A lot of people wonder, can disabled people be happy? Can disabled people have relationships? Or jobs? Or swim? And you were teaching us a lot that we can do things if we are supported. And I don’t know a lot about Suriname. Can you share a story about what it is like trying to get healthcare there?
Rachel Veldkamp: Yes. Being healthy is very important. It is like having a strong body. If you want to be a great athlete you need to–you need a strong body. It is hard to play sports or do your best if you are hurt. Exercise is important for good health. I once got hurt while training. My back hurts a lot and didn’t go away. I went to go to the doctor, they gave me medicines and told me to do exercises and I got physiotherapy but the sessions were too expensive and I couldn’t pay for them. So, I had to keep feeling the pain. I can’t swim when I’m in pain. Sports and health services should not be only for rich people.
Haben Girma: It is frustrating to not be able to access healthcare because of financial barriers. And I have heard that from other disabled people all over the world. That money is often a struggle. What do you think should be a solution? What should organizations do in Suriname to help people get access to healthcare?
Rachel Veldkamp: In Suriname, people with disabilities, like me, found it hard to do everyday things. The Government helps by giving us a small bit of money each month, about 9 euros, but signing up for this is like solving a puzzle. Some people can figure it out. So they don’t get any help. Even for those who do get the money, it is not enough to pay for everything. We… I mean it’s like medicines, and special exercises called physiotherapy. It’s like trying to fill a big bucket with a tiny cup. Families of people with disabilities have to work really hard to pay for everything. They want to give their loved ones the best life, but it is very difficult.
Haben Girma: Yeah, it is very, very difficult. It sounds like. And in other places too, when there are supports for disabled people, often there’s a lot of administrative bureaucracy that makes it difficult, and if you have an additional cognitive disability, or you’re facing barriers to even access those supports, that’s a problem. So, I want to ask, are there any final comments, advice, or stories you want to share?
Rachel Veldkamp: Yes. We can do more together than we can do alone. Anyone needs to work together to help people with disabilities stay healthy. And we all want to be happy, to be healthy and happy. It’s important to listen to people with disabilities. We should be part of the talks about how to make things better. We should never make decisions about people’s lives without talking to them first. Thank you. (Applause)
Haben Girma: I absolutely agree. We should all be listening to disabled people. Nothing about us without us. My assistant just gave me a secret message. Thank you for that! (Laughter) so, talking about listening to disabled people, disabled people in Australia have been coming together to advocate for change and it’s been really moving to learn about what’s happening in Australia, and today we are very lucky that Her Excellency Mrs Natasha Smith, Australia’s ambassador to Germany, is with us today. Miss Smith, can you take the lectern? (Applause)
Natasha Smith: Thank you very much, Haben and can I thank the organizers for the opportunity to contribute to this important side event today. I have to say I am both honored and humbled to be part of this event. I am not someone who is living with a disability. But I have worked on these issues in the past and feel very passionately about them, as someone whose background in development and human rights as well. The health inequities that are experienced by people with disabilities are stark. And they are as stark in countries like Australia as they are anywhere else.
We know that people with disabilities have difficulty accessing health services that meet their needs and support them to lead healthy and fulfilled lives. And that the unfair conditions people with disabilities experience throughout life means they often experience poorer health outcomes, compared to people without disabilities. The WHO global report, as Jerome has shared with us, really highlights these equities, inequities and frankly calls on all WHO Member States to take action to advance health equity for people with disabilities. It empathizes the need for political leadership, for adequate resourcing and most importantly to work together with people with disabilities. As you say, Haben, nothing about us without us.
I want to share very quickly some of the examples of what we are doing in Australia to answer that call. Both domestically but also in our support for other countries and the political leadership in other places. We are proud of the steps we have taken to invest in good policies and programs that address the factors that contribute to health disparities. Firstly through Australia’s disability strategy 2021-2031 where the Government has really recognized the importance of ensuring that all health insurance providers have the capabilities to meet the needs of people with disabilities and importantly people with disabilities are empowered and able to make their own decisions about their own health. This was developed in consultation with people with disability, and the strategy reflects our commitments under the United Nations’s Convention on the Rights of Persons with Disabilities.
Commitments we take very seriously. We are also focused on addressing the serious health inequities faced by people with intellectual disability. Through our national road map for improving the health of people with intellectual disability, which was released in 2021. Priority actions underway including improving the knowledge and skill of health professionals to be able to provide high-quality healthcare. Often it is not that health providers don’t want to, it is that they don’t know how to and that is an important role that Government can play to help with.
We are also now working on a new national autism strategy, which will be released next year. Disability rights, as I said, is something we are very focussed on and committed to domestically but also an integral part of Australia’s international engagement, including our engagement on health. As highlighted in our international development policy which was released last year, Australia is committed to advancing the rights of people with disability to prioritizing and to prioritizing disability equity as a core priority for action in our aid program.
We are also developing a new international disability equity and rights strategy which will contribute to the outcomes of our overarching international development strategy. It will replace the development for all program or strategy that we’ve had since 2015. We have been very proud to be a leader in this space internationally. The first Australian international development disability strategy was actually released in 2009. But it doesn’t mean that the job is done by any means and there’s so much more for us to do. We are working throughout our region to support our partner Governments to progress health equity for persons with disabilities.
