International Development Committee inquiry

FCDO and disability inclusive development

Written evidence submitted by CBM UK

September 2023

CBM UK works in the world’s poorest communities to fight poverty and exclusion to prevent blindness, improve health, build inclusive communities and transform the lives of people with disabilities. We believe that our world needs everyone and that people with disabilities should participate in all spheres of society on an equal basis, without discrimination, alongside their non-disabled peers to build a world in which all people are included, valued and respected.

The Committee will consider the inclusiveness of FCDO development strategy and delivery, the adequacy and effectiveness of the FCDO’s disability and inclusion rights strategy launched 2022 and the consequences for disability-inclusive programmes of the decision to cut aid spending from 0.7% to 0.5% of GNI. All key questions are answered by CBM UK.

1. The adequacy of FCDO’s new Disability Inclusion and Rights strategy (DIRS) as a framework for approaching disability-inclusive development

Recommendations:

a)   The aims and commitments made in the DIRS are delivered across all UK aid and Government departments, with transparency on all mainstreaming initiatives. 

b)   The UK Government sets out in detail how it will align with a more locally driven approach to directly support people with disabilities and implement the DIRS.

When the FCDO launched the DIRS 2022-2030, CBM UK welcomed[1] the ambition, particularly the firm commitment to listen to the voices of people with disabilities and facilitate opportunities for Organisations of People with Disabilities (OPDs) to influence FCDO decision-making. This continued trajectory in the UK’s approach to inclusive development, with commitments to being a global leader and championing the rights and freedoms of people with disabilities, is to be celebrated. However, it still lacks integration across all subsequent FCDO strategies, a transparent delivery plan with indicators and targets, and adequate finance to ensure implementation.

CBM UK is a member of, and supports a Co-Chair for, the Bond Disability and Development Group, and align to their recommendations. We would also urge:

Full and broad coherence: The championing and mainstreaming of delivery of the DIRS cannot be left to the passionately committed but small Disability Inclusion Team e.g. the lack of DIRS reference in the FCDO’s International Women and Girls Strategy 2023-2030 is concerning. The unique challenges faced will not be overcome unless all UK Government strategies and delivery plans demonstrate commitment, backed by Ministers, to those most marginalised.

DIRS Delivery Plan: A transparent plan with targets to which FCDO can be held accountable is crucial. Any aspiration to reach those left behind will fall short without prioritising active involvement by people with disabilities in shaping the delivery plan (as promised in the DIRS), capacity and needs assessments, and programme planning. The delivery plan must be open to scrutiny by those it seeks to impact.

Finance is critical: Repeated calls were made at the Global Disability Summit (GDS) 2022 to fund more grassroots organisations directly. Access to such donor funding typically involves lengthy cumbersome financing mechanisms, and mismatched expectations. The DIRS referenced ‘participatory grant making with OPDs’, which is exciting as trust based relational partnership is key. Yet 18 months on, FCDO direct funding of grassroots OPDs remains rare, especially in the light of the two Equality Impact Assessments (EIAs) and aid cuts. 

2.The adequacy of FCDO’s spending on disability-inclusive programmes and the impact of cuts to ODA programmes on people with disabilities

Recommendations:

c)    Targeted funding for disability inclusive programmes must increase and additional priority ODA provision given for disability inclusion to be mainstreamed throughout all FCDO and UK Government programming.

d)   Such funding must be seen as a priority and once committed to, not cut.

e)   Prioritise alleviating extreme poverty amongst the most marginalised and ensure funding for in core FCDO areas, such as health, humanitarian, climate response, social protection and education, includes disability both in mainstream support and in specific ways.

Globally there is a mismatch between commitments to and investment in disability inclusion[2]. Lack of spending on disability inclusion hampers progress on eradicating poverty and long-term sustainability of improved outcomes. The number of people with disabilities, currently estimated at 1.3 billion[3], could double by 2050 with aging populations and rises in noncommunicable diseases, with the vast majority (80%) of the poorest living in LICs/MICs.

UK funding investment is required to ensure accessibility for and the reasonable accommodation of people with disabilities in health, education and employment development programmes and humanitarian responses. Interventions which reach the poorest and most marginalised should be seen as fundamental to all value for money assessments.[4] Without everyone being included, programmes cannot be rated effective, efficient, economic or equitable.

Alongside a strong human rights case it also makes good economic sense. People with disabilities participating in their communities without discrimination enables them to contribute economically[5] [6] Ensuring equal access to health services, enabling children with disabilities to attend school, or supporting people with disabilities to be more independent in self-care and entering employment[7], can all have hugely beneficial knock-on economic impacts.

