Equalization of opportunities: inclusion of disabled persons in the development process (E/ESCAP/1176)

Considerable progress has been made in the ESCAP region in the implementation of the Agenda for Action for the Asian and Pacific Decade of Disabled Persons, 1993-2002. Nevertheless, the achievement of its targets, which were endorsed by the Commission at its fifty-second session in 1996, remains uneven between and within countries and areas of the ESCAP region, and for the 12 policy areas of the Agenda for Action.

ESCAP convened two regional forums on the education of children and youth with disabilities and on meeting the targets for the Decade and equalization of opportunities. The forums reviewed progress on target action and formulated strengthened targets in the 12 policy areas of the Agenda for Action for the three remaining years of the Decade (2000-2002). The Commission is invited to endorse the strengthened targets for promoting the equalization of opportunities for people with disabilities in the ESCAP region.

The guidance of the Commission is also sought on the preparatory actions to be initiated during the last three years of the Decade in order to build on the momentum already generated through the Decade to promote the inclusion of disabled persons in the mainstream development process in the first years of the twenty-first century.

NEW MILLENNIUM IMPETUS TO EQUALIZATION OF OPPORTUNITIES FOR DISABLED PERSONS IN THE ESCAP REGION: STRENGTHENED REGIONAL TARGETS

1. An important indicator of twentieth-century progress in the ESCAP region is the extent to which development actions have facilitated or hindered the freedom of movement of people with disabilities in society. The ESCAP region has entered the new millennium with seven years of commitment to the full participation and equality of people with disabilities, which is the goal of the Asian and Pacific Decade of Disabled Persons, 1993-2002.

2. In pursuance of Commission resolution 48/3 of 23 April 1992 on the Asian and Pacific Decade of Disabled Persons, 1993-2002, and resolution 54/1 of 22 April 1998 on strengthening regional support for persons with disabilities into the twenty-first century, the secretariat has initiated collaboration with institutions and organizations concerned with the built environment, infrastructure development, tourism, education, information technology, rural poverty alleviation and the training of statisticians.

3. In November 1999, ESCAP organized two regional forums mandated by the Commission in resolution 54/1. The regional forums, held in Bangkok, focused on education for children and youth with disabilities and on meeting the targets for the Decade, and equalization of opportunities for persons with disabilities in the ESCAP region. The forums were organized in close cooperation with the Subcommittee on Disability-related Concerns of the Regional Inter-agency Committee for Asia and the Pacific, which met at Bangkok on 25 November 1999.

4. Altogether, over 200 persons concerned with disability-related matters in the ESCAP region reviewed critical issues concerning the equalization of opportunities for persons with disabilities in the light of the experience already gained on the 73 targets that had been formulated in 1995 for action in the Decade. On the basis of that review, they proposed 107 strengthened targets for action by 2002, when an evaluation of the Decade would be conducted.

5. The revised target action time frame is January 2000 to December 2002. The targets cover all 12 policy areas of the Agenda for Action for the Asian and Pacific Decade of Disabled Persons, 1993-2002: national coordination, legislation, information, public awareness, accessibility and communication, education, training and employment, prevention of causes of disability, rehabilitation services, assistive devices, self-help organizations and regional cooperation.

6. The Commission is invited to adopt the strengthened targets for enhanced implementation.

1. National coordination

(a) Critical issues

7. One issue of concern is that, whereas most countries in the ESCAP region have bodies that undertake national coordination on disability, progress on disability matters has not penetrated sufficiently to the community level. A second concern is a need for permanent national and subnational coordination committees whose work will be sustainable beyond the year 2002.

(b) Revised targets

1.1 To establish and strengthen a national coordination committee (NCC) on disability concerns with an appropriate mechanism to ensure its accountability to the legislature or head of government to promote a multisectoral approach to the implementation of the Agenda for Action for the Asian and Pacific Decade of Disabled Persons, 1993-2002, and with representation at the policy-making level of all state/provincial and district governments, and concerned ministries/departments and government agencies, substantial representation in non-governmental organizations (NGOs), including self-help organizations of disabled persons, parents' organizations of people with intellectual disabilities and women with disabilities, as well as with adequate allocation of resources.

