Legal Framework

The right to health is well established in international human rights law, including in the International Covenant on Economic, Social and Cultural Rights[1] , which recognizes the right of all persons to the highest attainable standard of health (Art. 12); and the Convention on the Rights of the Child, which requires State parties to recognize the rights of children with disabilities to specific assistance to ensure their effective access to health care services and rehabilitation services in a manner conducive to the child achieving the fullest possible social integration and individual development, including his or her cultural and spiritual development (Art. 23).

The Constitution of the World Health Organization (WHO) also enshrines the highest attainable standard of health as a fundamental right of every human being. The right to health includes access to timely, acceptable, and affordable health care of appropriate quality. The right to health means that States must generate conditions in which everyone can be as healthy as possible. It does not mean the right to be healthy.

The Convention on the Rights of Persons with Disabilities (CRPD) reinforces and strengthens protection for persons with disabilities in relation to health and rehabilitation. It recognizes that persons with disabilities have the right to the highest attainable standard of health and that State parties must recognize that right without discrimination on the basis of disability (Art. 25) and further guarantees the right of persons with disabilities to access rehabilitation services of all kinds (Art. 26). Moreover, the Convention recognizes the right of persons with disabilities to access, within their communities, a range of in-home, residential and other support services (Art. 19).

In prohibiting all forms of discrimination, the CRPD also requires that reasonable accommodation be provided. States are therefore required to take measures to:

• ensure that persons with disabilities are reasonably accommodated in the context of health care services, and
• ensure accessibility more generally to health care services.

Essential for many individuals with disabilities, the right to health includes access to health- related rehabilitation. The right to rehabilitation is more broadly set forth in Article 26 of the CRPD.

As with other rights addressed in the present toolkit, the rights of persons with disabilities to health is indivisible, interdependent, and interconnected with the other rights enshrined in the CPRD. A bidirectional relationship often exists between one’s enjoyment or inability to enjoy one’s rights. For example, poor health negatively impacts on one’s ability to obtain an education or to work. At the same time lack of access to education or to work impacts on one’s ability to access appropriate health care. The present module focuses on the right to health. However, the inter-connected relationships between the rights set out in the CPRD underscore the need for a holistic approach to its implementation.

The WHO global disability action plan 2014-2021 focuses on achieving optimal health, functioning, well-being and human rights for all persons with disabilities. The action plan calls for WHO Member States to remove barriers and improve access to health services and programmes; strengthen and extend rehabilitation, assistive devices and support services, and community-based rehabilitation; and enhance collection of relevant and internationally comparable data on disability, and research on disability and related services[2] .

The action plan has the following three objectives:

1. to remove barriers and improve access to health services and programmes;
2. to strengthen and extend rehabilitation, habilitation, assistive technology, assistance and support services, and community-based rehabilitation; and
3. to strengthen collection of relevant and internationally comparable data on disability and support research on disability and related services[3] .

On May 27, 2021, the 74th World Health Assembly adopted Resolution EB148.R6 “The highest attainable standard of health for persons with disabilities.[4] ” The resolution aims to make the health sector more inclusive and accessible to persons with disabilities by tackling the significant barriers to health services they face. These include:

• Access to effective health services: persons with disabilities often experience barriers that severely affect their rights, including physical barriers that prevent access to health facilities; informational barriers that prevent access to health information and attitudinal barriers that lead to discrimination.
• Protection during health emergencies: public health emergencies, such as the COVID-19 pandemic, disproportionately affect persons with disabilities because national health emergency preparedness and response plans often do not consider them.
• Access to public health interventions across different sectors: public health interventions do not reach persons with disabilities because the information is not in an accessible format and their specific needs and situations are not reflected in the interventions.

The Resolution also aims to improve collection and disaggregation of reliable data on disability to inform health policies and programmes[5] .

The European Disability strategy 2010-2020: A Renewed Commitment to a Barrier-Free Europe focuses on eliminating barriers[6] . The Commission has identified eight main areas for action: accessibility, participation, equality, employment, education and training, social protection, health and external action. Section 7 - Health, states:

“People with disabilities may have limited access to health services, including routine medical treatments, leading to health inequalities unrelated to their disabilities. They are entitled to equal access to healthcare, including preventive healthcare, and specific affordable quality health and rehabilitation services which take their needs into account, including gender-based needs. This is mainly the task of the Member States, which are responsible for organising and delivering health services and medical care. The Commission will support policy developments for equal access to healthcare, including quality health and rehabilitation services designed for people with disabilities. It will pay specific attention to people with disabilities when implementing policies to tackle health inequalities; promote action in the field of health and safety at work to reduce risks of disabilities developing during working life and to improve the reintegration of workers with disabilities[7] ; and work to prevent those risks.[8] ”

The rights of persons with disabilities to health is indivisible, interdependent, and interconnected with the other rights enshrined in the CRPD. A bidirectional relationship often exists between one’s enjoyment or inability to enjoy one’s rights. For example, poor health negatively impacts on one’s ability to obtain an education or to work. At the same time lack of access to education or to work impacts on one’s ability to access appropriate health care. The present module focuses on the right to health. However, the inter-connected relationships between the rights set out in the CRPD underscore the need for a holistic approach to its implementation.