We have provided support to the Fiji Government, for instance, as they have developed and are implementing their national disability for inclusive health and rehabilitation action plan. We have also supported this policy and action plan through practical partnerships that look at how to empower and enable people with disability to access health services. I am getting the wind up, so I will go faster. Sorry! I have to especially with Evensia (?) here with us, also note that we have through our Australia Indonesia security partnerships supported disability inclusive approaches to vaccinations during COVID-19 and one of the outcomes of that wasn’t just making sure that vaccinations were provided to people with disability, but it is actually led to an improved recognition amongst local Governments in Indonesia for the need for inclusive public services and for the enactment of provincial regulations for Disability Inclusion.
We are committed to ensuring – I am going as fast as I can. 30 seconds. Committed to ensuring that all our health partnerships, our whole international development program as well as our domestic services are inclusive for people with disabilities. And we are committed also that, to the global leadership and multilateral action in this space as well. Through our co-chairing of the inclusive health working group in GLAD the Global Action on Disability Network and our ongoing commitment and work through the committee of the rights of people with disabilities and our partnership with WHO, including through the International Disability Alliance. There’s more to be done. Lots more to be done, but this panel is a really good example of how the Disability Inclusion is now really becoming part of the health discussion broadly through the World Health Summit. Thank you. (Applause)
Haben Girma: Thank you, Ambassador Smith. We have a panel that is coming up next. And on this panel, we have from Nigeria, Helen – let me do this… Helen, can you introduce yourself? (Laughter)
Visual Description: Hellen smiles and starts signing. An interpreter voices what she signs.
Hellen Anurika Beyioku-Alase: Hello, everyone. My name is Hellen Anurika Beyioku-Alase. I am a deaf woman. I became deaf in 1994 and what caused this deafness? Just one morning I went to school, came back and had a little fever. I felt feverish and my mum took me to the hospital. At the time, there were no cell phones and the doctors and nurses just gave me an injection and then that injection led me to the world of silence until this day and that did not stop me from progressing in life. I enrolled in a deaf school, learnt sign language and this is just my deaf history. Thank you. (Applause)
Haben Girma: Thank you Hellen. I apologize for struggling with your last name. So Hellen is also Executive Director of Deaf Women Aloud Initiative and I want to ask Hellen, what are some of the challenges facing deaf women when it comes to access to healthcare?
Hellen Anurika Beyioku-Alase: Thank you very much for the question. To start with the challenges, you know we have legislations about disability. We have the universal health coverage, which talks about everyone having access to health services regardless of their status. Regardless of their race or disability, have access to quality health services without any financial hardship. Also we see situations where we have other legislations, like the UNCRPD, other protocols that are readily available and also we have the African protocol on disability.
We have articles there that stipulates about health equity and access for persons with disabilities. Also we talk about the Sustainable Development Goals, all these recognizes the needs of health for persons with disabilities. For me, as a deaf woman, having access to health services or equity for disabilities is a challenge, especially when it comes to the models of disability for which health professionals, you know, approach us, most times where we access health services they tend to look on more on the impairment or disability rather than what actually is the reason for, you know, such visits. So, the attitude is actually a huge barrier. Attitude of healthcare workers towards persons with disabilities, who are sick and for healthcare.
And 12 years ago, I went to the hospital for my antenatal care, when I was pregnant. You know, as a, you know, deaf women also have access to healthcare – you agree with me? So, yes, I went to the hospital very early, just like everyone and you know, that in the collection form, there is nowhere to fill in you have a disability or no disability. Just like everybody we are just sitting waiting for the healthcare workers to come. So, numbers would have to be distributed to everyone to come in according to your own number. But I was there, and no one was able to, you know, attend to me. There’s no form of identification of if you have a disability or if there is special accommodation to be given to you. So, it was really frustrating.
So, communication at the hospital was a challenge, no sign language interpreters to explain to me what was going on. So the stigma that you see there, at the hospitals, and due to this it becomes very difficult for deaf women to follow truly with what is happen. They talk about equipments and the assistive technology in terms of, you know, trying to take the weight of, measure of pregnant women who are in wheelchairs the challenge is there and when the doctor is trying to diagnose what actually is the issue, the lack of communication would sometimes make the doctors to misdiagnose and you know, most of this leads to serious health conditions which actually affect women.
Deaf women get married (inaudible) get married and we also we raise families, too. So, talking about antenatal services, the type of quality for which access to contraception for instance because of the SRHR needs for all, so we don’t have the opportunity to make the right choices. Most time, they just assume that this model, this is okay for you, just assume that is perfect for you to go for maybe contraception, stuff like that. So this most times, the systems are different and most of them when these decisions are made on behalf of the women with disabilities it actually affects them. So these are just a few of the challenges we face. Thank you. (Applause)
Haben Girma: Thank you, Hellen. Also we have from the International Disability Alliance Jarrod Clyne, Deputy Executive Director. And I want to ask Jarrod: What are the problems of those with disabilities?
Jarrod Clyne: Thank you, Haben. Firstly, I would like to acknowledge it is a very diverse population, right, so the experience of a Deafblind woman in Eritrea or California is very different in Suriname. There is difference in diversity across impairment type, so that means the response also needs to be individualized while also addressing systemic barriers. I think that clearly the common experience though is of exclusion, marginalism in health systems and society more broadly and that is the key question we are wrestling with today and I guess for many years to come.