1.2 To establish and strengthen an executive committee with appropriate representation from state/provincial governments, ministries/departments and government agencies, NGOs, including self-help organizations of people with disabilities, parents' organizations of people with intellectual disabilities and women with disabilities, to ensure timely follow-up and monitoring of the implementation of NCC decisions, and to facilitate its functioning.

1.3 To establish coordination and executive structures at the subnational level, with adequate means of participation by grass-roots groups and bodies.

1.4 To formulate a national plan of action and incorporate it in national development plans with a time frame and an inbuilt mechanism for monitoring and evaluation, as well as adequate multisectoral allocation of resources for the implementation of the Agenda for Action, and specifically, the targets for national action contained in the present document.

1.5 To identify and prioritize, within the national plan of action, means of promoting the participation of poor persons with disabilities in all poverty alleviation programmes, including urban and rural development programmes and projects implemented within the country.

1.6 To specify the participation of persons with disabilities as a criterion for the approval of funding for poverty alleviation and other development programmes and projects.

1.7 To strengthen the coordination and executive structures with adequate resources and infrastructure to enable them to function effectively as permanent statutory bodies.

1.8 To pursue urgently means to promote a positive image of people with disabilities, including their potential, capabilities and achievements in the areas of education, training, employment, sports, arts and cultural activities, as well as in community life, including through the use of occasions such as national or international days of disabled persons, community festivities and other media opportunities.

1.9 To establish effective communication channels among all parties concerned with disability matters, at national and community levels, to ensure information flow, effective problem-solving, as well as timely and adequate multisectoral consultation, especially with self-help groups and NGOs serving disabled people.

1.10 To ensure that information on all programmes, services and provisions for people with disabilities, including all legislation and amendments pertaining to equalization of opportunities for people with disabilities, is adequately compiled, disseminated and publicized in accessible formats and languages suited to the literacy levels of persons with disabilities and their families.

1.11 To set up appropriate mechanisms to obtain accurate data and regular updates on disability groups, as well as information about their family and life situations, including case studies, and such other information that will encourage informed conclusions about disabled people's access to services and progress towards equalization of opportunities for people with disabilities, for the purpose of policy formulation, as well as to ensure responsible use of all personal data to protect the privacy rights of persons with disabilities.

2. Legislation

(a) Critical issues

8. Although progress has been made in the enactment of basic laws concerning the equalization of opportunities for persons with disabilities in many countries, there has been little or no progress in the review of substantive laws, such as those pertaining to marriage and inheritance, and procedural laws such as those related to criminal and civil procedure enactment.

(b) Revised targets

2.1 To establish a suitable mechanism to examine and identify all substantive and procedural laws, such as those covering inheritance, marriage and property, as well as criminal and civil procedure codes and policy provisions on various subjects.

2.2 To amend substantive and procedural laws to include enabling provisions for equal legal protection for persons with disabilities, including women with disabilities and people with intellectual disabilities, and to repeal provisions that restrict their full participation and equalization of opportunities, or which are discriminatory.

2.3 To enact a basic law with an effective inbuilt implementation and enforcement mechanism to protect the rights of people with disabilities, including women with disabilities and people with intellectual disabilities, to promote affirmative action in their favour and to eliminate discriminatory practices, as well as architectural and communication barriers.

2.4 To introduce a national scheme of social security measures covering financial assistance and subsidies for persons with extensive disabilities and their families living in poverty, as well as primary breadwinners who become disabled and have no other means of income support for their dependants.

2.5 To review laws relating to customs duties and to introduce amendments to provide exemption from customs duties on the import of vehicles, assistive devices, health and medical supplies, including all equipment and materials needed to improve the quality of life and, in particular, to facilitate the education, employment, sports and leisure activities, cultural pursuits and daily living of people with disabilities, including women with disabilities.

2.6 To review laws pertaining to taxation to provide tax benefits for persons with disabilities and incentives for employers of disabled persons and manufacturers of indigenous assistive devices, including exemption from excise duties for such products.

2.7 To enact or amend laws and regulations, including traffic and industrial/labour laws, for promoting health and safety in the workplace, in public places, in transport and in the home, as well as set safety standards for modes of conveyance, equipment, implements and other items of industrial, domestic and personal use, with particular attention to the needs of users with disabilities.

