Written Evidence to International Development Committee of UK Parliament

Humanitarian Crisis Monitoring: Impact of Coronavirus COVID-19

from

Commonwealth Disabled People’s Forum

1. The Commonwealth Disabled People’s Forum recognises that we are facing a global health crisis unlike any in the 75-year history of the United Nations — one that is killing people, spreading human suffering and upending people’s lives. This is much more than a health crisis. It is a human crisis. The coronavirus disease (COVID-19) is attacking societies at their core. The crisis requires a call to action, for the immediate health response required to suppress transmission of the virus to end the pandemic; and to tackle the many social and economic dimensions of this crisis. It is, above all, a call to focus on people – women, disabled and elderly people already at risk, and youth, low-wage workers, small and medium enterprises, the informal sector that are likely to be heavily impacted.

2. The Commonwealth Disabled People’s Forum (CDPF) was restarted in New York on 13th June 2019.

The Commonwealth promotes democracy and equality across its member countries with over 2.5 billion citizens. Over 450 million are persons with disabilities, mainly young people. The self-organisation of Commonwealth Disabled People’s Organisations and their collaboration, capacity building with each other and advocacy play a crucial role in implementing the Convention on the Rights of Persons with Disabilities (CRPD) and the Sustainable Development Goals. The relaunching of the Commonwealth Disabled People’s Forum with the support of DPOs in the majority of Commonwealth countries gives us a supportive and democratic structure to ensure disabled people across the Commonwealth are not left behind.  The CDPF was originally set up in 2008 and operated until 2013 but through administrative and financial problems ceased to function. At the UK Government Global Summit on Disability, in July 2018, a side meeting of 25 disabled people from 20 Commonwealth countries agreed that it was important to restart the CDPF. It was agreed that we should raise funding and hold the launch event in New York during the Conference of State Parties. The Disability Rights Fund agreed to fund us for 2 years with a fiscal partner Action on Disability and Development. Representatives from Disabled People’s Organisations in 27 Commonwealth countries came together and adopted a revised Constitution, Action Plan and elected a new Executive Committee of 20.[1]

3. The CDPF  priorities for Work of Commonwealth Disabled People’s Forum (CDPF) 2019-2020:

1. The recruitment and active engagement of Disabled People’s Organisations across all Commonwealth Countries in the CDPF.
2. To continue to support the full ratification and implementation of the UN Convention on the Rights of Persons with Disabilities (UNCRPD),the Sustainable Development Goals (SDGs) and other legally binding treaties in all Commonwealth Countries.
3. To challenge the continuing inequalities and exclusion that disabled people face throughout the Commonwealth in all areas of life. Specifically, by developing inclusive education, employment opportunities - economic empowerment and entrepreneurship, equality of livelihood, assistance in humanitarian situations, gender equality and the provision of assistive technology. To challenge stigma, discrimination and other intersectional oppressions which lead to negative attitudes, stereotypes and inequality.
4. To develop the capacity of DPOs at local, regional and national levels in each country, to understand the principles of disability equality, the requirements of the UNCRPD and SDGs, the requirements and practices of running representative DPOs, and methods for effectively influencing Government policies for Disabled People, shadow reporting and monitoring.
5. To develop National Umbrella cross impairment organisations of Disabled People which are widely geographically based and inclusive of different impairments.
6. To support, develop and promote leadership amongst young disabled people.

To achieve all the above we will:

i)                    Encourage and support North-South and South-South Collaboration of DPOs

ii)                   Promote the Social Model and Human Rights Approach to Disability Equality,  provide and facilitate training on these

iii)                 Share good practice and information

iv)                 Work with Governments, funders and donors to fund DPO projects to capacity build to implement the UNCRPD, Sustainable Development Goals and other initiatives

v)                  Capacity Building by developing strong representative National DPOs of cross impairment groups, which are gender responsive and reach disabled people in all areas, across each country

vi)                 Develop the capability to gather data, research and monitor programmes and spread effective good practices

vii)               Encourage disabled women’s and girls’ self-organisation and to make our DPOs habitable to women

viii)             Work for the inclusion of disabled youth and other under-represented groups and people of all ages in our organisations

ix)                 Encourage representation on global, regional and national bodies and work with UN Development organisations, other international agencies and Non-Governmental Organisations.

4. Disabled People is the Commonwealth Disabled People’s Forum chosen description rather than persons with disabilities which features in the UNCRPD and many other international documents and is only used  when not quoting texts. Disabled people are subject to a common oppression regardless of our different impairments. It is the barriers of environment, attitude and organisation that disable us because we have impairments. This disablement needs to be challenged by Governments with legislation, shifting practices and attitudinal change to ensure disabled people have full equality, accessibility and human rights. Impairments can include physical, sensory, mental, intellectual or psycho-social and represent a loss of function which can be mitigated by assistive devices and technology.