Historically, at best, Governments have focused on prevention, or rehabilitation or assistive technology but not tended to look at health systems so holistically. That is a major challenge and a major problem. That is not to say, of course, that prevention policy is not legitimate or that rehabilitation and AT is not a very essential issue. AT helps unlock the every day. There is a huge unmet demand for rehab as well and those are all important but we also have to look at the bigger picture. And that is to consider the issue of health equity for persons with disabilities.
I think that if, you know, if we ask questions and thoroughly, and the amazing WHO global report, what other rates of NCDs of persons with disabilities compared to others; are women with disabilities getting accessible and quality reproductive health services or not? Are children with disabilities being immunized at the same rate as others? Are people with psycho-social disabilities receiving cancer screening at the same rates as others or are there still barriers to those services. The answer is clear if we look at the evidence that there is a considerable gap in their equity and that is for many different interrelated republics, but we have to acknowledge also that there are many legal barriers.
Many people with disabilities are not allowed to make decisions for themselves. That is a huge barrier. There is inaccessible information for various reasons, whether it is you are deaf and you cannot communicate with the doctor or the information is not an easy read for persons with intellectual disabilities. There’s physical inaccessibility, attitudes of health workers, as we have heard, discourage people with disabilities from seeking health treatment. We also have to say, as mentioned in Suriname context, that affordability is a huge one, a huge factor. This brings us to issues like the underlying and social determinants of health. Persons with disabilities have very little political power. That are excluded from education and employment.
They have less money than other people so they can afford less services and often those costs are not socialized, right, imposed on the individual. So, clearly, there are really significant systemic challenges, and barriers and the response also has to be systemic. That is what has been missing. We need to reframe our expectations of what health systems can and must deliver for persons with disabilities, particularly those with higher support needs and additionally we do need stronger political commitment.
Australia is probably the leading country in the world in having a very coherent approach, but domestically and in the context of international co-operation, but that is surprisingly rare. We also have a lot of positive language about involvement of persons with disabilities through their representative organizations. But actually, integrating organizations of persons with disabilities and policy design monitoring and implementation is also very rare. So, there are lots of things that can be done. That is quite a big list. But at the same time, what we didn’t have before, before the global report, a year-and-a-half ago, two years ago, was the right framing, the right narrative.
So, we understand what we need to do: It is reduce the health equity gap for persons with disabilities. We now have guidance from WHO on how to do it. We have 40 recommendations. Producing a tool, a guide to action. And have a platform. All of the constituent elements and theories should be in place. We are really conscious all of that is still just words on paper until we have the national level action and then we can be inspired by examples like Australia and the US and other places and learn a lot from good progress, but it is a shared challenge and a shared responsibility. Thank you. (Applause)
Haben Girma: We have such different situations around the world. But studying some of the solutions that each community has can help ideas from what other communities can do to address these challenges. So, I want to ask Hellen and Jarrod, if you can share two action stamps that advocates and health organizations can take to address the health challenges people with disabilities are facing? So, let’s start with Hellen and then Jarrod. What are two recommendations you can share?
Hellen Anurika Beyioku-Alase: Thank you very much for the question again. So, as you know, we have various provisions and implementation. We have policies and legislations, challenges on implementation. So, I think first of all, would want to have ownership of most of the interventions, that different organizations like NGOs, you know, bringing up when Government decides to own these projects, projects, and adopt them afterwards example, thanks to the Australian Government, there was a project funded in Nigeria, which ensured having sign language interpreters in hospitals. Now that project ensured sign language interpreters in selected hospitals but at the end of the project, the service ended.
If the Government actually had gone ahead to adopt such a project it would have gone ahead and sustained up until now. That is an issue of ownership and we also have, when Government decides to own these projects and continue with them, that is, you know, we talk about sustainability it goes on that. The second I would like to recommend would be about being intentional, it is very important for us to be intentional about developing projects and developing ideas, policies that you know, having that intentionality to ensure persons with disabilities are carried along and their health needs are duly taken care of.
It could be in the forms of budgetary allocation, increased budgetary allocation or development of more projects that would contribute to our health needs. So, these two recommendations, ownership and intentionality, I think it will go a long way to create more access to healthcare for persons with disabilities and to a large extent reduce the stigma, reduce the challenge that we, you know, experience in the field. So we need to show commitment and continue to help us to have access to healthcare services. Thank you so much. (Applause)
Jarrod Clyne: I will answer now, if that is ok, Haben. So on my side I would highlight also two things. The first is, participation and the second is accountability. And they both relate to each other. But, on participation, I mean in the health sector, of course, the issues that arise are quite individual. So that is why often collective action through organizations are persons with disabilities which provide a representative function and to take account of the diversity of experiences of persons with disabilities can be a very useful and the institutional support can also play a leading role in the designing policies, providing feedback and monitoring.
And also on accountability, this can take various forms. Of course, legally, strictly, we rather hope that the CRPD and ratification and regular reviews and this would lead to long-lasting societal transformation in all sectors, including the health sector. If we are being really honest we have not seen it in the last 15 years. We need to reflect on that. Whatever form that accountability can take, with a legal or political and it needs to rely of course also on the data side as well.
We need to think how we can measure the inequity gap and then address it. And without that accountability, we’ll have probably empty promises for another 15 years. But finally, while I have the floor, I think the key point is that looking at the broader inequalities, the historically accumulated inequalities have deadly consequences. We saw that during COVID and then even afterwards, I guess things have not quite got to the place they should. I hope for participation and accountability can be the next steps. Thanks. (Applause)
Haben Girma: We have brilliant expertise in our panels here and this is your opportunity to ask them questions. So if you have a question, raise your hand, and Miriam will pass you the microphone.
