Summary: CBM UK believes that international aid is most effective and impactful when underpinned by a rights based approach with authentic partnerships between all levels of society, government, business and non-governmental organisations committed to active engagement with the more marginalised such as persons with disabilities. International aid should support the strengthening of global systems to serve people and provide good quality services, such as in health and education, which are accessible to all. This increases economic, political and social participation so that the whole community benefits and flourishes leading to improved health, quality of life and wellbeing, as well as reduction of poverty. To facilitate this an intentional shift of power in international aid must be made to those more likely to be caught up in the cycle of poverty and those most often left behind, including persons of disabilities, enabling them to advocate for their own priorities. Those supported by international aid should be promoted and engaged as active agents of change and not to be treated as passive beneficiaries. As improved educational attainment, better health, access to essential equipment, greater economic power, access to justice and other rights are experienced wider society and attitudes are transformed with reduced discrimination and improvements for all.
Emergency and humanitarian contexts. In disasters, such as the current situation in southern Madagascar, the response from the international community is vital and our global responsibility to assist is in the interest of all. Without such intervention it is possible that many will die, lives will be much harder and poverty will increase with wider consequences for everyone. In humanitarian crises, persons with disabilities are amongst those most marginalised and affected but very often the last to receive help at a time when even more people are at greater risk of disability. International aid in these situations should be used as a mainstream response that fully recognises the needs and capacities of marginalised groups who are best informed about their needs and appropriate responses. In doing so each group can bring to bear their unique knowledge and experience essential to their ongoing survival and the continued resilience capacity of their communities. Additionally they have agency to ensure that international aid in an emergency situation leaves no one behind and does no harm. Without disability inclusion and delivery in conjunction with local Organisations of Persons with Disabilities (OPDs) humanitarian aid exacerbates and lengthens the crisis situation leading to worse outcomes, especially for people with disabilities.
Non-emergency and development contexts. At CBM, our ambition is for international aid that it is locally owned, contextually appropriate, accountable to citizens, and does no harm (for example by exacerbating existing inequality or prejudice). It recognises that everyone has the potential to contribute to their own personal and community flourishing. International aid can be used to develop, promote and enable that change so it can be fully inclusive with mutual responsibility, accountability, trust and respect between all partners. To achieve this international aid should aim to shift and rebalance power, recognising that building an inclusive world requires an admission that deep-rooted inequality and injustice must be addressed and power must be used for the good of all. Governments, national and local, must be encouraged to bring everyone to the table, and work in partnership with strong local implementers who have the expertise and knowledge to break down the barriers that exclude the full participation of all people in that change, especially girls and women, and persons of disabilities to enable decisions on what works best to be fully inclusive.
In Bangladesh, CBM and our partner, the Centre for Disability and Development, have developed an effective model for building the capacity and confidence of local OPDs to effect change. Self-help groups of people with disabilities are formed at local level and, through an understanding of their rights, support leadership development to bring about change and improved lives. From these locally driven self-help groups representatives are chosen to form an OPD which provides greater amplification of their voice and a district-wide focus on advocacy and influencing local change, with attention given to ensuring women’s participation in leadership, and that people with different impairments are involved. Using models such as these, OPDs gain the agency to engage and fully participate in deciding issues regionally and nationally.
Technical assistance and finance in international aid should be specifically directed to those who are the most marginalised, with the greatest need and whose barriers often prevent inclusion. This does not mean that without aid there is no hope, but without this lens on how to focus international aid and development the most marginalised are left behind and overlooked.
International aid is effective in reducing poverty when it is done in a way that is inclusive of all. At CBM UK we promote a rights-based approach to locally led development. This ensures that in driving and setting the needs, planning, scoping, implementation, monitoring and evaluation of interventions the rights of everyone, including persons of disabilities are recognised. One in five people living in poverty has a disability and around 15% of the world’s population, approximately 1 billion, are living with disabilities. Ensuring non-discrimination, fairness and equality is upheld for all, including persons with disabilities, means removing all barriers to participation in society.
