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CBM position paper on the post-2015 Millennium Development
Goals (MDGs) global framework
1. CBM’s position on a post-2015 framework: Content and process
1.1
1.2
1.3
1.4
1.5
1.6
1.7
A revision of the current understanding and definition of poverty,
progress and development beyond material living standards alone
(income, consumption and wealth)1.
A framework that addresses causal explanations of poverty and
promotes agency rights and equality for people with disabilities2.
Disability-inclusive development that adopts a human rights-based
approach adhering to the principles of empowerment, participation,
equality and non-discrimination, with a focus on the poorest, most
excluded groups, such as people with disabilities3.
Disaggregation of data4 and the collection of new datasets on
disability can be used as an evidence base for global comparisons as
well as monitoring against any new nationally set targets and
indicators.
National governance and ownership in any new structures or
institutional arrangements. The involvement and participation of
people with disabilities through deliberative processes that take into
account the context and starting point of each country’s
circumstances; the strengthening of accountability processes and
mechanisms that are accessible to people with disabilities.
Any new global partnerships on poverty reduction have a more
equitable relationship5 and mainstream disability6 in their
international cooperation efforts7.
A revision of overseas development assistance (in terms of
financing channels and mechanisms, accountability contracts for
donors and ‘beyond aid’ approaches) to include disability markers
identifying the percentage spend for disability-inclusive development.
CBM working paper on the post-2015 Millennium Development Goals
(MDGs) global framework: March 2012, subject to revision.
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2. The context: Poverty, disability and development
2.1
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2.5
2.6
Disability is both a cause and consequence of poverty, yet
international policy-makers and stakeholders have not recognised or
prioritised this issue within international development efforts such as
the MDGs.
Fifteen per cent of the world’s population are people with disabilities
– over one billion people8, of whom 80 per cent live in developing
countries9.
The current MDGs have given rise to distortions of national
progress by focusing on percentages and non-universal cover rather
than targeting and changing the situation of the poorest people,
including those with disabilities10.
Across the world, people with disabilities have poorer health, lower
educational achievements, less economic participation and higher
rates of poverty and inequality than people without disabilities11.
The MDGs are framed by conventional ideas of development that
have not recognised the importance of inequality in poverty
reduction.
The shifting global distribution of poverty means that 72 per cent
of the world’s poorest people (800 million) now live in middle-income
countries (MICs), and most of those in stable MICs12, which are not the
main recipients of overseas development assistance.
CBM reducing poverty-related diseases:
CBM works with its partners to tackle a group of poverty-related diseases,
including the neglected tropical diseases13 (NTDs). Globally NTDs affect 1.4
billion of the poorest people and another 2 billion people are at risk. Because
of their adverse affects on child development, maternal morbidity and worker
productivity, the NTDs have a major impact on poverty14.
3. Emerging Issues on the post-2015 MDG agenda
Since the Millennium Declaration, the global context in relation to poverty
and development has changed significantly. Three key areas which are
currently emerging in global post-2015 MDG debates are summarised below:
increasing inequality, climate change and urbanisation. These issues
are also framed by the global economic and debt crisis.
4. Inequality and global justice
4.1
4.2
Inequality affects all countries, rich or poor, and arguably mediates
poverty and wellbeing to a greater extent than growth does15.
Intra-country inequalities have widened16, of which people with
disabilities are disproportionately represented17. Social protection
mechanisms can provide safeguards for the most marginalised people.
CBM working paper on the post-2015 Millennium Development Goals
(MDGs) global framework: March 2012, subject to revision.
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4.3
4.4
4.5
Most of the world’s poor have shifted from low-income countries to
middle-income countries18. The global burden of malnutrition,
disease and mortality are middle-income concentrated19.
Key explanations for escaping from poverty are largely a) equity
related, for example, changes in employment, land ownership and
education; b) related to social exclusion and discrimination; and c)
linked to location in remote or otherwise disadvantaged areas20.