5. We have continued to recruit more national umbrella DPOs to the CDPF. We currently have member organisations  in 44 of the 54 Commonwealth Countries and 38 of these are the national umbrella Disabled People’s Organisation. In addition we have 32 other DPOs affiliated. For a full list see https://commonwealthdpf.org/members/ as of the end April 2020.

6. Since then our Executive has met regularly by Skype, in person in Malta in February 2020 and developed policy documents in the area of Girls and Women, Employment, Inclusive Education, Humanitarian Situations, Accessibility and Assistive Technology and Media, Stigma and Discrimination and Global Environmental Crisis. We were planning to run capacity building in Kigali, Rwanda in the week before the Commonwealth Heads of Government Meeting. Due to COVID-19 we are now developing a series of on-line trainings to replace this which will develop new resources and training methods and reach a far larger number of DPO leaders and potential leaders.

7. In March our Executive met and adopted a series of principles and statement for our member organisations to put to their Government’s concerning COVID-19 and Disabled People [https://commonwealthdpf.org/covid-19-statement/] The key principles were that :

•                    Disabled People must receive information about infection mitigating tips, public restriction plans and the services offered, in a diversity of accessible formats with use of accessible technologies.
•                    Additional protective measures must be taken for people with certain types of impairment and for many disabled people to function, they require close personal assistance from carers or family members.
•                    Rapid awareness-raising and training are essential for all personnel involved in the response. This must include accommodations and the support disabled people require.
•                    All preparedness and response plans must be inclusive of and accessible to disabled women and children.
•                    No disability-based institutionalization and abandonment is acceptable.
•                    During quarantine, support services, personal assistance, food and clean water supply, physical and communication accessibility must be ensured.
•                    Measures of public restrictions must consider disabled people on an equal basis with others.
•                    Disabled people in need of health services due to COVID19 cannot be deprioritized on the ground of their disability.
•                    Disabled People’s Organisations (DPOs) can and should play a key role in raising awareness of disabled people and their families.
•                    DPOs can and should play a key role in advocating for a disability-inclusive response to the COVID19 crisis to their Governments, Health Service and Communities.

8. On the 24th April the CDPF adopted the following policy re the immediate COVID 19 Pandemic. “The CDPF will continue to publicise and gather information on the impact of the COVID -19 Pandemic on disabled people and their families across Commonwealth Countries. Campaign and advocate for equality of treatment and maintaince of human rights for all disabled people during and after the COVID-19 pandemic. Influence and Educate DPOs, Governments, Funders and the population as a whole on the detrimental effects that the Pandemic is having of disabled people throughout the Commonwealth. Advocate and develop inclusive and sustainable futures that prevent the re-occurrence of the impacts of this pandemic and create a more equitable, environmentally sustainable and fairer world, based on the principles of human rights and disability and gender equality. To achieve this, the CDPF will establish a Covid-19 sub-committee, an advice desk/ worker and web presence with regular exchange of information between member organisations and CDPF and  encourage the organisation and delivery of:- a. Regional and Global level coalition to intervene with the emergency disability support services based on present lesson learned at national level responses; b. A very strong national level disability support and coordination mechanism to take spontaneous actions during the emergency situation and post-pandemic; c. Commencement of a Regional and Global level policy dialogue and accessible guideline formation in order to better address the disability issues under any emergency situations and contingency planning based on future scenarios; d. Requesting international donors/ funders to include disability as a pre-requisite in their funding application process during this period and aftermath of Covid-19 with a possible backing of international organisations agencies including UN, World Bank and International Monetary Fund”.

9. CDPF have had reports from a majority of our country members, both through a questionnaire and verbally at a COVID-19 online video summit. These included the largest in terms of population India, Pakistan, Bangladesh, Nigeria, South Africa, Tanzania, Malaysia, Kenya, Sri Lanka, Mozambique. They showed that a majority of Governments had responded well to our principles and statement, but there were major issues with roll out on the ground[2].

10. CDPF are most concerned that despite in many cases inclusive Commonwealth Country guidelines, disabled people are being left out of COVID 19 responses.

