Disability, Poverty Reduction and Social Development

by Anita Kelles-Viitanen, Asian Development Bank

The following article appeared in DISABILITY INTERNATIONAL; Asia-Pacific Region, Vol.11, No. 2 1999. Disabled Peoples' International. The paper was presented by Ms. Viitanen at the Disability and Development Workshop held at the ADB Headquarters in Manila, Philippines from October 13-14, 1999 under the sponsorship of the Finnish government and ADB.

Poverty reduction and improving the quality of life of all people in Asia and the Pacific has become the overarching objective of the Bank. In the future, the Bank will focus all its activities more clearly to meet this goal. Social development has been and continues to be one of the key objectives of the Bank. It has also been recognized as a key area for poverty reduction together with pro-poor, sustainable growth and good governance.

The Bank recognizes that "poverty is a deprivation of essential assets and opportunities to which every human is entitled. Everyone should have access to basic education and primary health services. Poor households should have the right to sustain themselves by their labor and be reasonably rewarded, as well as have some protection from external shocks. Beyond income and basic services, individuals and societies are also poor - and then tend to remain so - if they are not empowered to participate in making decisions that shape their lives."

This section, as quoted from the draft Bank's strategy on poverty reduction is very relevant to the concerns of disabled people in Asia. Disability is estimated to be more prevalent in the developing countries. It has been estimated by the UN that approximately two-thirds of the world's disabled people live in developing countries.

In some developing countries, nearly 20 percent of the general population is in some way disabled. As a result, it has even been proposed that the incidence of disability could serve as a good proxy indicator for poverty and development. If disability is a good proxy indicator for poverty, we would need to have a clearer understanding of the links between poverty and disability. So far, this link has not been systematically examined, even in developed countries ⁽¹⁾. We would need to establish "poverty paths" that link poverty to disability.

Poverty creates conditions for disability. Poor people are more likely to have poor health as well as poor living and working conditions. They live in lower quality housing and work in more dangerous occupations. They suffer from malnutrition and hunger, and they also lack adequate health services including maternity and trauma services.

Social unrest and communal violence, even civil wars are also more prevalent in poor countries. Violent crime is also more common in poor communities. Analysis of case studies in some developing countries have indicated that higher disability rates are associated with higher illiteracy, poor nutritional status, lower inoculation and immunization coverage, lower birth weight of babies, higher unemployment and underemployment rates, and lower occupational mobility. The proportion of disability caused by communicable, maternal and perinatal diseases as well as injuries is also higher in the developing countries compared to developed countries.⁽²⁾

Disability reinforces poverty. Exclusion and marginalization of disabled people reduce their opportunities to contribute productively to the household and the community, and thus increase the risk of poverty. Among the disabled, women and girls suffer from double discrimination: first in their gender roles as the needs of the girls and women take a secondary position and second, they being disabled.

I have spoken at some length on the issues that must be well-known to the disabled and other people present in this meeting. I have done this in order to emphasize that such concerns are at the center of social development and that we see a clear linkage between poverty and social exclusion. 

Social Development and Disability

The key objective of the Bank's Social Development agenda is to ascertain that the Bank, through its activities, does not exclude and harm vulnerable categories of people. The Bank's internal processes such as the initial social assessment, that is carried out on all our projects, has been established to identify vulnerable and excluded social groups and address and integrate their needs and concerns into the Bank projects. The Bank has policies on gender and development as well as on indigenous and ethnic minority populations. Attention is also paid to other vulnerable groups such as children, the aged, and vulnerable workers.

As indicated by Vice President Sullivan, attention has also been paid to the disabled people. The Bank has a Framework on Participation, which is enforced in the Bank's policy on Good Governance. According to this policy "the principle of participation emanates from an acceptance that people are at the heart of development. They are not only the ultimate beneficiaries of development, but are also the agents of development." The Policy points out that "participation is necessary for governments to make informed choices in respect of people's needs, while allowing social groups to protect their rights." According to the Policy "the Bank could help expand participation in several ways, such as through (i) participation in projects, (ii) the public sector/private sector interface, (iii) decentralization of economic functions (empowerment of local government) and (iv) cooperation with NGOs."

This augurs well with the disabled people and their organizations as they have indicated that they wish to make their own choices and that they do not wish to be in roles of passive participants or just recipients of services. There is a need, therefore, to consult disabled people and their organizations on their concerns more closely in making development more inclusive.

As indicated by Vice President Sullivan, the Bank has also supported development programs that have prevented disability. These can be expected to continue, but with strengthened focus on poverty reduction. Some of these will be on health, but also on transport, where the Bank will continue its efforts on road safety. The Bank's new efforts in addressing occupational safety and health issues will also he helpful. 

Future Trends

Disability can be expected to increase in the future if the economic growth is unbalanced and does not accommodate equity, environment and social concerns: due to increase of violence and crime as well as to substance abuse, poor environment, traffic accidents and work related injuries.

The disability will also increase with the demographic transition with Asian societies becoming older. The age-structure of disabled people is usually predominantly elderly, although the proportion of disabled children in developing countries is also generally higher compared to developed countries. There is therefore an increasing need to establish sustainable social safety nets. ADB is preparing a strategy on social protection. Other interventions may also need to be considered to integrate the elderly and the disabled in their societies not only as recipients of welfare benefits, but as active participants and contributors to their societies.

A truly inclusionary form of welfare is required. What role the market will play in such a welfare, and whether it is possible to create enabling and inclusive market welfare structure is an issue that may need to be addressed during the workshop.