There are more than 1 billion persons with disabilities worldwide. The COVID-19 pandemic is likely to disproportionately affect these individuals, putting them at risk of increased morbidity and mortality, underscoring the urgent need to improve provision of health care for this group and maintain the global health commitment to achieving Universal Health Coverage (UHC).
Persons with disabilities -- including physical, mental, intellectual, or sensory disabilities -- are less likely to access health services, and more likely to experience greater health needs, worse outcomes, and discriminatory laws and stigma. COVID-19 threatens to exacerbate these disparities, particularly in low-income and middle-income countries, where 80% of persons with disabilities reside, and capacity to respond to COVID-19 is limited. Preparedness and response planning must be inclusive of and accessible to persons with disabilities, recognizing and addressing three key barriers.
First, persons with disabilities might have inequities in access to public health messaging. All communication should be disseminated in plain language and across accessible formats, through mass and digital media channels. Additionally, strategies for vital in-person communication must be safe and accessible, such as sign language interpreters and wearing of transparent masks by health-care providers to allow lip reading.
Second, measures such as physical distancing or self-isolation might disrupt service provision for persons with disabilities, who often rely on assistance for delivery of food, medication, and personal care. Mitigation strategies should not lead to the segregation or institutionalization of these individuals. Instead, protective measures should be prioritized for these communities, so care workers and family members can continue to safely support persons with disabilities, who should also be enabled to meet their daily living, health care, and transport needs, and maintain their employment and educational commitments.
Third, persons with disabilities might be at increased risk of severe acute respiratory syndrome coronavirus infection or severe disease because of existing comorbidities, and might face additional barriers to health care during the pandemic. Health-care staff should be provided with rapid awareness training on the rights and diverse needs of this group to maintain their dignity, safeguard against discrimination, and prevent inequalities in care provision. COVID-19 mitigation strategies must be inclusive of persons with disabilities to ensure they maintain respect for dignity; human rights and fundamental freedoms; and avoid widening existing disparities. This necessitates accelerating efforts to include these groups in preparedness and response planning, and requires diligence, creativity, and innovative thinking, to preserve commitment to universal health care, and ensure persons with disabilities are not forgotten.
Mwavuna Kazungu