2.8 To establish a mechanism for periodic review of the list of items for exemption from customs duty.

2.9 To provide for the coverage of people with disabilities in an existing free legal aid service or to develop a free legal aid service for people with disabilities.

2.10 To establish implementation and enforcement (such as an ombudsman) mechanisms for basic laws for the protection of the rights of people with disabilities and to notify such rules and regulations for their effective implementation and enforcement.

2.11 To amend laws relating to copyright and make provisions for the protection of the rights of persons with disabilities to have access to educational, informational and recreational materials and for the transcription, transference, translation and reproduction of all such materials.

3. Information

(a) Critical issues

9. Access to accurate and regularly updated information is vital for advocacy, and for the purposes of planning and implementation of services for people with disabilities. Inadequate resources and lack of focal points at various levels for the establishment of databases relating to disability issues are major difficulties encountered in developing information systems in many countries in the ESCAP region. Particular problems are experienced at the subregional level. Furthermore, information access is a problem at the local level. The lack of simple, common and functional definitions of disability compounds the problem of collecting useful, accurate and comparable data. The Regional Training Workshop on Disability Statistics, held in New Delhi in February 2000, was the first regional forum to discuss such definitions in relation to ongoing international revisions.

(b) Revised targets

3.1 To establish, in collaboration with NGOs, self-help organizations, and national and local focal points on disability, a regularly updated database on the disability situation, including demographic data on persons with disabilities, as well as social and economic dimensions, including educational level, employment status, housing, household composition and membership in registered organizations of people with disabilities for the purpose of (a) indexing available information related to disability within various ministries and organizations; and (b) disseminating, through appropriate means and to local-level organizations, information in formats and languages that are accessible by people with disabilities and their families.

3.2 To strengthen the capability of national statistical offices, and develop and apply common functional definitions of disabilities that will facilitate regionwide comparisons, and to advocate the conduct of national disability-related surveys.

3.3 To pursue immediate action to translate into national and local languages the Agenda for Action and the revised targets to facilitate implementation, and to disseminate the translations through the mass media, folk media, government agencies and voluntary organizations.

4. Public awareness

(a) Critical issues

10. A major factor restricting the equal participation of people with disabilities is the prevalence of negative perceptions and practices. Often, the abilities of persons with disabilities remain unrecognized. Opportunities are limited for the full development of their potential. To rectify this, it is important that all awareness campaigns for full participation and equality emphasize the abilities of persons with disabilities and their value as productive citizens and members of their societies with full rights to participate in the mainstream development process.

11. The awareness of government officials needs to be raised, especially those in departments and ministries that have not yet addressed issues concerning the rights of disabled persons to participate fully in the mainstream development process, as well as disability as a development issue.

12. The terms "persons with disabilities" and "disabled persons" are used interchangeably, to reflect the diversity of preference and usage in the ESCAP region.

(b) Revised targets

4.1 To undertake immediate action to ensure that the national and provincial print and electronic mass media, including the private sector and the folk media, feature issues related to the Decade through regular and accurate coverage that improves public awareness and attitudes concerning people with disabilities.

4.2 To undertake phased action to encourage all education and training institutions, government agencies and NGOs that implement programmes and projects for children and youth to identify and provide means of ensuring that disabled children and youth are included in activities designed for all children and young persons.

4.3 To encourage immediate action by ministries of education and all other relevant agencies to initiate a review of all educational and functional literacy materials, in different formats, in use in each country and area, with a view to excluding content that is derogatory towards persons with disabilities, and with a view to including illustrations and references that support the inclusion of persons with disabilities in mainstream community life.

4.4 To encourage immediate action to ensure the issuance of first-day covers and commemorative stamps promoting the full participation and equality of persons with disabilities in the Asian and Pacific region.

4.5 To advocate the inclusion of disability issues in information and media policies and programmes, as well as the provision of appropriate time and space for disability concerns, and the prohibition of the depiction of negative and inaccurate images of persons with disabilities in performances, especially comedies, films and cartoons.

4.6 To encourage government agencies and NGOs to establish a press clipping service to collect documentation on media efforts concerning the raising of public awareness and the improvement of attitudes towards persons with disabilities.