High inequality can inhibit growth, discourage institutional
development towards accountable government and undermine civic
and social life leading to conflict21 and undermine human rights.
CBM, inequality and global justice:
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All of CBM’s work is underpinned by disability-inclusive development.
Estimates of the number of people with severe disabilities, a key group for
CBM’s work, vary between 110 million and 190 million22.
CBM advocates for inclusive development to improve the quality of lives
for people with disabilities. It recognises the importance of other
existing inequalities such as gender, age (children23 and older
people), race, ethnicity, or HIV status etc.24 and their impact on the lives
of people with disabilities that can lead to multiple discrimination.
5. Climate change
5.1
5.2
5.3
5.4
The impacts of climate change (extreme weather, sea level changes
and agriculture productivity changes, leading to food insecurity) will
affect the world’s poorest people25.
Higher food prices due to climate change combined with urbanisation
trends will lead to more households being net food consumers, this too
will affect (urban) poor people more26.
Most of the world’s poor (800 million) live in ten countries, six of
which are listed in the top 20 countries27 most at risk of extreme
weather in 2015: China, India, the Philippines, Vietnam (middleincome countries) and Bangladesh and Ethiopia (low incomecountries).
Any new agreement must address climate change, sustainable
consumption, climate resilient development and the protection of
people with disabilities in situations of risk and humanitarian
emergencies28.
Climate change and CBM:
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In 2010, CBM’s partners provided services to over half a million people in
situations of risk and humanitarian emergency.
CBM works in all of the six countries where both the poorest people and
those most at risk of extreme weather live.
CBM has worked in partnership to ensure people with disabilities are
included in food security emergency response programmes in the horn of
Africa where over 4.5 million people are in need of assistance from the
worst droughts experienced in the last 60 years.
CBM working paper on the post-2015 Millennium Development Goals
(MDGs) global framework: March 2012, subject to revision.
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6. Linking climate change and urbanisation
As the effects of climate change force people to move in search of food and
water, migration or dislocation may increase. Significant numbers of people
relocate, especially from rural to urban areas, for example people moving from
the Sahel zone of West Africa to coastal areas, due to regular crop failures in
their home regions29. There are an estimated 3.5 million refugees and internally
displaced people with disabilities worldwide30.
7. Urbanisation
7.1
7.2
7.3
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7.6
7.7
High rates of overall population growth, together with significant rural–
urban migration, have contributed to rapid urbanisation and related
unplanned expansion of low-income settlements on the outskirts of
many large cities31.
In sub-Saharan Africa two-thirds of urban dwellers live in low-income
settlements32.
Worldwide, approximately 900 million people live in low-income
settlements, of which approximately 135 million could be people
with disabilities33.
Those living in urban low-income settlements lack improved water,
sanitation, and durable housing, all three are harder to access for
people with disabilities.
Environmental conditions such as indoor air pollution from cooking
fires and atmospheric pollution in urban areas lead to chronic
respiratory diseases and a heightened risk of tuberculosis, which is a
significant cause of disability34.
With greater reliance on the monetised economy, urban populations
depend on integration into informal employment markets to earn
cash income to meet their ongoing consumption needs.
The rate of economic inactivity is 2.5 times higher amongst
people with disabilities35.
Urbanisation, CBM and the rural question:
CBM advocates for disability-inclusive development in both urban and rural
areas. Urbanisation is a critical issue for the post-2015 MDG agenda, however,
most poor people (70%) still live in rural areas36. CBM remains committed to
working for the rights of people with disabilities in both rural and urban areas.
For more information please contact Diane Mulligan, the Coordinator of
International Advocacy and Alliances for CBM: [email protected]
CBM working paper on the post-2015 Millennium Development Goals
(MDGs) global framework: March 2012, subject to revision.
