1. The present report presents the results of the fourth five-year review and appraisal of the World Programme of Action concerning Disabled Persons (A/37/351/Add.1 and Add.1/Corr.1, annex, section VIII, recommendation I (IV)), adopted by the General Assembly in its resolution 37/52 of 3 December 1982. The report is submitted pursuant to Assembly resolutions 56/115 of 19 December 2001 and 52/82 of 12 December 1997, by which the Assembly decided that the next review and appraisal, in 2002, should consider key social and economic policy issues related to equalization of opportunities, in particular (a) accessibility, (b) social services and safety nets and (c) employment and sustainable livelihoods.
2. The current review has three objectives: (a) to report on progress in implementing General Assembly resolution 56/115, (b) to review and assess trends in policies and programmes from the disability perspective since the last review and (c) to submit recommendations to further implement the goals of the World Programme of Action: full participation of persons with disabilities in social life and development, and equality. The report presents conclusions and recommendations for action for consideration by the Assembly. The annex to the report provides an overview of recent policy and programme activities of Governments, international organizations, the United Nations system and the non-governmental community to promote the full participation and equality of persons with disabilities.
II. Progress in implementation
3. Available data suggest widespread support for the goals and objectives of the World Programme of Action and for the guidance provided by the Standard Rules on the Equalization of Opportunities for Persons with Disabilities  for disability-sensitive policy design, planning, evaluation and drafting of national legislation. However, Governments have yet to pronounce themselves on the proposed supplement to the Standard Rules, contained in the annex to the third monitoring report of the Special Rapporteur on Disability of the Commission for Social Development (see E/CN.5/2002/4). In accordance with Economic and Social Council resolution 2002/26 of 24 July 2002, views of Governments on the proposed supplement will be considered at the forty-second session of the Commission for Social Development, in 2004.
4. The present report considers progress in terms of instruments, structures and capacities that are in place to further the equalization of opportunities by, for and with persons with disabilities. An important development during the period under review is the proposal made by Mexico to the General Assembly at its fifty-sixth session for a comprehensive and integral convention on the rights of persons with disabilities. The quantitative basis for the evaluation of progress has improved during the period under review in terms of methods and availability of data on disability, but variations still exist with regard to concepts and terminology of disability, so that cross-country comparisons are not possible. The monitoring reports submitted by the Special Rapporteur on Disability (see A/52/56, E/CN.5/2000/3 and E/CN.5/2002/4) have been recognized as important and valuable contributions to policy dialogue. The Special Rapporteur also submitted proposals for better correspondence between the monitoring of the Standard Rules, normally at three-year intervals, and the quinquennial reviews of progress in implementing the World Programme.
A. Strategic framework
5. The overall conclusion of the present review and appraisal is the strong commitment by Governments to equalization of opportunities and to the rights and dignity of persons with disabilities in the context of development. Differences in emphasis and approach are inevitable, but the basic commitment is widespread. This does not suggest that such a continuation of efforts is a sufficient response. The challenges of development indicate the need to address the advancement of persons with disabilities in a broad human rights framework in terms of next not best practices: positive action and concrete results are the operational imperatives. Recommendations for further action are developed with reference to the following strategic framework:
(a) The disability perspective is an essential prerequisite for the successful design and implementation of sustainable, rights-based approaches to development. The large and increasing number of persons with disabilities in society makes the issue a key component of programme design, implementation and monitoring. If development programmes do not consider how all persons in society will access their structural components, they are most likely doomed to failure. Human rights for all cannot be advanced without consideration of individual needs and interests from a disability or functional perspective.
(b) The disability perspective requires consideration of policies and programmes based on the inclusive principles embodied in universal design. A key component of universal design is to embrace and honour diversity. By considering the needs of all and promoting the positive functioning of all people, universally designed policies and programmes produce benefits that not only exceed the functional needs of persons traditionally classified as disabled but also extend those benefits to society as a whole. However, the promotion of universally designed policy options and programmes should not undermine efforts to provide reasonable accommodation where it is not practical to redesign elements of society for the positive functioning of all. Nor does the promotion of universal design deny that differences exist between people, which should be recognized and accommodated.