New Speaker: Thank you, Haben, we have a couple of hands. One in the front row. Do you want me to pass the microphone from this end? I can do so. Please introduce yourself and where you are from.
Paulina: Thank you so much, everyone. My name is Paulina. I am here representing the Youth Health Organization and I am also myself chronically disabled. This is my second time at the World Health Summit. Last year, there was not a single panel that talked about disability. What is your experience of disability in the healthcare system, and it was very frustrating, as the first big international event to come here and to see that the people who are discussing what is relevant in, for me and for my daily life, don’t actually discuss it.
And I was at the World Health Assembly this year as well. I was the only person with a service dog. And most of the staff had no experience with how to deal with a service dog. Even doubted it was mine because I don’t look disabled. And I wanted to say a huge thank you for doing this. This means so much and I am close to tears for the whole time because A, seeing another person with a service dog being represented, but also just seeing people like me talking about our lives and our experiences just means a lot. Because we have been here forever and you either die young or you become disabled. This is not irrelevant. This is not a small part of the population.
So, thank you. And as for my question, I was wondering because it is a question that I spend a lot of time with, talking about it, topic, it’s the wording we use. Because Haben, you used “disabled” and I also use the word and identify myself as disabled, not a person with a disability. Because I think I am not the problem, the lack of accommodation for me is the problem. Where’s the name of this panel and the wording that some people use, is persons with disabilities, which implies that I am the problem, that I have something that needs to be fixed. But it is nothing that needs to be fixed.
I am a valuable human the way I am. I just want to participate in society. And that needs accommodation. So I was wondering why each of you uses different language, especially if you don’t choose disabled? And what is your view on the topic? Because I think the more that it is coming up as a discussion topic in the global health sphere right now we should address the proper wording we use, especially, yeah. Thank you. (Applause)
Haben Girma: Thank you so much for saying that. This is so important to be talking about health equity for us at the World Health Summit and we should be having panels like this every year, so that it becomes normal and everyone working in health thinks about disability. The language we use is different all over the world. And when we have international events like this, with people with different need of languages, different sign languages, different cultural preferences, we start to notice how we talk about disability all differently.
From the American disability perspective, many advocates are saying you know by 2024 we should know that disabled people are people. Do we really need to remind ourselves that these are people? Can we talk about it just the way we talk about women? Or other groups, without having to remind ourselves over and over again that we are people? So, some advocates are saying, identity verses language, let’s celebrate disability. We are not ashamed. We don’t want to hide it. We want to be able to bring our full selves to medical school, to the hospital, to the Health Ministry and get full respect. I want to turn it over to our panel, you have thoughts you want to share on language, Hellen or Jarrod.
Hellen Anurika Beyioku-Alase: Yes, Hellen. Thank you very much for the question. So truly everyone has the way they want to be identified and what is most important there, as we have different forms of disabilities, we have different ways we want to be addressed. For instance myself I am a deaf woman. Some people think if they use the word deaf I will be offended. No. I am a deaf person with the word D: I am a deaf woman, I am a deaf person and maybe, you might see a blind person. I say this is a blind person.
Most others will feel offended I use the word blind, but for me it also depends on what I wish to be called, for me actually personally I want to address myself personally. Although we have internationally recognised terminology to describe different from disability, however it is all about ownership and what you want to be called or what you are comfortable. Someone to be called disabled. Some want to say persons living with disabilities. Some say the argument is I am not living with disability as a tenant, I am a person that has a condition or disability, so there are different things. So, I feel is what makes you proud, you own it and that way I guess, so, for me I don’t feel discriminated when you call me deaf. I identify with that and that makes me proud. Thank you very much. (Applause)
Jarrod Clyne: I will just say that the term persons with disabilities is used in international meetings because it comes from the convention, it comes from the CRPD. Of course, embodies and enshrines the social model of disabilities. So certainly in International context it is not understood to be stigmatising or to be impairment-focussed and the idea of fixing society is at the core of the CRPD. For myself, my background is from the movement of persons with psychosocial disabilities.
There are not many people with psychosocial disabilities who even like that term particularly. I mean they prefer “users and survivors of psychiatry” which is a phrase which I am not sure is welcome in the World Health Summit all the better for me having said it. But I want to recognise that national contexts inform the language and it is important that the language is used that does reflect the right approach, which is the right space one. So I fully support every one’s choice of language. In New Zealand it is people with disabilities. Persons can seem a bit clinical and legal, so I acknowledge the deficiency of that.
New Speaker: Haben, we are asking a follow-up question on this, please go ahead.
New Speaker: Yes, thank you. Just as a clarification, because you said persons with disabilities comes from the social model of disability but as far as I understand it, the word person with disability comes rather from the medical model of disability more than a social, because persons with disability is the idea that the person does have something that needs to be changed as a medical difficulty and that is why the person has a disability. Whereas the social model of disability is the idea that I as a person, I am doing perfectly fine and it is the society that is disabling me through its lack of accommodation, which goes to the term disabled person. So, historically I understand that it comes from the convention, but the convention already used wrong wording because it kind of addresses the social model but uses medical model language.