Effective aid which reduces poverty happens when international cooperation is fully committed to authentic partnership with the most marginalised. In keeping with the motto “nothing about us without us”, CBM views partnership with OPDs as fundamental to tackling the power imbalances between persons with disabilities and persons without disabilities in ODA. Empowering partnerships bring voices to the table, help balance decision-making in favour of marginalised people, and enables more sustainable interventions based on deeper needs assessment, appropriate implementation and accountability for impacts to all. For international cooperation to Leave No One Behind and achieve poverty eradication the full and direct participation of those affected by development policies and initiatives must be assured. This means a commitment to strengthening capacity of all in society to influence changes on policy at regional and national levels, enabling decisions to be significantly directed towards the areas of concern for those receiving aid leading for example to better health outcomes, accessible education and everyday living standards for those who most need it.
A local OPD in Ethiopia fed back to CBM that our partnership approach has “motivated OPDs to move from the charity model of support …important because it changed the mentality of people in the OPD and the community towards disabled people. It empowered the OPDs.”
For aid to be effective it needs to be marked by a long term commitment based on good investment and a parity of power in partnerships. CBM UK has seen this demonstrably work in reducing poverty which breaks down barriers to achieve long term systemic change through the “Seeing is Believing” project. CBM partnered with international and numerous local and national civil society organisations and governments across 20 countries over fourteen years. This collaborative and long term partnership approach ensured that a comprehensive and inclusive approach to eye health provided front-line interventions to more than 7.4 million adults and children, with over 2.2 million sight-saving surgeries, reaching over 150 million people with information on how they could improve their eye health and access treatments. The partnership had a strong focus on capacity building of local actors, ensuring sustainability long past the project duration, so breaking the cycle between poverty and disability. Millions of lives were transformed and poverty reduced as opportunities for education, employment and economic livelihood became more easily accessible.
In contrast aid is ineffective at reducing poverty when the power and decision making remains in the hands of those with the funds who determine what success looks like and how reporting is to be done. Such aid is often ineffective as contextually inappropriate approaches create dependency with little or no local ownership reducing the long term sustainability of development within the community, and not enabling the most affected to bring lasting impact. Such donor (power) directed and led aid has its foundations in beneficiary (servant) reception, which suppresses agency, input or acknowledgement of the needs and experiences of those closest to the issues. It habitually excludes the most marginalised and has provides no meaningful participation or mutually agreed outcomes that are fully inclusive of all. It is often characterised by high spends on donor consultants and management fees compared to more efficient and cost effective partnership models that develop local capacities and focus on outcomes.
International aid should be “Rights-Based” through agreed conventions, frameworks and practices that are monitored, evaluated, transparent and accountable. The United Nations Convention on Rights of Persons with Disabilities (UNCRPD), clearly demonstrates that international aid will only be properly focused when persons with disabilities are never over looked, left behind or harmed, and when persons with disabilities and OPDs are fully included in meaningful participation in all international aid planning, implementation, monitoring and evaluation. Failure to ensure that people with disabilities are at all times involved in international aid responses leads to further discrimination, and exacerbates barriers rather than breaking them down.
In an emergency situation The IASC Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action provides the framework in which international aid can be both effective and meaningful in these circumstances.
In development situations international aid must be universal and non-discriminatory, ensuring fairness and equality for all including persons with disabilities. Structural injustices that perpetuate inequity must be challenged so that all barriers to participation are removed, including when the rules are being set and agreed. CBM’s Inclusion Advisory Group, along with the Centre for Inclusive Policy and key Organisations of People with Disabilities, provided advice to Indonesian government legislators on how to ensure rules and measures are in line with international human rights obligations as regulations were developed. In doing so the voice of those seeking to break down the physical, environmental and attitudinal barriers is amplified.
Defining success comes from meaningful participation, listening and dialogue from the outset, led as closely as possible by those who will receive aid and who themselves articulate what success would look like and how it is measured. This means international aid giving full realisation to UNCRPD commitments to inclusion and the delivery of rights for the most marginalised people – particularly women and girls with disabilities so that attitudes and behaviours, systems and institutions are changed to the point that they are fully inclusive and held accountable. This should be consistently monitored and captured through the collection and dissemination of disaggregated data.
By using the expertise of local knowledge systems shaped by their lived experience the sustainable delivery of their own defined successful outcomes will be ensured. Full inclusion and non-discrimination will mean that the voices of everyone is included in deciding upon what success will be. CBM has seen this through our World Bank Community Based Water Supply and Sanitation Program (PAMSIMAS) which identified and supported people with disabilities to address the water and sanitation needs with their lived knowledge at its core. Disability inclusion is now an integral part of PAMSIMAS that targets 15,000 new villages.