The sudden and severe FCDO funding cuts hurt some of the world’s most marginalised communities. Both EIAs acknowledge the cuts impacted equalities and inclusion objectives, concluding that “the impact of the ODA reductions on FCDO programming with a strong focus on fostering equalities is expected to be severe” and that programmes to provide specific targeted or mainstream to disability support “will be negatively impacted”.[8]

The IDC’s own Inquiry report on Extreme Poverty and the Sustainable Development Goals (SDGs) confirmed: “cuts were made with little reference to need or poverty impact, and they disproportionately impacted the most vulnerable groups.”[9] at a critical time for many grassroots, and often small, OPDs already deeply challenged by the COVID-19 pandemic.

CBM UK experienced this abrupt breach of trust, leading to relationship breakdown with local partners and devastating impacts on communities e.g. an extremely successful health project in Bangladesh was forced to close 2 years into a 3 year cycle. Programme activities increasing access to essential health services for 2m highly marginalised people, including over 140,000 people with disabilities, were stopped without notice, despite A ratings by FCDO[10] . 

Trust has broken down with local partners on UK Government commitment. Going forward FCDO needs to be transparent in indicators and targets, ensure adequate funding for disability inclusive programming and follow through on commitments to people with disabilities to Leave No One Behind.

3. FCDO’s work to encourage and facilitate the participation of people with disabilities, and relevant advocacy groups, in developing its strategy and approach

Recommendations:

f)     Provide adequate resources needed by OPDs (including technical and operational capacity, data and information, finance, human resources, transparent budgets), to support implementation approaches to the DIRS Delivery Plan and demonstrate that all mission posts are actively engaging with OPDs.

g)   To retain a leadership role, FCDO must make the participation of people with disabilities and their lived experience fundamental to all aspects of programming, budgeting and delivery.

h)   Welcome the role of OPDs being a critical friend and holding the FCDO accountable.

The DIRS drafting team set an excellent example by consulting 100 OPDs, but true partnership requires investment and long-term commitment. A strategic intent of the DIRS is to “meaningfully engage, empower and enable people with disabilities to equitably exercise and enjoy their full rights and freedoms”, with mention of supporting development solutions “informed by and respecting people with disabilities’ lived experience, expertise, and knowledge on what works to transform their own lives”[11].  A key enabler, ‘strengthening OPDs’, is weaved through the DIRS, whilst committing to partnering “with OPDs in the delivery of programmes and policy objectives and implement feedback mechanisms”[12]. 

Greater transparency is needed on how these commitments are being met and the entry points for OPDs and people with disabilities to support, challenge and enable FCDO in ensuring this ambition. Successful achievement depends heavily on demonstrating how the DIRS “will be underpinned by a delivery plan developed with meaningful participation from people with disabilities and their representative organisations”[13].

Such approaches were key findings from a CBM UK report when we asked OPDs what lessons needed to be learnt from our partnership[14]. Encouraging and enabling meaningful engagement with OPDs beyond strategy consultation can only happen with authentic listening. Strengthening OPDs requires structural changes to funding that allow OPDs to really be in the driving seat, as well as providing organisational support in IT, data and information. Sadly the EIA 2023 noted that funding cuts meant some specific grants to OPDs did not happen[15]. 

A positive step has been the development of internal FCDO OPD engagement “guidance” to help FCDO staff working on programme delivery, diplomacy or policymaking to consult and engage with OPDs. Developed with input from OPDs, in-country staff are encouraged to seek meaningful participation to aim for effective interventions driven by people with disabilities in shaping decision-making to be locally owned and achieve better outcomes.

The DIRS also highlights ‘Living our values’ and leading by example with aspirations to empower, equip and enable FCDO employees with disabilities to be central. A further delivery plan is intended[16], aligned with the FCDO Inclusion Framework, with expertise identified to help meet 6 clear overriding goals. Assuming this is shared openly, its development and roll out will be easy to support and draw lessons from.

4. The extent to which other ODA-spending departments are ensuring that their ODA expenditure is inclusive of people with disabilities

Recommendations:

i)      Ensure a consistent use of the disability DAC marker across all ODA spending departments and champion its use as a mandatory tool. 

j)     Provision of available, accessible, comprehensive and transparent budget data with engagement of disability rights advocates and wider sector

10 years on from 2014 DfID Disability framework[17], the OECD Development Assistance Committee (DAC) disability policy marker suggests only 25-26% of all recent UK ODA incorporates a disability-inclusive activity[18]. Whilst the UK’s record in this area is better than many other countries, the “every programme” ideal is distant.