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References and additional information:
For example, non-economic aspects of people’s lives that reflect multiple dimensions of poverty
such as access to education, health, social connections, wellbeing, levels of insecurity, housing,
environmental conditions etc.
2 Article 28 of the Universal Declaration of Human Rights clearly links human rights with poverty
reduction and development. The UN Convention on the Rights of Persons with Disabilities (CRPD)
has comprehensive inclusive articles: the right to education (article 24), the right to health (article
25), the right to work and employment (article 27), the right to adequate standards of living and
social protection (article 28).
3 Comprehensive accessibility for people with disabilities would need to be integral to a human
rights-based approach, namely: physical, communication, policy and attitudinal barriers are all
identified and addressed. Additionally, a human rights based approach would serve to highlight
areas neglected by the MDGs, such as equal access to justice (article 13 of the CRPD), the rule of
law (article 12 of the CRPD) and democratic governance (article 29 of the CRPD: the right to
participation in political and public life; as well as notions of entitlements and accountability into
the development process.
4 Article 31 of the CRPD states that countries that have ratified the Convention will collect statistics
and data about people with disabilities and disseminate it in accessible formats.
5 Any new global partnerships are more balanced in terms of their relationships and accountability
between donor countries and developing countries.
6
The CRPD is the only international human rights instrument to have an article on international
cooperation; the CRPD provides a comprehensive normative framework for mainstreaming
disability in the development agenda. Countries that have ratified the CRPD will ensure that
international cooperation, including international development programmes, are inclusive of, and
accessible to people with disabilities.
7 Including aid, debt, trade, tax, corporate regulation and accountability, fiscal policy and foreign
policy support to national, regional and global human rights mechanisms, diplomatic support, and
military assistance.
8 World Health Organization and World Bank (2011) World Report on Disability. Geneva: WHO
Press.
9 Disability and Poverty: a Survey of World Bank Poverty Assessments and Implications’. Jeanine
Braithwaite and Daniel Mont, SP discussion paper No. 0805, World Bank, February 2008.
10 For example, children with disabilities are much less likely to attend school than children without
disabilities. World Health Organization and World Bank (2011) World Report on Disability.
Geneva: WHO Press, p. 225.
11 World Health Organization and World Bank (2011) World Report on Disability. Geneva: WHO
Press.
12 Sumner, A. & Tiwari, M. (2011) Global Poverty Reduction to 2015 and Beyond. Journal of Global
Policy.
13 Parasitic and bacterial infections, namely: three soil transmitted helminthiasis (ascariasis,
hookworm infections,and trichuriasis), lymphatic filariasis, onchocerciasis, dracunculiasis (guineaworm disease), schistosomiasis, Chagas’ disease, human African trypanosomiasis, leishmaniasis,
Buruli ulcer, leprosy, and trachoma.
14In addition, the disease burden of NTDs is more than double that caused by tuberculosis. Hotez,
PJ. Kamath, A. Neglected Tropical Diseases in Sub-Saharan Africa: Review of Their Prevalence,
Distribution, and Disease Burden. PLoS Negl Trop Dis 3(8).
15 Vandemoortele, J. (2011) The MDG Story Intention Denied: Development and Change.
Development and Change, Vol. 42, (1), pp. 1-21. The Hague.
16 Palma, J.G. (2011) Homogeneous Middles vs. Heterogeneous Tails, and the End of the
‘Inverted-U’: It's All About the Share of the Rich. Development and Change, Vol. 42, (1), pp. 87153. The Hague.
17 20.7% of people in the poorest quintile of both lower and higher income countries have
disabilities; 18% of all people in lower income countries have disabilities; and 20% of all people in
the poorest three quintiles of lower income countries have disabilities: World Health Organization
and World Bank (2011) World Report on Disability. Geneva: WHO Press p. 28.
18 Sumner, A. and Tiwari, M. (2011) ‘Global Poverty Reduction to 2015 and Beyond’, Journal of
Global Policy.