Jarrod Clyne: It can an interesting critique. I have heard it before from people in the UK. I think everyone’s interpretation is valid in a sense but I think that we should know there’s not even a definition in the CRPD. It is a bit awkward and not ideal. I think the general comments and the views of the committee clear it up in a positive way. I take your point. Yes. Thanks.
New Speaker: So we have a lot of questions, Haben in the room, unfortunately at this point, only time for one more. Please those people who want a question hold it with you. We will do one more question and then we will move to the next panel. Thank you, please go ahead.
Armed: Thank you very much. My name is Dr Armed, I am from Bangladesh and I am represented in Gramman Digital Health Solution, which is actually dreamt by Professor Unis we have – we are working towards offering 15 cents video consultancy of healthcare and we are actually, we have already done it. I am so much inspired to actually join this session and I was just wondering like how fast we can actually have this visible communication at least for the digital healthcare solution. I can foresee a lot of apps out there for sign languages, but if we launch, if can launch it multi-language and then you know, in our country people cannot get even a normal healthcare service, so this is a longtail vision, but we want to address the digital divide and make it happen. Jarrod can shed some light if there is any roadmap for international community to actually offer them a digital healthcare solution. Thank you.
Jarrod Clyne: There are WHO ITU standards. I am not sure what it means in terms of quick rollout. I guess it is acknowledging there is a need for some standards to be met, to have them standardised. On how fast that is a technical question, beyond my expertise. Hopefully sooner rather than later. I am sure the people at AT Scale are probably working on that and involved in that and so can may answer more or Kalyan, no?
Haben Girma: All right can we get a round of applause for our panelists? (Applause) Can panel two come and take your seats? So, this second panel is about finance. Many of these projects—digital healthcare, sign language interpreters—require money. So in our second panel, we’ll be exploring how do we get access to that money? And this second panel also has Hellen with us still and we have from Indonesia, from Indonesia Dr R Vensya Sitohang and we also have from Ecuador, the honorable Maria Jose Plaza. And I want to ask, how do you get access to funding for disabled people to ensure that we get access to healthcare? Can you share some of the strategies you have found? And maybe let’s start with Dr Sitohang, and then go down the table. (Pause)
Vensya Sitohang: OK. Thank you, Haben.
Haben Girma: I will repeat the question – no problem. No rush, we can take as long as we need. So, finance, how do we get access to money, so that we can make sure healthcare is accessible to disabled people? I want to ask all of you to think of examples of how we get access to funding. And we will start with Dr Sitohang, and then go down the table.
Vensya Sitohang: Yes, thank you, Haben. It is a pleasure to be present in this room with this very interesting and noble topic heading. It is very touching that people with disabilities have aids and they also have to be empowered like other else. Okay, in answering the question in our country, in Indonesia, that Indonesia health survey 2023, approximately 1.4% of the population in Indonesia are persons with disabilities. Persons with disabilities already defined in our law, since 2016, as every person who has physical, intellectual, mental and/or sensory limitation for a long period may encounter barriers and difficulties in interacting with the environment, which can hinder their full and effective participation alongside other citizens based on equal rights.
The situation is out of 289 outpatients in Indonesia case group cohort. 28 related to the care needs of individuals with mental, physical, sensory and intellectual disabilities. Additionally, 112 of the almost 1,800 inpatients in Indonesia care-based cohort addressed these needs which cover by national insurance and actually more than 80% of individuals with disabilities have national insurance. It’s estimated that over 94% of individuals with disabilities utilize national insurance for their treatment and in-health services because they understand the benefit of national insurance for their medical needs, like Rachel and Hellen mentioned and her experience also. Fortunately, now seven types of assistive devices are covered national insurance benefit packages. Claim for assistive device has increased over the past three years, out of 1.4 million cases utilized as devices, about 1.3 million are for glasses. The other side, currently we are also conducting further studies to promote and other expanded use of national insurance in covering assistive technology and the second one currently we also being drafted in the Ministry of Health declaration on health efforts include health services for people with disabilities. The minister of finance is drafting a Government regulation on concession and incentives for individuals with disabilities, which includes incentive and concession for healthcare services, including health aids, assistive technology. So, there are steps in Indonesia, Government has taken steps to address the financial challenges that people with disabilities face in accessing health services. Thank you. (Applause)
Haben Girma: Hellen, can you go ahead.
Hellen Anurika Beyioku-Alase: Please can you come again with the question? I can answer now if you want.
Haben Girma: Absolutely. So the question is, what strategies have you found to get access to funding so you can have projects to help deaf women or other disabled people get access to healthcare? How do you get access to funding?
Hellen Anurika Beyioku-Alase: Thank you very much. Hellen speaking. When we talk about funding, funding is about ensuring we have access to a system that designs finance allocation for persons with disabilities and it does raise very difficult in our country, Nigeria, we don’t have a good system where we have access to phones.
When it comes to accessing healthcare facilities, in Nigeria most times people with disabilities are the ones who use their personal money to pay sign language interpreters or their aids in assisting them to the healthcare facilities and the report shows that persons with disability are the poorest of the poor and most times they do not have opportunity to get better employment, have better businesses and with the little change that they make is still what they may use to pay for sign language interpreters in accessing healthcare services.
Then back home, most, what we call health insurance and health insurance doesn’t really cover all of our needs. It doesn’t even cover 50%. So we still get to spend more from our pocket and you can imagine someone who has a very little amount of money, finds it very hard to feed, not alone the transportation to the health centres and then I would still have to pay from that little money and pay for a sign interpreter all because I need health services in the health care centres. This means access to phones is not accessible.