Within the new International Women and Girls Strategy, a target commitment is “at least 80% of FCDO’s bilateral aid programmes having a focus on gender equality by 2030 (using OECD DAC markers)”[19]. Could this not also be the ambition for Disability Inclusion across the FCDO, and all ODA spending?. All programmes can take simple measures to promote, and progressively adopt, disability inclusion as a prerequisite. CBM UK alongside our OPD partners are here to support.

Performance target-driven styles of FCDO funding have reshaped approaches to programming so initiatives designed to deliberately seek out people with disabilities and accommodate their needs are perceived as more complex, time-consuming, and expensive for mainstream aid programmes. Pressure to demonstrate that funding is reaching high numbers risks leaving behind the most marginalised e.g. women and girls with disabilities in Sexual and Reproductive Health (SRH) as CBM UK reported recently to the IDC[20].

People with disabilities are often unable to access mainstream programmes because of attitudinal, social, environmental, and physical barriers.  Only by being intentional and deliberately emphasising the need for disability inclusion across the whole of ODA spending will the ambition of reaching the most marginalised be realised. Barriers could easily be identified and challenged if UK Aid actively recognised that women and men, girls and boys with disabilities living in poverty are socially excluded as key actors in the needs assessment and planning stages of programmes and spending. It is critical that new funding mechanisms are accessible to and include OPDs including Organisations of Women with Disabilities who have often been excluded from feminist movements, and often underrepresented and underfunded within the disability movement[21].

CBM UK knows from asking OPDs directly about their needs that lack of access to quality funding, including UK aid, remains a significant challenge[22].

5. The role of the UK in disability inclusion within the global humanitarian and development community

Recommendations:

k)   To retain a leadership role, the UK Government needs to demonstrate fulfilling both the stated ambitions of the DIRS and GDS commitments to positively influence others.

Under the UNCRPD Art32, the UK has an obligation to ensure that international cooperation, including development programming, is inclusive of and accessible to persons with disabilities[23]. The UK can leverage its diplomatic and advocacy approach alongside financing priorities whilst utilising the commitments of GDS22 and implementing the DIRS to demonstrate this. This means regular engagement on disability inclusion with all stakeholders, including country governments, and consistent signalling of its importance to UK Government departments. 

CBM UK carried out a review of four DfID funded humanitarian projects[24], highlighting the UK’s historical role in challenging the injustice of discrimination and structural inequalities that many people with disabilities face in LICs/MICs, but found room for improvement around data collection, accessibility, accountability and coordination on disability inclusion. As the UK renegotiates its role in the world approaching the 2030 SDG deadline, there are real opportunities to ensure disability inclusion is addressed globally to regain leadership and influence other stakeholders to follow the UK’s inclusion example.

6. Safeguarding issues within disability inclusion that should be prioritised in FCDO’s work tackling sexual exploitation and abuse in the aid sector

Recommendation:

l)      Recognise that traditional safeguarding approaches may not reach everyone, particularly people with sight, hearing and intellectual disabilities, and adapt processes and procedures to be more inclusive

People with disabilities may be more vulnerable to abuse and exploitation, including sexual abuse. This risk needs to be factored into FCDO and partner safeguarding policies and practice.

People with disabilities must be consulted about potential risks to their involvement in any project, with reporting mechanisms accessible to people with physical, visual and hearing impairments, intellectual and psychosocial disabilities. Information on expected standards of behaviour by organisations’ representatives and how to raise concerns must be presented in accessible languages and formats. Follow up of concerns raised and investigations must take into consideration any specific needs of those involved, with information and processes that are accessible to people with all disabilities.
 

CBM’s UK Aid Match project in Rwanda provided strong examples of inclusive safeguarding from  participating hospitals that meant key staff, including the Customer Care teams, learned basic sign language; patient orientation meetings were held in the waiting areas each morning to share information on hospital layout and procedures as well as where to go for questions or concerns; posters displayed in key locations with short large-print messages in local language explained how to raise a concern and gave the hotline number; patient advisory groups included people with disabilities; hospitals proactively sought feedback, including through meetings in the communities and social media, SMS and phone surveys.

