The International Society of Physical and Rehabilitation Medicine Response to the WHO Disability Action Plan

Introduction: The WHO Global Disability Action Plan 2014 – 2021 “better health for all people with disabilities” [1] is a milestone on the way to implement the UN-convention of the rights of people with disabilities [2]. The Action Plan responds to the World Report on Disability [3] is at the same time a chance and an opportunity for the medical specialty of Physical and Rehabilitation Medicine [4] and its world organisation, the International Society of Physical and Rehabilitation Medicine (ISPRM) [5]. It aims at “optimal health, functioning, well-being and human rights for all persons with disabilities” and has “three objectives: to remove barriers and improve access to health services and programmes; to strengthen and extend rehabilitation, habilitation, assistive technology, assistance and support services, and community-based rehabilitation; and to strengthen collection of relevant and internationally comparable data on disability and support research on disability and related services” [1]. It is remarkable that health, functioning and well-being is in the centre of the Action Plan and challenges PRM to contribute to all three of the objectives.

Goals: The discussions within the ISPRM-WHO-Liaison Committee aims at the identification of projects within ISPRM and in collaboration with national and regional PRM societies that may contribute to the success indicators and actions of the plan. Those projects that can achieve measurable outcomes within a three years period of time will be proposed to become part of the new ISPRM-WHO collaboration plan. This plan needs mutual agreement and adoption by the WHO. However, besides these concrete projects a wider range of contribution should be aimed at.

Activities: In 2014 ISPRM decided to take a strategic initiative to respond to the WHO Global Disability Action Plan. It contains the following areas:

• Dissemination: e.g. to spread out information to ISPRM members and to publish articles in PRM journals;

• Analysis: to establish a web forum: discussion about the action plan, to identify main objectives for ISPRM, and to development of a work plan;

• Implementation: to develop an implementation framework for rehabilitation services, to strengthen education and training for PRM specialists and other rehabilitation professionals.

After intensive discussions three main projects were will be proposed to WHO as collaboration projects within the framework of the new collaboration plan:

• Project 1: Learning Health Systems for Spinal Cord Injury, an initiative incl. international spinal cord injury survey (in co-leadership with ISCoS) (referring to objectives 1 and 2 of the Global Disability Action Plan)

• Project 2: Fast response teams on strategies and plans of rehabilitation and related services (referring to objective 2 of the Global Disability Action Plan)

• Project 3: ICF based routine data collection in national health information systems (referring to objective 3 of the Global Disability Action Plan)

Additionally its seems to be crucial to contribute to the success indicator of objective 2 that aims at an increase of the “number of graduates from educational institutions per 10,000 population – by level and field of education (for example, physical rehabilitation medicine, physical therapy, occupational therapy, and prosthetics and orthotics)” and to identify further research projects for objective 3: “to strengthen collection of relevant and internationally comparable data on disability and support research on disability and related services”. The ISPRM WHO Liaison committee is also working on conceptualising the contribution of Physical and Rehabilitation Medicine to the community delivered rehabilitation services, a conceptual description and classification of rehabilitation services [6, 7], and a framework for the implementation of rehabilitation services in low and lower middle income countries.

To work on these projects and issues will not only contribute to the goals of the Action plan but also will contribute to the development of Physical and Rehabilitation Medicine as the medicine of functioning [see 8, 9]. Within all the activities a close collaboration with other NGO's with special relations to WHO such as Rehabilitation International (RI), the International Society of Spinal Cord Injury (ISCoS), and the international Society for Prosthetics and Orthotics (ISPO) are agreed or planned.

Expected Outcomes: The WHO Global Disability Action Plan 2014 – 2021 “better health for all people with disabilities” induced a high awareness to the needs of persons with disabilities in terms of access to health services, the provision of rehabilitation services, and research on the epidemiology of functioning and the outcomes of services. ISPRM immediately responded with a strategic initiative aiming at dissemination, analysis, and implementation of the action plan. This is work in progress. The Action plan also will shape the new ISPRM-WHO-collaboration plan. It has been agreed to match it with the objectives of the Action plan. Concrete activities toward the start of the tree projects have been started. Last but not least it is expected that other activities of ISPRM and its member societies as well as the organisations with mutual recognition agreements will be stimulated and influenced by the Action Plan, in particular with respect to education and training, as well as to data collection and research.

Conclusion: The WHO Global Disability Action Plan will significantly accelerate initiatives within and outside the PRM community. It already has induced many activities on the information and policy levels and is influencing political decisions, activities among NGO's with special relations to WHO. ISPRM has started a strategic initiative to respond to the Action plan and identified three main projects to contribute to the outcomes f the Action Plan. Additionally other activities such as education and training and research will focus on the objectives of the Action Plan.

References:

[1] World Health Organisation: Global disability action plan 2014–2021: Better health for all people with disabilities. WHO, Geneva, 23 May 2014

[2] United Nations General Assembly. Convention on the rights of persons with disabilities. Resolution 61/106; UN, New York 2006

[3] World Health Organisation & World Bank: World Report on Disability. Geneva & New York, June 2011

[4] Gutenbrunner C, Egen C, Nugraha B: Der „Global Disability Action Plan 2014-2021“ der Weltgesundheitsorganisation und seine Relevanz für die Physikalische und Rehabilitative Medizin. Phys Med Rehab Kuror 2015 (in press)

[5] Gutenbrunner C, Nugraha B, Kiekens C, Zampolini M, Negrini S: The Global Disability Action Plan 2014-2021 of the World Health Organisation (WHO): a major step towards better health for all people with disabilities. Chance and challenge for Physical and Rehabilitation Medicine (PRM). Eur J. Phys. Med. Rehabil (in press)

[6] Meyer T, Gutenbrunner C, Kiekens C, Skempes D, Melvin JL, Schedler K, Imamura M, Stucki G: ISPRM Discussion Paper: Proposing a conceptual description of health-related rehabilitation services. J Rehabil Med 2014; 46: 1–6

[7] Gutenbrunner C, Bickenbach J, Kiekens C, Meyer T, Skempes D, Nugraha B, Bethge M, Stucki G: ISPRM Discussion Paper: Proposing Dimensions for an International Classification System for Service Organisation in Health-related Rehabilitation (ICSO-R). J Rehabil Med 2015 (in press)

[8] Gutenbrunner C, Nugraha B: Why the collaboration with the World Health Organisation (WHO) is important for Specialists in Physical and Rehabilitation Medicine? PM&R 2015 (in press)

[9] Gutenbrunner C, Meyer T, Melvin J, Stucki G: Towards a conceptual description of Physical and Rehabilitation Medicine. J Rehabil Med 2011b; 43: 760-764