Most especially from the Government and the opportunities are not there. And persons who are not disabled, they have access to more opportunities than persons with disabilities do, and the problem is double. Now, in Nigeria, we have 1,000 Naira where we want to pay for a service we get to pay double the amount than is usual. These are the challenges we face as a deaf person. This is because we don’t have a standard system that gives waivers for persons with disabilities. Thank you. (Applause)
Haben Girma: It is frustrating when we don’t have access to funding and end up having to pay more than nondisabled people. I think Members of Parliament can be allies and trying to increase access to these resources. And Maria, you were a Member of Parliament in Ecuador. What is the best way for us to work with Members of Parliament to increase access to healthcare for disabled people?
Maria Jose Plaza: Thank you, Haben. I think the best way is to try to work with social entities and with ONGs to help funding, because in Parliament we can check the national budget for health and for disabilities. But we don’t have much control of how much is given to, for disabilities and for the rest of the people, the country. In Ecuador, health is considered a right. And health is free for every citizen in Ecuador. And still we have problems of getting those funds for the people in need.
We still have many, many problems with, especially with disabilities. Even though we have organizations that we created in Congress called CONADIS, the National Council of Disabilities, that plays a crucial role in collaboration with various ministries to promote and fund Disability Inclusion initiatives. It helps develop policies and programs and ensure the integration of individuals and disabilities across sectors including education, employment and health, by providing technical support and resources, it enables other ministries to implement effective strategies for inclusive practices, ensuring that funding is allocated appropriately, to meet the needs of people with disabilities. I still think there’s a lot more we can do. Thank you. (Applause)
Haben Girma: So, I have to agree that there is so much more that we could be doing. And I want to learn what more we could be doing. So, a lot of people here are here for ideas and action stamp; can you all share one more action stamp for securing funding for different disability projects?
Vensya Sitohang: Agree that health equity is a buzzword. Based on existing regulation in our role and Government regulations, a person with disabilities have various rights, including the rights to health and access to quality healthcare services. Currently, it is estimated that there are 3,000 primary healthcare that have achieved full accreditation. Fully accredited health centre must at least be able to identify barriers faced by persons with disabilities, arrange space accordingly and ensure his safety and comfort to access.
Therefore it is essential to enhance the communication skills of healthcare personnel. It is necessary that health workers must have a positive attitude and be able to interact and communicate according to the different types of disabilities like sign language in this room. Communicate with … most health centres face challenges in both facilities and human resources to provide healthcare services in inclusive care for persons with disabilities. But at some local level there are best practices such as in Bandu(?) in Java with its inclusive services, in other local efforts like (inaudible) with therapy services for children as well as at the community level.
And currently situation, we are drafting a Minister of Health regulation on health efforts that includes regulation for the health of persons of disabilities, using a life cycle approach with promotive, preventive, curative and rehabilitative and also palliative efforts as well as improving skills and standards and the other one, developing a master plan for health, 2025, 2029. Which will serve as a guideline for ministers, for ministries, agencies and local Governments in their planning and activities.
This plan includes subjects related to the healthcare services for people with disabilities. And drafting long-term and medium-term plans, 2025, 2029, and the health strategic plan of the Ministry of Health, also empathizes various targets to enhance healthcare services and disabilities for people with disabilities.
The last one, earlier you mentioned support at WHO, yes, but we are currently preparing capacities assessment, and the developing strategies to achieve health service global goals for disabilities according to inclusive standard and now we currently are continue the result of this preparation will be implemented to access and drafting the healthcare for people with disabilities road map in 2025, but I think our Government have a commitment to achieve health equity for persons with disabilities. In fact, the government has taken quite a lot of steps to find financial solutions to make it easier for people with disabilities to access health services. Thank you, Haben, for being a guiding light.
(Applause)
Maria Jose Plaza: Maybe engaging civil society organizations and international partners could help advocate for the necessary reforms and funding accessibility to quality for care for persons with disabilities and I think we have to do that fast. (Applause)
Hellen Anurika Beyioku-Alase: Thank you again for this. So, from my personal experience, I am going to use the Nigerian perspective now. Provision of equal opportunity for all – once you provide this opportunity for persons with disability, then they are able to access the resources needed for their healthcare needs and services and also to subsidize assistive technology like in the US we have the cochlear implants for the deaf which cost about $10,000 but with health insurance the persons have to only pay about $1,000 or thereabouts. We would love that.
The Nigerian Government adopt this, that is my thought and implement it in the country so it would be much easier for persons with disabilities and deaf persons to access healthcare services. Like I said earlier before; I went, I go to the hospital with my own responsibility to pay for sign language interpreters and also as person with a disability they go with their… so it would be so good that the Government came to subsidize the transportation cost as well.
And also we would also want the Government to also reduce transportation costs because persons with disabilities, especially the ones who make use of the wheelchair would have to pay for two, for two, which is paying for the wheelchair and also for themselves. So the Governments can actually intervene in this it would go a long way for us and also persons with disabilities should always be involved from the beginning plan, from the starting stage to the design stage because they tend to be the ones who know where the shoe fits and they have to speak for themselves, so that they can guide, give the right needs and expectations and also most times in Nigeria there should be budgeting and allocation, more especially more finance allocation given to persons with disability.