4.7 To promote, at regional, national and subnational levels, all cultural activities (including art and the performing arts) and sports by people with disabilities, as part of public awareness campaigns to highlight the abilities and aspirations of persons with disabilities.

4.8 To develop and include disability as a mainstream development issue in the curricula for pre- and in-service training of public administration and technical personnel in all sectors, in order to facilitate multisectoral collaboration on disability issues, and to promote the inclusion of persons with disabilities in all mainstream development activities.

5. Accessibility and communication

(a) Critical issues

13. Ensuring that disabled persons have the means to move freely is essential for building capacity, self-esteem and confidence for full participation in the mainstream development process. Programmes (education, training and employment) and disability-related decision-making are located in inaccessible places.

14. The three main interrelated components of freedom of movement are accessibility, communication and assistive devices.

15. The level of achievement varies in the ESCAP region in enhancing the access of disabled persons to the physical environment and effective communication systems. Of critical importance are information exchange and networking at all levels and involving government agencies, autonomous bodies, NGOs and individuals.

16. Another challenging task is the systematic and phased introduction of barrier-free features into existing public transport systems, buildings and other existing infrastructure.

17. Another critical area concerns the need to examine measures for the modification of the layout of workplaces, tools, equipment and machinery to improve the physical accessibility of training and employment places.

18. There is an urgent need to assess the possibility of developing indigenous sign languages where these do not exist. Another issue concerns the feasibility of identifying a set of basic signs that could facilitate communication among persons using diverse languages in the ESCAP region.

(b) Revised targets

5.1 To initiate immediate action to incorporate barrier-free features as a standard requirement in designs and plans for all new construction, renovation and expansion of buildings and facilities used by members of the public, including transport systems, educational facilities, housing schemes and recreational facilities, with measures to ensure effective implementation, particularly for the renovation and new construction of government infrastructure.

5.2 To undertake immediate action to make external built environments accessible, including by installing pavements with kerb ramps and by providing adequate signage and facilities for all disability groups.

5.3 To take immediate action to initiate the introduction of barrier-free features in mass transport systems and services, beginning with the main lines and trunk routes, and to ensure that all further modifications of, and additions to, mass transport systems incorporate barrier-free features at the outset of the planning stage.

5.4 To take immediate action to promote the inclusion of barrier-free design in the curricula for the training of architects, engineers, and urban and rural planners.

5.5 To pursue immediate action to incorporate access provisions for people with disabilities into existing building by-laws.

5.6 To establish and strengthen access-related networking among governments and organizations concerned with disability issues in the ESCAP region, especially to promote the exchange of information on skills development, standards, procedures, experiences and resources.

5.7 To undertake immediate promotion of studies on the layout of workplaces, as well as the design of tools, equipment, machinery and instruments to make them more usable by persons with disabilities.

5.8 To initiate urgent action towards the development of official indigenous sign languages, with mechanisms for the certification of sign language interpreters.

5.9 To work towards guaranteeing the right of access to sign language interpretation services in television programmes (especially news and documentaries) and in vital public services and facilities, particularly police departments, hospitals, law courts and financial institutions, and to provide alternate means of communication in other public places.

5.10 To work towards guaranteeing the right of access to reading materials in Braille, large print, computer diskette, audio cassette and other suitable formats for people who have difficulty in reading regular print, and who need access to human readers.

5.11 To introduce and enhance captioning and audio descriptions, and to improve the availability of, and access to, computer applications, web sites, radio, telephone, fax machines and visual media for information and entertainment purposes to benefit all disability groups.

6. Education

1. Critical issues

19 The development and implementation of policies and programmes for the education of disabled children and youth are inadequate. In many ESCAP countries and areas, less than 5 per cent of children with disabilities have any access to educational opportunities. In addition, the available statistics reveal a gender imbalance, with girls having poorer access to education. Many disabled children and youth belong to marginalized groups. They suffer an additional disadvantage.

20 Many children have learning disabilities that are not recognized. This may result in their dropping out of the educational system, with attendant social and economic problems. A further group remains in school, with their educational needs unmet.

21 Disabled children and youth have limited or no access to educational, informational and recreational materials in appropriate formats. To improve their access to such materials, it is essential to harness new and emerging technology. The issues of copyright must be addressed with the greatest urgency in executive-level meetings between the relevant United Nations bodies and other international organizations, and representatives of copyright owners, producers (for example, song writers, musicians, authors and software writers) and manufacturers of such materials, in order to secure tangible commitments concerning the access of disabled persons to such materials. This issue should also be addressed at the national level.