(c) Application of the disability perspective also requires reconsideration of the population to be served so that it includes the various domains of the new universe of disability. The International Classification of Functioning, Disability and Health  has taken a universal approach to describing phenomena related to disability. Disablement is viewed as a dynamic interaction between health conditions and other personal factors (age, sex, level of education) as well as social and physical environmental factors. The new usage of disability as an umbrella term reflects growing recognition that the search for a comprehensive definition for disability to identify a truly disabled population is probably fruitless. In a narrow sense, the concept of the new universe of disability expands the population with disabilities to include persons with various conditions such as HIV/AIDS and attention deficit disorder. In a broader sense, the concept recognizes the applicability of disability concerns to persons marginalized on the basis of gender, race, poverty, aboriginal status or a variety of other factors. Equalization of opportunity becomes, thus, a goal for all people.
(d) The successful formulation and implementation of universally designed policies and programmes for all persons requires a systematic, specific consideration of accessibility issues. As the disability perspective with a universal design is a prerequisite for human rights and development, systematic consideration of accessibility is an essential prerequisite for achieving the goals and objectives of the World Programme of Action and the target areas for equal participation of the Standard Rules. Systematic appraisal of access to societal institutions directs special attention to both conditions and circumstances by which all people exercise their human rights. Such an appraisal would contribute to sustainable and equitable economic and social development for all.
(e) To ensure environmental accessibility, institutions, services and development activities must be focused on where people live. In many countries the majority of the population continues to reside in rural areas, where services for all are often scarce. A large part of the rural population consists of older persons, many of whom are older women who live alone as the surviving head of a household. Consideration of rural issues is of critical importance for persons with disabilities. Of special importance is the association between poverty and disability, which needs to be addressed with reference to a territorial development framework. Moreover, efficiency considerations suggest that the time required to plan and implement public programmes and services is better used by incorporating accessibility considerations as a key design parameter at the outset of the planning process rather than as a subsequent accommodation. Approaches to the provision of services based on expedient solutions are rarely sustainable or cost-effective, or contribute to balanced national development. The successful promotion of sustainable livelihoods for people with disabilities involves their full and effective participation and increased access to social and economic opportunities.
(f) A holistic approach is required to relate disability to human rights and dignity, technological advances and development initiatives. Certain of the building blocks of this holistic approach are based on the parts of the Standard Rules in which the focus is on moving from accessibility (rule 5) to education (rule 6) and employment (rule 7), using universally designed policies and programmes. Enhancing educational and employment opportunities for all through environmental accessibility provides a basis for sustained and equitable social and economic development. That is the logic underlying the proposition that disability is not an isolated state but an experience that all may experience as part of the normal life experience. This represents an important shift in the disability paradigm. Technology has an important role to play in the process of social and economic development. In particular, technologies associated with genetics and biomedical developments raise policy, legislative and ethical questions. Views have been expressed on the need to monitor genetic and biomedical developments to ensure that technological and scientific advances do not undermine the human rights of the individual. In a general sense, the monitoring of global policies and programmes related to the advancement of persons with disabilities that focus on participation, functioning and accessibility would lead to better targeting of resources to further the World Programme of Action goals of full participation and equality.
6. With the adoption of the Standard Rules by the General Assembly in resolution 48/96 of 20 December 1993, the initial frame of reference for policies and programmes was equalization of opportunities for persons with disabilities. As the disability paradigm has evolved, attention has focused on the contribution of the Standard Rules in promoting equalization of opportunities for all persons, based on the principle of universality. There is growing recognition that the empowered participation of persons with disabilities is required to bring about the World Programme of Action goals of full participation and equality. Empowerment requires that persons with disabilities not merely be members of advisory bodies and committees but be able to exercise control over decisions that have an impact on their lives and contribute to public dialogue on policies and programmes that are affected by those decisions. Equalization of opportunities by persons with disabilities requires that people with disabilities have access to, and opportunities to be placed in, positions to set and implement disability-sensitive policy. Equalization of opportunities with persons with disabilities requires that people with disabilities be recognized as partners in the formulation and implementation of development policies and programmes in a broad human rights framework. These are aspirations of all persons and have influenced the formulation of this set of recommendations on equalization of opportunities.
7. Recommendations are submitted on actions related to policy options to promote the rights of persons with disabilities in the context of development; substantive aspects of mainstream approaches to equalization of opportunities; and improved coordination of activities of the United Nations system.
1. Progress on the elaboration of a comprehensive and integrated international instrument on the rights of persons with disabilities in the context ofdevelopment
8. The initiative of Mexico on the elaboration of a comprehensive and integral convention on the rights of persons with disabilities, endorsed by the General Assembly in its resolution 56/168 of 19 December 2001, was presented in the context of the global development agenda to ensure that all citizens have opportunities to be stakeholders in the creation and distribution of development.