Further concerns were :-

1. Guidance is often not accessible in terms of Sign Language, Easy Read or Braille;
2. The social welfare measures for disabled people are often not reaching them on the ground; for example in Orissa State in India, local DPOs carried out a survey and found that no disabled people had received food or financial compensation they were entitled to.
3. Lockdown measures are hitting disabled people who rely on personal assistance particularly hard and l PPE for those who provide personal care is in short supply or non-existent;
4. Those with psycho-social impairments such as autism, find it additionally difficult and need dispensation to go out in a safe way. Some Governments have agreed this.

8. CDPF is very concerned that many Governments while signing up to the United Nations Declaration of Human Rights (1948), United Nations Convention on the Rights of Persons with Disabilities (2008) and the Sustainable Development Goals are ignoring their commitments and responsibilities under these treaties when it comes to disabled people in the COVID 19 pandemic. In countries where healthcare professionals will not be able to provide the same level of care to everyone, due to lack of equipment and underfunding of the healthcare sector, medical guidelines need to be non-discriminatory and follow international law and existing ethics guidelines for care, in the event of disaster and emergencies. These are clear: disabled people cannot be discriminated against. The World Medical Association Statement on Medical Ethics in the event of disasters notes: “in selecting the patients who may be saved, the physician should consider only their medical status and predicted response to the treatment, and should exclude any other consideration based on non-medical criteria.”

9. The CDPF is very concerned about Eugenicist responses to the COVID-19 pandemic. The infamous history of the pseudo-science, Eugenics, and its link to incarceration and death of disabled people and others judged inferior e.g. Jewish People, Gypsies, Gay people, must stand as a seminal warning to this type of thinking. Human Rights sets itself against such notions as the ‘survival of the fittest’. Yet towards the end of January 2020 the UK Government was putting forward theories of ‘Herd Immunity’ letting COVID-19 do its worse, when it was known that disabled people, especially elderly people with impairments were more at risk of serious illness and death from the COVID-19 virus. This means leaving those most at risk to die. People more at risk should have attracted the greater medical and personal support e.g. testing, Personal Protective Equipment and safe personal care. Yet in the UK and in many Commonwealth countries this was not the case.  What has happened in UK Care Homes inhabited largely by disabled people, through the neglect and lack of testing and PPE has meant far higher levels of infections and deaths than necessary, could be seen to also be the result of this eugenicist thinking. The Guidance issued by National Institute of Clinical Excellence which had to be withdrawn following criticism by disabled people and various GPs who approached their disabled patients to sign ‘Do Not Resuscitate Notices’, as reported by Disability News Service show that disabled people’s lives have not been given equal value in the Covid-19 Pandemic in the UK. These and other difficulties reported arise from lack of proper consultations with DPOs by the UK Government.[3]

10. Using the word ‘vulnerable’ to describe those at greater risk shifts the responsibility onto them and fails to come up with the right protections and support. Another example of breaches of human right is in Romania.

Eight organisations strongly condemned the discriminatory actions that Romanian authorities took in relation to the outbreak of COVID-19 in the Sasca Mică psychiatric institution, where 242 of the 369 residents and 59 of the 86 members of staff are infected. 

In a letter sent today to the Romanian Prime Minister, Minister of Health and Minister of Labour and Social Protection the organisations stated that infected residents were isolated in a separate building instead of being hospitalized as is standard practice. The letter details that the institution does not have adequate medical equipment or staff to provide medical care, that the institution lack personal protective equipment and that the living conditions were sub-standard even before the infection. They told the government that “We believe that such measures are obvious discrimination and will result in spiralling death rates and people being subjected to conditions that are akin to inhuman and degrading treatment.”

The letter also details explicit demands for the government: “adopt more effective testing routines, provide universal access to health care for all persons with disabilities living in institutions, provide personal protective equipment and facilitate independent monitoring of all institutions, to promptly identify any cases where residents are being denied medical treatment, collect and make public information about the number of infections in institutions and launch a time-bound detailed deinstitutionalization plan”. Signatories of the letter include the International Disability Alliance, the European Disability Forum, the European Network on Independent Living, the Romanian National Disability Council, Validity Foundation, Disability Rights International, the International Disability and Development Consortium, and the  Centre for Human Rights, University of Pretoria”[4] 

11. CDPF is of the view that in many parts of the Commonwealth- Africa, Asia in particular, although lockdown measures including school closures have been introduced, as these ease the likelihood of accelerated infection and death is very high, because of the lack of basic health and public health infrastructure, (lack of clean running water for more than 3 billion people in the world) and the great, if not impossible difficulty of introducing social distancing measures in overcrowded slums and shanty conditions. As the United Nations have said this calls for the Governments of the World and large Corporations and agencies to fund a COVID-19 recovery fund that must be at least 10% of the world’s global Gross Domestic Product.  