22 Recently, there has been a major change in education thinking and practice. It is acknowledged that disabled children and youth have a right to be included, along with their siblings and peers, in local schools and non-formal education programmes. Education programmes should be more responsive to children with diverse needs. At the same time, the role of the family and the community needs to be strengthened. It is anticipated that, in the early years of the twenty-first century, many more disabled children and youth will be educated in inclusive rather than segregated settings.

(b) Revised targets

6.1 To increase the enrolment of children and youth with disabilities to close the gap between their current level of enrolment and the net enrolment rate of non-disabled children in each respective country or area in the ESCAP region, and to achieve this through formal and non-formal education systems, including open schools and distance education systems.

6.2 To include boys and girls and women and men with disabilities in all policies, plans and programmes to ensure Education for All, with adequate financial allocations and appropriate technical assistance; the financial allocations should also adequately cover the provision of necessary and appropriate support to ensure effective educational outcomes for children and youth with disabilities in inclusive settings.

6.3 To ensure the provision of appropriate teaching aids, assistive devices and facilities for promoting effective educational outcomes for children and youth with disabilities.

6.4 To introduce and expand early intervention programmes for children with disabilities, with provision for the active involvement of their families and communities, in both rural and urban areas, and to promote the inclusion of children with disabilities in regular pre-schools.

6.5 To increase progressively the retention rates of all children and youth in education systems, including children and youth with disabilities.

6.6 To strengthen pre- and in-service teacher preparation programmes to ensure the effective teaching of children with diverse capabilities, including those with disabilities.

6.7 To introduce the entire educational curricula to all children, including children and youth with disabilities, and to ensure that the curricula include the teaching of science, mathematics, technical, pre-vocational and vocational education.

6.8 To promote the adaptation of teaching approaches and materials to facilitate effective educational outcomes for children with disabilities, and to ensure that this includes appropriate provisions for teaching children and youth who are intellectually disabled, deaf, blind, multiply disabled, autistic, and those who have learning disabilities, as well as behavioural, speech and communication problems.

6.9 To develop appropriate policies and legislation to change the focus of education systems from a subject-focused to a learner-centred approach to benefit children and youth with disabilities.

6.10 To strengthen support mechanisms and systems, including the provision of teacher aides, assistive devices and other necessary supports, to facilitate the effective inclusion of children and youth with disabilities in inclusive educational settings.

6.11 To promote and support the involvement of families and communities in the provision of inclusive education for children and youth with disabilities.

6.12 To target policy makers, public administration and technical personnel, school administrators and educators to promote the inclusion of children and youth with disabilities in education programmes.

6.13 To encourage ministries or departments of education to assume responsibility for the education of children and youth with disabilities.

6.14 To ensure appropriate transition processes from early childhood education to primary and secondary levels to ensure access, with support, to post-school activities, including pre-vocational and tertiary education, and employment.

6.15 To assert the legal rights of disabled people to educational, informational and recreational materials in accessible formats, including the right to transcribe, transfer, translate, reproduce and use materials currently subject to copyright laws.

7. Training and employment

(a) Critical issues

23. The globalization of the economy and advancements in technology, particularly automation, information technology and new developments in assistive devices, have changed employment prospects for disabled persons in the ESCAP region. This has sometimes opened up new options, but it has often reduced opportunities.

24. In the past, the public sector provided many employment opportunities for people with disabilities. In many countries of the ESCAP region, however, the public sector is in the process of being downsized, with some of its functions being privatized. This trend has given rise to a formidable challenge to all concerned with helping disabled job seekers to identify other options, either in the private sector, or through the promotion of self-employment opportunities. Furthermore, there is an immediate need to open up all sectors of the economy so that employment opportunities may be expanded for persons with disabilities.

25. Skill training has been traditionally provided for disabled persons in special centres. The skills that they acquire through these centres are frequently outdated and do not reflect job market demands. Increasingly, there is an emphasis on opening opportunities for disabled people in mainstream training centres where non-disabled people are trained, and to ensure that the training provided leads to employable skills.