9. Because of the link to global development, the proposed comprehensive and integral convention differs from other international human rights instruments. A major issue in the elaboration of the convention on the rights of persons with disabilities would be to identify options to bring the disability perspective into international development instruments, such as the Millennium development goals, that do not address specifically the situation of persons with disabilities, and to provide thereby a normative basis for the advancement of current and future generations of persons with disabilities in the context of development.
10. Since disability is a condition that can affect all and can be influenced by a range of environmental variables, the aim of a comprehensive and integral convention is to provide a framework of options to address the condition of disability, its consequences and actions to promote and protect the rights of persons with a disability. These conditions are not covered in a comprehensive and integrated manner in the existing international instruments. Elaboration of the convention should be framed with reference to the global development ethics and standards, such as the determination stated in the Preamble to the Charter of the United Nations to promote social progress and better standards of life in larger freedom. The convention process would also need to consider an appropriate definition of disability, which would include members of the new universe of disability, thereby promoting and protecting the rights of all persons with a disability.
2. Policy priorities for action on equalization of opportunities in the context ofdevelopment
11. At its fifty-second session, in paragraph 4 of its resolution 52/82 of 12 December 1997, the General Assembly identified three priorities for action to further the equalization of opportunities: accessibility, social services and safety nets, and employment and livelihoods. Available data suggest the continued relevance of these priorities to further the equalization of opportunities for persons with disabilities. The Ad Hoc Committee established pursuant to Assembly resolution 56/168 may, in this regard, wish to include consideration of these priorities in its work.
(a) Accessibility. The first session of the Ad Hoc Committee directed special emphasis to the question of accessibility, with reasonable accommodation, to facilities and documentation of the United Nations. The Ad Hoc Committee may wish to consider the dimension of environmental accessibility in its work. The rapid pace of technological change makes environmental accessibility a complex question, and an area in which analyses may result in the identification of technology issues for which there is little or no appropriate policy, legislative or ethical guidance. The Ad Hoc Committee may wish to invite interested parties and experts from countries to provide relevant input.
(b) Social services and safety nets. Several of the Millennium development goals are relevant to the promotion of social services and safety nets to further the equalization of opportunities for persons with disabilities, especially in connection with the Standard Rules, such as in relation to the priority goal of poverty eradication; the goal of promoting universal primary education; the goals of reducing child mortality and improving maternal health status and the goal of combating HIV/AIDS, which is part of the new universe of disability. The Ad Hoc Committee may wish to consider possible ways in which the situation of persons with disabilities can benefit from various support measures identified for the implementation of the Millennium development goals by 2015 on the basis of equality with non-disabled populations.
(c) Employment and sustainable livelihoods. Employment is a key component of the World Programme of Action and the Standard Rules. Employment policies and programmes should be disability-sensitive and promote equalization of opportunities with reference to the non-disabled, to skills development training, to technical and extension services, to market information and to development incentives and capital markets. There is, moreover, a complementary relationship between progress in the equalization of opportunities in social services, education in particular, and sustainable livelihoods. Monitoring the implementation of equal protection provisions in these areas will be of critical importance. The Ad Hoc Committee may wish to invite interested parties and experts to provide input related to progress in the development of international agreements on employment and livelihood indicators, such as labour force participation and unemployment rates for persons with disabilities. Data for these efforts would derive from monitoring both the implementation of International Labour Organization Convention 159 concerning Vocational Rehabilitation and Employment (Disabled Persons) and progress in implementing such global development instruments as the Monterrey Consensus of the International Conference on Financing for Development and the Doha Development Agenda. The Ad Hoc Committee may also wish to obtain input on progress made by the United Nations Educational, Scientific and Cultural Organization in the implementation of the Salamanca Statement and Framework for Action and the Dakar Framework for Action, as well as its technical work on educational indicators, such as school enrolment, educational attainment and literacy rates for persons with disabilities and the non-disabled population. Information on new directions in school-to-work transition programmes would useful.
3. Progress in reinforcing the disability perspective in technical cooperation activities
12. Building national capacities is a main objective of technical cooperation activities of the United Nations system for development. The role of technical cooperation activities of the United Nations system, including the Bretton Woods institutions, in building national capacities for equalization of opportunities has been frequently cited in General Assembly resolutions concerning persons with disabilities, most recently in resolution 56/115. Mainstreaming the disability perspective in technical cooperation activities of the United Nations system remains, however, the exception. To promote greater coherence, efficiency and sustainability in activities of the United Nations system aimed at building national capacities, the General Assembly may wish to consider identifying policy options and target areas that could be used by United Nations funds and programmes to incorporate the disability perspective in their activities, and to provide input to the Ad Hoc Committee.