7. FCDO’s learning from other approaches and global work on disability inclusion

Recommendation:

m) Prioritise making representations in mainstream diplomatic spaces about disability inclusion

A good example of learning and exchange networks among development partners, UN agencies, foundation and CSO networks is the GLAD network[25], providing opportunity to share learnings in inclusive health, climate action, inclusive education and gender equality.

This approach to learning and exchange can strengthen individual donor approaches and maximise synergies at all annual face to face Summit meetings and provide a dedicated space for this. FCDO must take all opportunities for learning and sharing different approaches across UN and other major gatherings e.g. UNGA, Conference of State Parties and G7 on disability inclusion.

8. FCDO’s progress in implementing the Committee’s previous recommendations, and the commitments made at the Global Disability Summit

Recommendation:

n)   A full review in this Inquiry of the IDC 13th Report (2017-19) on DFID’s work on disability–inclusive development and Government response on what recommendations/commitments have been progressed or not. 

o)   Prioritise transparency through an open process of accountability with mechanisms to publish updates that are open to scrutiny.

The last IDC report and Government response[26] on Disability Inclusive Development came in 2019 prior to the pandemic and aid cuts. At that time the IDC made 39 distinct recommendations including: “DFID should develop a robust accountability mechanism that enables all actors to be held to account for making progress towards meeting their commitments.” The UK Government agreed stating: “We are developing plans for an independent secretariat and governance structure so that everyone, including DFID, is made accountable for their commitments”… and in amongst other promises stated “We expect the independent secretariat to be supported by working groups, CRPD committee advisors, and a high-level advisory group of representatives from across relevant stakeholder sectors including DPOs. We plan to have this in place at the beginning of 2020.”

That hasn’t happened to date. An External Disability Board promised by the DIRS is in place, but those five volunteer members meet with a different remit to what was envisaged in 2019.

Many important recommendations agreed to have been affected by both the pandemic and aid cuts. With the number of specific recommendations made in that report a full review of commitments made is now needed. 

Tracking of the GDS 2022 commitments is through the International Disability Alliance portal[27], which to date does not appear to have any UK commitments updated (recognising that these may have been passed on by the UK Government but not yet posted). 

Further considerations – CBM UK has identified crucial gaps in FCDO disability and development policy and programming that need strengthening. These include Mental Health, Climate Change and Disability Data.

Climate Change

Recommendation:

p)   The perspectives of persons with disabilities and OPDs must be included in all relevant policy and programming, enabled through direct training and promotion of climate awareness.

DIRS has climate change as an “emerging” area but progress now is critical[28]. The disproportionate impact of climate change on persons with disabilities in LICs/MICs is not in dispute, and the cycle of poverty and disability means they are often among the most marginalised in their communities. This increases the likelihood of them living in low quality housing in more at-risk environments. Yet, despite understanding their context better than anyone else, and having capacity to contribute to appropriate solutions, they have little, if any, say in the processes, policies and programmes being formulated in response to the climate crisis[29]. Championing their inclusion must be a priority for the FCDO and UK Government.

Mental Health

Recommendation:

q)   There is a need for UK Aid to support partners and encourage other governments to recognise mental health as an intersectional issue.

Mental health and psychosocial disabilities are too often overlooked despite being the world’s leading cause of disability, affecting over 450 million people at any time. 80% of people with mental illness live in LICs/MICs, where most have little or no access to treatment or support and many face extreme poverty, discrimination and abuse.  Stigma and exclusion, combined with a lack of support and treatment, pulls whole families deeper into poverty.

Data

Recommendations:

r)    Significant UK Government effort is required to ensure:

1. all UK Aid spending is measured by its impact on persons with disabilities
2. national governments are encouraged to use the Washington Group Questions in their national Census and household surveys
3. innovative initiatives to collect disability data at community level are encouraged.

Reliable data, a critical enabler for disability inclusive development[30], is urgently needed to understand the real situation of people with disabilities, identify successes and gaps not yet addressed. This is foundational to evidence-based policy, programming and learning (design, evidence collection, analysis, dissemination)[31]. Disability is specifically referenced in SDGs relating to education, growth and employment, inequality, accessibility of human settlements, as well as data collection and monitoring. There are significant data gaps in many countries inhibiting this. Despite national population data (e.g. health status, literacy levels, etc.) collected through regular census and sample surveys, disability disaggregated data is absent, poorly done or misses large numbers of people. This is holding back equitable policy processes, counter to the ‘leave no one behind’ principles of the SDGs.

CBM UK, Munro House, 20 Mercers Row, Cambridge CB5 8HY

Contact Mark Barrell, Head of Advocacy: markb@cbmuk.org.uk