(a) Revised targets

7.1 To make accessible mainstream training programmes and to revise entry requirements and eligibility criteria where necessary, so that people with disabilities can participate in them, with due attention to gender equity and the participation of disabled persons from low-income and poor families.

7.2 To develop and strengthen curricula and support services (for example, physically accessible training sites and equipment, Braille text, sign language interpreters and trainers' aides) to enable persons with disabilities to participate fully in all pre-vocational and vocational training and apprenticeship programmes leading to gainful employment and self-employment in rural and urban areas.

7.3 To set national targets for the placement and promotion of the employment of persons with disabilities in the public and private sectors and to formulate a government policy to promote the achievement of these targets (such as through a mandatory quota scheme, employer incentives, focused awareness-raising campaigns targeted at employers and employees, and technical support to employers).

7.4 To establish a collaborative body, including representatives of the public and private sectors, disabled people's organizations and other NGOs, to compile, on an ongoing basis, information on new employment and self-employment opportunities in the formal and informal sectors, as well as to provide training in skills relevant to these opportunities and discontinue training in skills that are obsolete.

7.5 To establish and fulfil annual training and job placement targets that are gender-equitable for people with disabilities, for joint action by all ministries (for example, those responsible for employment, human resources development, rural development), government development programmes, as well as employers' and workers' organizations and organizations of people with disabilities.

7.6 To provide appropriate training and employment opportunities for people with extensive disabilities and those who require a supportive environment (through, for example, the establishment of production centres, the provision of support services and assistive devices for self-employment and supported employment and, where necessary, arrangement of accommodation).

7.7 To introduce measures to ensure the equitable participation of persons with disabilities in all rural and urban schemes for poverty alleviation, income-generation in the formal and informal sectors, and the promotion of self-employment.

7.8 To introduce and undertake effective implementation of a national scheme for entrepreneurial skills development (including identification of business opportunities, development of a business plan, management and bookkeeping skills); support services to marketing and production; and access to interest-free or low-interest loans.

7.9 To identify disabled people in order to place them in jobs or to assist them in self-employment in rural and urban areas, through appropriate public and private agencies (including employment placement services) and NGOs.

7.10 To use funds to promote training and employment opportunities for people with disabilities (for example, through adaptation of the environment, provision of support services and assistive devices) to benefit people with extensive disabilities as well.

7.11 To protect the rights of disabled workers in all laws, policies and collective agreements relating to employment (including provisions on recruitment, promotion, dismissal and retrenchment).

7.12 To identify and commission appropriate institutions to carry out research studies in the areas of ergonomics, workplace adaptations, safety devices and other topics relevant to the training and employment of disabled persons in the context of Asian and Pacific developing and least developed countries and areas, to encourage innovations, and to identify research topics in consultation with service providers, user groups and the collaborative body for the identification of new work opportunities, and other relevant agencies.

7.13 To establish a monitoring and evaluation mechanism, with the active participation of representatives of disabled persons, to ensure that legislation relating to training and employment is effectively enforced, that policy is effectively implemented and that the relevant Decade targets are achieved.

7.14 To establish an international clearing house to identify, gather and disseminate information on existing employment-related equipment and facilities for people with disabilities, as well as similar clearing houses at national, regional, state, provincial and district levels.

8. Prevention of causes of disability

and

9. Rehabilitation (community-based rehabilitation, and health and social development)

(a) Critical issues

26. Most rural and slum people with disabilities do not have access to any form of rehabilitation services, particularly when access is considered in terms of time, cost and availability. Many countries and areas lack a comprehensive strategy to address prevention, rehabilitation and measures for the improvement of the quality of life of disabled persons.

27. Reliable and comprehensive data are required if disability issues are to be accorded high government priority for resource allocation and programme development. However, disability data are limited because data collection problems have not yet been resolved.

28. There is also a lack of expertise, information materials, training tools and programmes on disability issues to support personnel in diverse development sectors. This seriously limits the development of service provisions, including prevention programmes and community-based rehabilitation. Much more funding and other support are required to address these needs through the sharing of resources.

29. Policies and programmes in diverse sectors need to be strengthened to support preventive efforts and community-based rehabilitation as approaches to the delivery of appropriate health, educational, vocational and social services involving the combined efforts of people with disabilities, their families and communities.