CBM is involved in both and whilst it can be helpful distinguish humanitarian aid for disaster and crisis emergency situations as against long term committed development partnership towards sustainable impact, it is important to recognise that they are by no means completely distinct. The effects and underlying causes of crises often last years, if not decades, and as a result merge with development. Beyond an immediate emergency response, development goals and spending must be incorporated within the ongoing humanitarian response, so that longer term investment in education and health, livelihoods and economic empowerment is not neglected alongside shelter, food and water provision for those affected such as displaced persons in camps. How spending occurs and is allocated in each situation must be on a “nothing about us without us” basis. Persons with disabilities and OPDs being involved in spending decisions is crucial. In both humanitarian (emergency) aid and in long-term partnerships CBM recognises the need to provide disability-specific initiatives that support the empowerment of people with disabilities whilst also ensuring that mainstream policies and programmes include people with disabilities. This understanding is required in both emergency humanitarian responses and long-term partnership models of spending where the overall goal should always be to integrate and include people with disabilities and OPDs to address disability needs in the context of each situation with an aim of seeing long term change. In a humanitarian response OPDs may identify particular issues that need specific disability inclusive solutions which are locally-owned for that context. In addition the emergency situation might highlight a particular issue that needs mainstreaming disability inclusion spending for long term systemic change in future policy, practice and action to avoid future issues and problems.
The SDGs have been an agreed benchmark since 2015 negotiated by countries to seek to bring about poverty eradication by 2030 and to deviate would seem to be short sighted when there is a global commitment to this. The SDG agenda specifically commits to disability inclusion as part of the global effort to recognise that many people are hidden and their voices unheard, in the spirit of “nothing about us without us” and need to be kept as a priority so that no one is left behind or forgotten. Over the coming nine years all international aid and donors must actively involve people with disabilities and OPDs in securing the goals. This includes access to water, sanitation, food and health, alongside equal opportunities for education, employment and economic livelihoods. Whilst the SDGs could run alongside other objectives and aims that countries have devised it would be harmful and short-sighted to not keep the SDGs as development priorities for everyone including persons of disabilities. Within the context of increasing numbers and severity of climate emergencies worldwide, and the disproportionate impacts of this on more marginalised communities and people, the SDG focus on meeting the needs of all is imperative.
Different development actors have a role to play in enabling cooperation and partnership. This means each using their function to secure the widest participation and fullest accountability, and is especially true on inclusion. It is essential that every development institution and organisation is driven by a commitment to remove all exclusionary barriers within the processes, systems and structures within their sphere of control. Each need to adopt and sustain a focus on fighting the multiple and intersecting forms of discrimination for those who are marginalised and be alert to the fact that no one group represents the full array of interests that matter. It is not enough to leave just a few INGO’s to speak about and reinforce the need for disability inclusion, but each actor must play its own part in ensuring equity across all international aid. In Ethiopia, CBM and their partner organisation, Bright Futures International (BFI) ran training for government decision makers on international disability frameworks and OPD members were trained up at the same time - a win-win approach.
Such initiatives need to be utilised at various levels to make sure that each sector actor is listening to the other, learning together and reinforcing the messages that leverage every opportunity to reduce the causes of poverty and ensure that aid is both effective and good value for money. Mutual recognition of each other’s function means for example that governments are held accountable not only by financial donors but strengthen the required transparency and proof of successful use of funds by the inclusion and support of local civil society and INGOs. Building on this development actors must encourage close and trusting working relationships with local organisations and capacity building INGOs who enable wider society to understand how to engage with keeping governments answerable, reducing corruption and encouraging value for money.
CBM actively engages with OPDs as an intermediary organisation so smaller organisations are at the table enabling more flexible funding models whilst prioritising the full benefits of power shift within the development sector. This enables a culture that is fully representative, drives innovation and adaptation from the ‘lived experience’ perspective, and encourages challenge to accepted norms and assumptions. These innovative, practical and locally tailored solutions need greater international and local investment to support them. In doing so empowered, equitable and collaborative partnerships across the various sectors will influence governments to ensure that development actors will leave no one behind whilst guaranteeing that assistance is given where the need is greatest.
CBM UK, Munro House, 20 Mercers Row, Cambridge CB5 8HY
Contact Mark Barrell, Head of Advocacy: firstname.lastname@example.org