4. Progress in data and statistics on disability in mainstream development
13. There has been major progress in the development of concepts and methods of statistics on disability and in the compilation of data on disability, as defined by national statistical bodies or similar organizations. However, after 20 years of international cooperation to further the goals and objectives of the World Programme of Action, it still is not possible to present comparative data and statistics on the prevalence of disability globally, or on social and economic trends for persons with disabilities and the non-disabled. This is due to variations in screens employed to collect and organize data on disability from diverse national data collection sources. To address the challenge of greater comparability in national data on disability, the Statistics Division of the United Nations Secretariat prepared guidelines on the collection of data on disability as a recommended new topic for the round of population and housing censuses in 2000 . The recommendations noted that, owing to limitations of space in a census, focus should be on the disability dimension of the World Health Organizations International Classification of Impairments, Disabilities and Handicaps, with the impairment and handicap dimensions to be covered by household survey data. The Statistics Division recently published Guidelines and Principles for the Development of Disability Statistics, which focuses on technical guidance for collecting, compiling and disseminating statistics on persons with disabilities. With the World Health Assemblys adoption in 2001 of the International Classification of Functioning, Disability and Health, the recommendations on the next series of population and housing censuses, scheduled to commence in 2005, will have an expanded conceptual and substantive basis. The General Assembly may wish to provide guidance on the importance of urgent action to improve data and statistics on persons with disabilities so that they can be compared internationally for purposes of policy design, planning and evaluation from the disability perspective. The Assembly may wish to note, in this connection, the important contributions of the Washington Group on Disability Measurement of the Statistical Commission (see E/CN.3/2002/7). The Assembly may also wish to recommend options to incorporate national capacity-building to improve national census and household survey data from the disability perspective as a mainstream consideration in technical cooperation activities of the United Nations system. With regard to equalization of opportunities and promotion of the rights of persons with disabilities in the context of development, the Assembly may wish to consider identifying priorities for action related to statistics and indicators, with top priority accorded to indicators for education and employment.
5. Progress in improved planning and coordination of activities of the United Nations system to promote equalization of opportunities
14. The Special Rapporteur on Disability of the Commission for Social Development has highlighted the importance of systematic exchanges of experiences and ideas between bodies and organizations of the United Nations and programmes in the disability field in each of his monitoring reports (see A/52/56, E/CN.5/2000/3 and E/CN.5/2002/4). He has recommended that the Programme on Disability of the Department of Economic and Social Affairs, as the focal point on disability of the United Nations Secretariat, use accessible Internet-based technologies, an area in which the Programme on Disability has undertaken a number of pilot efforts in countries, and establish a virtual inter-agency consultation mechanism. In response to that recommendation, the Division for Social Policy and Development of the Department of Economic and Social Affairs has established a United Nations system and persons with disabilities home page (http://www.un.org/esa/socdev/enable/unandpwd.htm) to provide in accessible format links to selected resources of the United Nations on global disability policies and programmes, and a companion United Nations resources on disability available on-line (http://www.un.org/esa/socdev/enable/rights/unpwdresources.htm#UNOtherResources) as a guide to resources among selected members of the United Nations system. Further progress to improve planning and coordination of activities of the United Nations system to promote equalization of opportunities would involve, at the technical level, a commitment to establish, on a pilot basis, a portal to promote an open dialogue among concerned members of the United Nations system as well as civil society. The Assembly may wish to express its views with regard to options and priorities presented to strengthen joint planning and evaluation of outcomes of the activities of the system to promote the advancement of persons with disabilities in the context of development.
1Resolution 48/96, annex.
2Geneva, World Health Organization, 2001.
3Rules 5-12 deal, respectively, with accessibility; education; employment; income maintenance and social security; family life and personal integrity; culture; recreation and sports; and religion.
4United Nations Secretariat, Principles and Recommendations for Population and Housing Censuses (ST/ESA/SER.M/67/Rev.1), paras. 2.258-2.277.
5 Geneva, World Health Organization, 1980; this classification was used prior to the adoption by the World Health Assembly in 2001 of the International Classification of Functioning, Disability and Health.
6ST/ESA/STAT/SER.Y/10 (United Nations publication, Sales No. E.01.XVII.15).