12.  This crisis is truly global. It is in everyone’s interest to ensure that developing countries have the best chance of managing this crisis, or COVID-19 will risk becoming a long-lasting brake on economic recovery. Governments should resist the temptation to resort to protectionist measures. This is the moment to dismantle trade barriers, maintain open trade and re-establish supply chains. Tariff and non-tariff measures as well as export bans, especially those imposed on medicinal and related products, would slow countries’ action to contain the virus.

13. The UK Government and the Governments of other developed countries should take explicit measures to boost the economies of developing countries. Developing countries need international support, given that their ability to fund expansionary stimulus is already limited, and has been further limited in recent days by currency instability. This will require debt relief for many countries to create the domestic fiscal space. This will also require creative thinking about how to mobilize large injections of concessional finance – not only from multilateral development banks but also from private lenders such as pension funds, who will be in a hunt for low-growth investment opportunities.

14.The CPDF calls on the UK Government and the Governments of other developed countries to strengthen international public finance provision. International financial institutions and regional development banks can play an important role in addressing the impact of the crisis and financing the recovery. A post-crisis coordination mechanism must be created to provide the resources to all countries to have adequate fiscal space.

15. The CDPF calls on the UK Government and the Governments of other developed countries to waive sanctions in this time of solidarity. Sanctions imposed on countries should be waived to ensure access to food, essential supplies and access to COVID-19 tests and medical support. This is the time for solidarity not exclusion.

16.THE CDPF believes the UK Government should seek to get the world to agree to  adopt “Do No Harm” trade policies, preserve connectivity and ensure regional monetary-fiscal coordination; to engage with private financial sector to support businesses; address structural challenges and strengthen normative frameworks to deal with transboundary risks and undertake fiscal stimulus and support for the most at risk. Now is the time for far greater international economic solidarity and collaboration. The Global connectivity of the world means that until the virus is eradicated, or properly controlled by means of an effective vaccine, as long as the outbreak continues anywhere, everyone is still at risk.  Furthermore, the global economic imbalance and lack of progress on developing policies in balance with environmental capacity of the globe, also put us all at great risk.

17. The CDPF calls on the UK Government and all Governments of the Commonwealth to Protect Human Rights and focus on inclusion as we go forward from here. This must include :

1. Ensure access to testing or treatment is not denied due to discrimination, whether on grounds of disability, gender, age, religion, sexual orientation, ethnicity, race or otherwise.
2. Monitor incidents of discrimination and xenophobia and swiftly respond and publicize.
3. Disseminate accurate and evidence-based information and conduct awareness-raising campaigns.
4. Clear and timely information needs to reach everyone, in particular formats e.g. Easy Read, Sign Language and Braille, national, ethnic or religious minorities, indigenous peoples, or LGBTI people.
5. Access to additional financial aid for disabled people and their families and ensure that disabled people under care, living in public and private facilities, are protected from neglect and abuse and provided PPE.
6. Reduce populations in prisons, jails, and immigration detention centers through appropriate supervised or early release of low-risk category.
7. Introduce moratoriums on evictions and deferrals of mortgage payments.
8. Ensure that homeless people and those living in inadequate housing are not negatively impacted by virus containment measures.
9. Adopt safe measured back to school strategies and create and employment opportunities for youth.

18. The CDPF is of the view that whole societies must come together. Every country must step up with public, private and civic sectors collaborating from the outset. On their own, national-level actions will not match the global scale and complexity of the crisis. This moment demands coordinated, decisive and innovative policy action from the world’s leading economies, and maximum financial and technical support for the poorest and most at risk people and countries, who will be the hardest hit. Given the world’s extensive economic and social interrelationships and trade— we are only as strong as the weakest health system.

19. When we get past this crisis, we will face a choice – go back to the world we knew before or deal decisively with those issues that make us all unnecessarily vulnerable to this and future crises. Everything we do during and after this crisis must be with a strong focus on building more equal and inclusive societies, more resilient in the face of pandemics, climate change and the many other challenges we face.

20. The CDPF calls on all Governments of the Commonwealth, all members states of the United Nations and The United Nations family to support all countries, to ensure first and foremost that lives are saved, livelihoods are restored, and that the global economy and the people we serve, especially disabled people, emerge stronger from this crisis. That is the logic of the Decade of Action to deliver the SDGs. More than ever before, we need solidarity, hope and the political will and cooperation to see this crisis through together[5].

Richard Rieser, General Secretary Commonwealth Disabled People’s Forum   on behalf of the Commonwealth Disabled People

rlrieser@gmail.com   07715420727