So that this resources would be used to meet the needs for persons with disability and assess healthcare services. The Government can say, OK, we are going to give 20% allocation to persons with disabilities so that things would be much more affordable for persons with disabilities most times in Nigeria we have beautiful laws. We have beautiful policies. But the problem is implementation. So what we want right now is implementation of this policies, and I believe that if this is done the systems would be good for persons with disability and this would meet our needs and I believe that, OK the Nigeria Government will make these things much more better and easier for us. Thank you. (Applause)
Haben Girma: We have another Q&A now, so if you want to ask our speakers a question, raise your hand and Miriam will pass you the mic.
Juliet: Thank you, Haben, this is Juliet. I will be more efficient this time. We will take three questions and then go to the panelists. If you don’t mind trying to be brief. I know it is important questions we are asking. Would you mind taking two people from over there. Thank you, that would be great. Thank you and then over to this side.
New Speaker: Hi, my name is Madaesna (?) and I am from India, from Disability Rights India foundation and also council member. I would like to know from the WHO representative here, like how many WHO office, country offices, have persons engage persons with disabilities in their offices? And work out health strategy for persons with disabilities and what are they doing about it? Number one. And number two, if the Australian Government official can say like whether people with disabilities are in role and included in the Health Ministry in the health department, you know, in key roles, so that you know inclusion is really enhanced, based on the UN’s inclusion strategy and also the community participation is ensured? Thank you. (Applause)
New Speaker: That is great, thank you. Let’s take another question on that side. Stand up if you can do so.
New Speaker: Thank you very much to the panelists and my name is Israel (?) I am a person with a disability myself, a medical doctor. And also currently a phD student at University College London. I’ve heard the challenges but my response, my question is this: What can WHO do and stakeholders do, to speed up the process of addressing health inequality? Especially in developing countries? Where the burden of disability is at its highest, 80% of the global population with disabilities are currently developing in in low to middle income countries. Unfortunately the global north have the resources to take care of their persons with disabilities compared to where they need is. That would be my question to the panel and I want to hear from other stakeholders. Thank you so much.
New Speaker: Thank you Israel. That is great. On this side. Please, go ahead.
Alexandra: Thank you. Thank you for the session and discussion. My name is Alexandra, I come from Ukraine and here I am representing International Federation of Medical Students Associations and my question is, basically, what can medical student associations and a medical universities do in order to make sure that education is equipping young medical staff to meet the needs of their people with disabilities? Thank you. (Applause)
New Speaker: Over to you, Haben and the guests. We had a couple of questions for WHO there, so we might need to…
Haben Girma: So I want to pass this to the panelists. Do any of you want to try these questions?
Maria Jose Plaza: I am going to talk about Ecuador. Active participation of people with disabilities in society is encouraged through initiatives which provide platforms for the voice and representation and decision making. We are doing a lot of progressions for all these challenges but the challenges still persist. So your answer was, what we can do. We have lots of laws, we have made like my colleague in the panel said, we have lots of laws that help and really nice laws but why are they not being implemented?
They have to evolve, focussing on improving social inclusion, accessibility and overall quality of life for people with disabilities and we have to work with civil society and international organizations. I see that’s the only way. Especially for us, we are in developing countries, South America, Africa, Asia. And we need to work with them. So we will be able to make the laws we have in our countries work for people with disabilities, and for everybody. For marginalized people, for Indigenous people because laws are not enough. We have nice laws but they are not working and we have to make them work. (Applause)
New Speaker: Apologies, the ambassador would like to respond to some of this.
Natasha Smith: Sorry, I think there was a question for me in there about whether people with disability are in our Department of Health? I cannot give you the exact numbers and I have more direct number of foreign aid and trade, but certainly across all our federal Government agencies, there are people with disability, at all levels, and we actually have some of our recruitment processes very specifically for attracting people with disabilities, and also for first nations Australians.
So we have special measures processes because we are committed to having our federal Government organizations look like and represent the Australian community. Of course the Australian community is made up with people from a whole range of backgrounds and abilities, and so that is something we are doing very directly as a way to, I suppose, walk our talk. (Applause)
Haben Girma: We need more agencies to measure the number of disabled people we are working with. If we are not measuring things it is hard to know what is happening and disabled people matter. Our health matters. So we would love for the WHO to do more measurements on the disability population.
What is changing? What is happening? And ministries and other organizations should also be measuring how many disabled people are you hiring? What percentage of disabled people are getting into medical school? This matters for all of us. Can we get a round of applause for our panelists? (Applause) so Jarrod Clyne from the International Disability Alliance. Hellen, yes?
Hellen Anurika Beyioku-Alase: Thank you. I wanted to raise the question from the medical students federation. You, I think you mentioned medical students have a long role and a huge role in ensuring that equity to healthcare is actually achieved. I think we could start from the curriculum, having things that have to do with attitudes or disability studies to be included. Perhaps that could help health workers.
Introduce that into the curriculum of studies in the medical school, to have at least an understanding about disability during the practice, so where we introduce disability right in the curriculum, right from school, when they get out into practice I don’t think it would be a challenge. You see about, that would lead to reduction in stigma and reduction to challenge that especially when people with disabilities go to hospitals. Thank you so much. (Applause)
New Speaker: Thank you. I understand we have time for one more question. So we will take it in the room. So, I went to the front row a bit. Let me give some equity to the back row. Is it possible for the lady with her hand up to have a microphone? Please stand up so we can…
New Speaker: Thank you. Hi I am East Asian woman, early 30s and I have a ponytail. I have a white shirt and black and white vest on. Thank you for the discussion. It was really helpful for me. I am from Global Health 50/50. We are trying to launch a report measuring and also looking to policies how organizations working in the global health field are working on inclusion policies and how disability justice is implemented in, at workplace, so in this sense, it was very helpful to listen to all of the questions and the answers today.