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(MDGs) global framework: March 2012, subject to revision.
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See Kanbur, R. and Sumner, A. (2011) Poor Countries or Poor People? Development Assistance
and the New Geography of Global Poverty. Charles H. Dyson School of Applied Economics and
Management Working Paper, Ithaca, NY: Cornell University; and also Glassman, A., Duran, D. &
Sumner, A. (2011) Global Health and the New Bottom Billion. Center for Global Development
(CGD) Working Paper, Washington, DC: CGD.
20 Dercon, S. & Shapiro, J. (2007) Moving On, Staying Behind, Getting Lost: Lessons on Poverty
Mobility from Longitudinal Data. Economic and Social Research Council Global Poverty Working
Group, Paper 75.
21 Birdsall, N. (2006) ‘Income Distribution: Effects on Growth and Development’ - Working Paper
118; Center for Global Development, Washington.
22 World Health Organization and World Bank (2011) World Report on Disability. Geneva: WHO
Press, p. 29.
23 There are 93 - 150 million children with disabilities under 15 years of age worldwide (World
Health Organization and World Bank (2011) World Report on Disability. Geneva: WHO Press, p
262).
24 While equally at risk of HIV/AIDS, for a variety of reasons people with disabilities do not have
equal access to HIV information, education and prevention services. UNAIDS (2009) Disability and
HIV Policy Brief.
25 Eighty per cent of the 300 million people who live within 5 meters of sea level are in developing
countries. The Intergovernmental Panel on Climate Change Debate on Sea-Level Rise: Critical
Stakes for Poor Countries: February 2, 2007.
http://blogs.cgdev.org/globaldevelopment/2007/02/the-ipcc-debate-on-sea-level-r.php (accessed
13 February 2012).
26 Skoufias, E., Rabassa, M. & Olivieri, O. (2011) The Poverty Impacts of Climate Change: A
Review of the Evidence, Policy Research Working Paper 5622, The World Bank.
27 Middle-income countries (China, India, the Philippines, Sri Lanka, Vietnam, Honduras, Thailand,
Zambia) and low-income countries (Kenya, Somalia, Mozambique, Bangladesh, Djibouti, Ethiopia,
Bolivia, Cuba, Madagascar, Colombia, Zimbabwe). UNHABITAT 2010.
28 See Article 11 of the UN Convention on the Rights of Persons with Disabilities.
29 Brauch, H. G. (2002) Climate Change and Conflict Prevention. German Federal Ministry for the
Environment, Nature Conservation and Nuclear Safety (BMU).
30 Women’s Commission for Refugee Women and Children (2008) Disabilities among Refugees and
Conflict-Affected Populations: Resource Kit for Fieldworkers. NY: Women’s Commission for
Refugee Women and Children.
31 Although the number of people living in low-income settlements in urban areas is declining in
incidence, it is rising in absolute numbers. The proportion is highest in sub-Saharan Africa where
two-thirds of urban dwellers are living in low-income settlements; the number of people living in
low-income settlements in this region has nearly doubled over the period 1990-2010: UNHABITAT
2010.
32 Sumner, A. (2012) A post-2015 global framework: key issues, criteria and options. Institute of
Development Studies at the University of Sussex (unpublished: commissioned research by CBM).
33 http://www.unmillenniumproject.org/documents/Slumdwellers-complete.pdf quotes 900 million
people, of which up to fifteen per cent (see World Health Organization and World Bank (2011)
World Report on Disability. Geneva: WHO Press.) could be people with disabilities.
34 European Commission (2007) Environmental Integration Handbook for EC Development
Cooperation.
35 World Health Organization and World Bank (2011) World Report on Disability. Geneva: WHO
Press.
36 http://www.ifad.org/rpr2011 (accessed 13 February 2012).
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CBM working paper on the post-2015 Millennium Development Goals
(MDGs) global framework: March 2012, subject to revision.
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