30. People with psychosocial problems (mental illness) constitute an increasingly large and underserved group in many countries and areas of the ESCAP region. In view of the rapid increase of the ageing population in the ESCAP region, particular attention needs to be given to programmes for older persons with disabilities.

(b) Revised targets concerning the prevention of causes of disability

8.1 To initiate public education campaigns, including gender-sensitive demographic data, associated with and directed at the prevention of the five most prevalent preventable causes of disability, together with smoking, consumption of alcohol and other addictive substances. Such campaigns, while targeting problems, should uphold the dignity of persons with disabilities.

8.2 To eliminate iodine deficiency, vitamin A deficiency, poliomyelitis and leprosy as major public health problems.

8.3 To achieve a substantial reduction in the incidence of three other preventable causes of disability, without neglecting good disability prevention efforts that may already be under way.

8.4 To formally join the international campaign to ban the production, use and sale of anti-personnel landmines, which has led to the Convention on the Prohibition of the Use, Stockpiling, Production and Transfer of Anti-personnel Mines and on Their Destruction.

8.5 To mount an immediate campaign to prohibit the manufacture and sale of laser weapons whose sole purpose is to cause total blindness.

8.6 To initiate, develop and implement legislation for road safety and the safe design and use of the built environment and equipment, as well as the compulsory use of personal, protective and employer-provided equipment for workers whose wages do not cover the provision of such equipment.

8.7 To develop mechanisms for the very early detection of new-born babies who are at risk of developing disabilities.

8.8 To promote, through the government and NGO sectors, early intervention services related to childhood disabilities.

8.9 To provide training for existing grass-roots workers in early detection of and early intervention in childhood disabilities.

8.10 To initiate special measures for prevention, early detection and intervention services for persons with psychosocial problems.

8.11 To initiate services for the early detection and management of age-related disabilities and to promote activities to improve the quality of life of older persons with disabilities.

(c) Revised targets concerning rehabilitation (community-based rehabilitation, and health and social development)

9.1 To increase substantially the involvement of people with disabilities and their families in the entire process of action to address disability-related issues and services.

9.2 To develop and adopt a comprehensive national strategy to address prevention, rehabilitation and measures for the improvement of the quality of life for persons with disabilities, including community-based rehabilitation as a preferred approach.

9.3 To integrate disability issues, including those which specifically concern women and girls with disabilities, into mainstream programmes, especially those for poverty alleviation, health, housing, transport, human resources development, labour, education, communications, culture, tourism, political activities and disaster management programmes.

9.4 To strengthen the coordination of all government and NGO efforts to support community-based rehabilitation programmes.

9.5 To include prevention and rehabilitation issues in the training curricula for personnel in the health, education and social development sectors, and to initiate the integration of disability-related issues in the training of other professionals concerned with the improvement of the quality of life of persons with disabilities.

9.6 To include rehabilitation services in all primary health care programmes and projects, as emphasized in the Declaration of Alma-Ata on primary health care, 1978, to support community-based rehabilitation programmes.

9.7 To facilitate and support the intercountry sharing of specialized personnel, materials and good practices between governments and NGOs.

9.8 To initiate and promote action research and innovative approaches on disability and rehabilitation.

9.9 To promote social security measures for persons with disabilities living in poverty as identified through appropriate means.

10. Assistive devices

(a) Critical issues

31. The functional independence of persons with disabilities is essential for full participation in development programmes and social activities. Having the use of appropriate and affordable assistive devices is a matter of entitlement of all persons with disabilities. Disabled persons also need to be trained in the effective use of assistive devices.

32. Research and development should be promoted on indigenous assistive devices that are culturally appropriate for and affordable by rural and urban disabled persons.

33. Systems for the production and distribution of low-cost and appropriate assistive devices should be developed and strengthened to meet the needs of the majority of disabled persons.

(b) Revised targets

10.1 To take immediate action to set up sustainable systems and procedures, including subsidy schemes, to ensure the production and distribution of assistive devices, as well as repair and maintenance services, with due attention to addressing the needs of all, especially the needs of the most marginalized groups of disabled persons.

