Disability-inclusive development isn’t cheap, but exclusion has a higher price

22nd June 2016 Sundar Ali

At ADD International, we are all too familiar with the human costs of disability and exclusion: costs for people like Mamun, a man with psychosocial disability in Bangladesh, whose family felt they had no choice but to tie him up for his safety.

This article titled “Disability-inclusive development isn’t cheap, but exclusion has a higher price” was written by Polly Meeks, for theguardian.com on Tuesday 21st June 2016 14.18 UTC

At a parliamentary meeting on the case for disability-inclusive development three years ago, one MP playing devil’s advocate said: “Yes, but isn’t this all too costly?”

Attitudes to disability inclusion may have moved on over the past few years, but concerns over its financial costs have not gone away.

It’s true there are expenses to disability-inclusive development. For example, printing documents in braille and tackling discriminatory attitudes, such as the idea that women with disabilities don’t need sexual and reproductive health services. Yet it can be lower than people think – making a new school building accessible is thought to cost less than 1% (pdf) of the total cost of construction.

But while inclusion isn’t cheap, excluding disabled people has a much higher price. In the long run, leaving disabled people out of global development is counterproductive and to do so is to deny them their human rights.

While I don’t buy-in to the idea that economic arguments matter most, researchers have shown (pdf) there’s a strong financial case to be made for inclusion.

The World Report on Disability (pdf) in 2011 found that disabled people are more likely to be unemployed, and to earn less when employed. Addressing this discrimination in work would have clear economic benefits – increasing production by disabled people, and increasing their spending.

We’ve seen this first-hand in Sudan, where ADD International’s partners work with women like Tahani, who is deaf. When Tahani left school, she was stuck at home with few opportunities. Then local disability activists offered her craft making and hairdressing training in sign language. At the same time, the group spoke out in the community about the rights and potential of deaf women. Now Tahani earns a decent income and is able to buy new goods for the family home.

The economic benefits of disability inclusion go far beyond direct access to work. Supporting people with complex disabilities to undertake self-care or to help with household tasks, and enabling a child with disability to attend school all have broader benefits in opening up new opportunities and redistributing care burdens, with knock-on economic as well as social impacts.

Several studies have attempted to put a figure on the economic cost of exclusion. One commonly quoted report (pdf) by the International Labour Organization suggested the cost could be up to 7% of GDP in some low- and middle-income countries. But in fact, the economic implications of exclusion are so wide-ranging, and depend so much on the context, that it’s hard to be sure of the exact costs without more research.

What we do know from our work in Africa and Asia, is that when everybody has the opportunity to contribute their talents and creativity without discrimination, this drives the whole community forward. As one witness told MPs during a recent parliamentary inquiry on disability and development: “One community leader from Malawi said to me: ‘Now that disabled people are benefiting our community, the whole community has come out of poverty … Before, they were dependent; they were drawing our resources. Now they are productive, it means the whole community has a better potential.’”

But of course the real costs of exclusion aren’t just narrow economic ones: it’s the human costs that matter most. Equality is a basic human right – an end in itself, not just a means to economic ends. As the Bond disability and development group argues, excluding disabled people from development on any grounds – including cost – is discrimination, and is at odds with human rights treaties such as the UN convention on the rights of persons with disabilities (pdf).

Or like Grace, a woman with physical impairment in northern Uganda. She was repeatedly raped by a neighbour, and infected with HIV/Aids. Grace has been prescribed anti-retroviral therapy, but struggles to pay for people to carry her to the local hospital to collect her medication.

The sustainable development goals reaffirm global commitment to non-discrimination, where cases like Mamun’s and Grace’s would not be tolerated.

Now the challenge is to allocate resources in a way that matches this ambition. All development actors – from governments to grassroots activists – have a role to play.

Meeting the ambition to leave no one behind will not be possible without a change in the way we think about the costs and benefits of inclusive development. Counting costs is important, but it’s also important to be clear about which costs – human, not just financial – really count. In the future, we shouldn’t be questioning if inclusive development is too expensive, but why disabled people have been excluded for so long.

This piece benefited from discussions with colleagues at ADD International (in particular Jasmine O’Connor) and the Bond disability and development group (in particular Hannah Loryman). However, the views expressed are solely those of the author.

Polly Meeks is deputy director of policy at ADD International.

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