My question is, since Hellen was also mentioning about the importance of implantation for you all, what do you think is important for the implementation of disability justice at workplace? My second question related to disability justice at workplaces. I do think it is very, sometimes very difficult to identify your–identify the disability components of disability at workplace, so how should this be accommodated from a policy perspective and also at the workplace or school perspective? Thank you. (Applause)
New Speaker: Thank you. That is the end of the questions for this session. Back to you Haben.
Haben Girma: So Hellen or anyone else on the panel want to answer?
Hellen Anurika Beyioku-Alase: Thank you so much for the question. So we have different access to health. We also have access to justice, remember. Based on my work, on access to justice, also which has a lot of resources which is needed, it has to do with having justice systems are accessible also and having the right structures on perspective to be able to have, and to seek justice and for them to be able to fight for their rights when they feel discriminated against. Also just like we have in the medical challenges when it comes to justice is same there, to get – or other challenges, access to justice to be equitable and just.
So we have most times percentage of funding, it has to do with pertained for fighting for justice to be taken care of or being the direct cause for disabilities, so I feel the government also need to show the willingness and the will to push for full implementation of the laws of accessibility because when you look at the different protocols and laws we have, it is not just for health. It has other places where they are needed. So where we talk about implementation it has to be multisectoral. And we just need that strong will to implement. Once that is done, the push making priorities and making, being intentional also in these things.
For instance, when I want to implement, try to monitor and see how effective most of the implementation processes are going on and see when things are not going correctly how we can improve or move forward. So I am giving an example based on my country, Nigeria and see if things are not going on, yes, the law is there. But if it is not implemented it is not carried out, there should be things to promote that and check if it is working or not. I don’t know if that answers your question. Thank you so much. (Applause)
Haben Girma: Any more questions?
Maria Jose Plaza: I just wanted to make a simple thing. Say something that we have advice today and it is very important to talk about mental health and implementations of laws to help in mental health. It is also disability and important disability and I am thankful I work on that in the Parliament in Ecuador and I was able to make the first law ever in my country for mental health so that is what I wanted to get in. (Applause)
Vensya Sitohang: Can I add information. I think at least when compiling the standard and regulation especially in about primary healthcare, we are together across program, our program and sectors, including people with disabilities and academia, including the medical faculty of course and so there is nothing that must be regulated that is not included in the rules, and various experience of people with disabilities and also the technology developments must also be included in the roles so it can be implemented and of course it becomes a social control because we are both compiling and together monitoring and evaluating, so there is nothing that is not served. Thank you. (Applause)
Haben Girma: Thank you so much everyone. I really appreciated you sharing your wisdom and our excellent questions from the audience. So, we have two more things – the next is an announcement about the global disability summit that is happening next year and Jarrod Clyne is going to tell us about that.
Jarrod Clyne: Haben, do you want me to do a quick summary of the session or is that not part of it? Either way it is fine?
Haben Girma: You could also do a quick summary of the session.
Jarrod Clyne: I will be very quick. First of all, it is very important this event to have a disability-specific event in a mainstream health summit. It is a first and very hugely important. At the same time we recognize that disability movement itself needs to put greater focus and emphasis health. There have been historical reasons why it has not been a such a popular topic which we can lay the blame at the foot of someone else. So the Global Disability Health Summit in Berlin the 2nd and 3rd April 2025, health equity for disabled persons will be a major focus one of the priority themes. There’ll be a pre-summit some time earlier in the year as well. We are hoping those events will help drive commitments.
We need political mobilization, we need resource mobilization and we need really strong engagement from OBDs around the world. We are hopeful the global disability summit will do that. Just to then briefly summarize this excellent session. We heard a lot about diversity and diverse needs. The need for medical culture to change. The impact of health to advance social inclusion in Suriname, Nigeria, Indonesia, the role of social determinants of health. Challenges in financing, recognizing that disability is a social construct, so the cost should be socialized.
So Government subsidies, AT provision and the costs should not be borne by the individual. Additionally, the role of international cooperation is very important. And we also heard that there are lots of nice laws and frameworks. I suppose we can add that the WHO work to that. But it doesn’t mean anything without the implementation. We need the political prioritization. We need accountability. We need monitoring and need to involve organizations of persons with disabilities and we need access to justice. So that might seem like a lot, but I would like to summarize it by stealing the words of Rachel from earlier on. Two points that I think really could be the whole session. The first was, we shouldn’t make decisions without talking to us, talking to persons with disabilities first. And second was, we can do more together. Thank you.
(Applause)
Haben Girma: So, before we all leave, I want to acknowledge that we have a really amazing group of people here. Not just our speakers but all of you in the audience. And right after this, we have a coffee break. And I invite you to challenge yourselves, to meet two new people and ask what action are you going to take? We need all of you to take action. So start your homework now and meet two new people and ask them, what are you inspired to do? Enjoy the rest of the summit. Thank you, everyone. (Applause)