10.2 To work with the department responsible for customs duties to introduce exemption of customs and other duties on the import of assistive devices, as well as components, materials and equipment for their production, repair and maintenance, especially items from within the ESCAP region.

10.3 To take immediate action to simplify customs clearance procedures to facilitate the import and export of assistive devices, as well as components, materials and equipment for their production, repair and maintenance, especially those items from within the ESCAP region.

10.4 To encourage research, innovation and improvements concerning indigenous assistive devices, especially those using local resources, by associating leading institutions in such activities, allocating funding, personnel and facilities for this purpose, and promoting intercountry exchange of information on related issues.

10.5 To encourage immediately the development of appropriate and sustainable local technology to provide quality standard assistive devices for people with disabilities.

10.6 To take immediate action to introduce schemes actively to encourage NGOs and private entrepreneurs, through tax incentives and subsidies, to pursue research on, as well as the indigenous production, distribution and maintenance of, assistive devices.

10.7 To promote the training of personnel on indigenous technology for assistive devices to improve services at subnational levels where the need is greatest.

11. Self-help organizations

(a) Critical issues

34. For full participation and equality, persons with disabilities must play a key role in the formulation of national policy on all issues that directly affect their lives. Self-help organizations provide the means for persons with disabilities to voice their needs and aspirations collectively. Lack of coordination and consultation among self-help organizations can reduce their effectiveness in this role. National forums of self-help organizations can facilitate the formation of common positions and strengthen their representation.

35. There has been a lack of understanding of the role of self-help organizations of disabled persons in some countries of the ESCAP region. Thus, in such countries, there are still no self-help organizations of disabled persons. Another issue is the low level of organizational and management skills on the part of disabled persons in the organizations, including skills for working effectively in the community. In some instances, the absence of an environment that is conducive to the development and strengthening of self-help organizations is a serious obstacle.

36. Particularly marginalized are slum and rural disabled persons, women and girls with disabilities, persons with psychosocial disabilities, users of psychiatric services, HIV-positive persons and persons affected by leprosy. There is a need for cross-disability organizations to address the issues of these particularly marginalized groups, to include them as members where appropriate, and to encourage them to form their own groups and organizations.

(b) Revised targets

11.1 To establish and strengthen a national forum of self-help organizations of persons with disabilities to include groups and organizations from rural areas, as well as of particularly marginalized disabled persons such as women and girls with disabilities, persons with psychosocial disabilities, users of psychiatric services, persons with intellectual disabilities, persons who are HIV-positive and affected by leprosy.

11.2 To develop self-help organizations of diverse disability groups, which focus on addressing the needs of rural people with disabilities in the provision of mutual support, advocacy and referrals to programmes and services, and which collaborate actively with rural and urban development NGOs.

11.3 To establish mechanisms under the direction of the national coordination committee on disability, aimed, inter alia, at increasing consultations between self-help organizations of persons with disabilities and diverse government ministries, as well as civil society and the private sector, to strengthen the implementation of the Agenda for Action.

11.4 To establish a national policy with the requisite resource allocations to support the development and formation of self-help organizations of persons with disabilities in all areas, and with a specific focus on slum and rural areas.

11.5 To develop programmes for capacity-building to empower all persons with disabilities, including youth and women with disabilities, as trainers in the leadership and management of self-help organizations, with the skills and confidence to work in the community.

11.6 To introduce the concept of independent living to all concerned with disability matters and promote the achievement of independent living in the community by implementing measures to respect the self-determination and control by people with disabilities over their own lives.

12. Regional cooperation

(a) Critical issues

37. There is a need for small countries in the ESCAP region, including those in the Pacific that have recently joined as signatories to the Proclamation on the Full Participation and Equality of People with Disabilities in the Asian and Pacific Region, to have access to support, particularly funding, to pursue the fulfilment of the targets for the implementation of the Agenda for Action.

(b) Revised targets

: 12.1 Small countries, including those that have recently joined as signatories to the Proclamation on the Full Participation and Equality of People with Disabilities in the Asian and Pacific Region, will approach the United Nations Development Programme and other concerned members of the United Nations system to mobilize the requisite funding and technical support to strengthen their capacity for developing and implementing policies that will lead to increased public awareness of disability issues and achievement of access by persons with disabilities to prioritized areas of development identified by each country and area from the Decade targets listed above.