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The Globalization of the Diabetes Epidemic

BONNEAU, Claire
2021

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As globalization continues to bring everyone and everything closer together, not all of the trade-offs are necessarily positive. As we export our unique cultures and experiences around the globe, we also increase the spread of chronic health problems.

For much of the 20th century, a person’s likelihood of developing a chronic health disease like type II diabetes depended on the wealth of the country they lived in equally as much as their own biology and genetic factors. In wealthy, developed countries, people are much more likely to survive to old age and eventually pass away from diseases of affluence — chronic diseases like cancer, heart disease, and diabetes that primarily impact the ageing population. In contrast, people living in developing nations are much more likely to experience malnourishment, violence, and communicable diseases that have a major impact on their overall health and quality of life.

This distinction has proven to be true across many developed countries, including globalization giants like the United States. Even in the more economically disadvantaged areas of America, hardly anyone dies as a result of communicable diseases like tuberculosis, a disease that is still a serious problem in lesser developed nations. Alternatively, in low to middle-income countries, these types of health concerns are still a going concern. Alongside the increased risk of encountering a communicable disease, people living in these areas are also at a higher risk for developing diseases of affluence such as type II diabetes. In this way, people living in developing nations are more likely to experience cancer while also battling cholera infections, and someone living with diabetes is also more likely to be struggling with chronic malnourishment. This lack of distinction between diseases of affluence and communicable diseases puts people living in developing nations at a disadvantage.

In this new global landscape of health and disease, the impact of diabetes is truly overwhelming. Since 1980, the number of people living with diabetes has almost doubled from 152 million to between 285-347 million (1). As a result of this dramatic increase, health spending and global costs have also had to increase to meet the growing demand for care. In 2019, it is estimated that diabetes caused over 760 billion USD in health expenditures, making up about 10% of all global spending on adults (2).

As the prevalence of diabetes continues to grow around the world, we need to shift our attention to finding global solutions to this invisible epidemic. Understanding the connection between obesity, globalization, and diabetes is a great starting point in order to tackle this ever-growing global health problem.

Disability Inclusion Helpdesk, July 2021 Evidence digest: disability-inclusive education in focus

SDDirect
July 2021

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Disability Inclusion Helpdesk evidence digest highlights the latest evidence, guidance, and programme learning on inclusive education. Within it you’ll also find the latest evidence, guidance and policy news on a range of other disability inclusion topics including stigma, discrimination, and violence; poverty, social protection, and employment; inclusive health systems; and disability inclusion in humanitarian settings.

Joint submission on promoting and protecting the human rights of women and girls in conflict and post-conflict situations

HUMAN RIGHTS WATCH
HUMANITY & INCLUSION
INTERNATIONAL DISABILITY ALLIANCE
WOMEN ENABLED INTERNATIONAL
WOMEN'S REFUGEE COMMISSION
April 2021

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Joint submission on promoting and protecting the human rights of women and girls in conflict and post-conflict situations on the occasion of the twentieth anniversary of Security Council resolution 1325 by Humanity & Inclusion, Human Rights Watch, International Disability Alliance, Women Enabled International and the Women’s Refugee Commission.

This submission sets out information and recommendations on promoting and protecting the human rights of women and girls with disabilities in conflict and post-conflict situations. Women and girls with disabilities are disproportionately impacted by armed conflicts, yet remain underreported and excluded from peace and security processes. Women and girls with disabilities account for nearly one-fifth of all women and girls worldwide and face multiple and intersecting forms of discrimination based on their gender, as well as their disability. Sustainable peace, recovery and inclusive humanitarian action requires the full, equal and meaningful participation of diverse women, including women and girls with disabilities. The Office of the High Commissioner on Human Rights, in its report, should request member states, the Human Rights Council and its mechanisms, as well as other stakeholders to ensure that monitoring and reporting on the experiences of women and girls in conflicts includes the specific experiences of women and girls with disabilities, and ensure their meaningful participation in conflict prevention, response, peacekeeping and peacebuilding.

Let’s not go back to ‘normal’! lessons from COVID-19 for professionals working in childhood disability

ROSENBAUM, Peter L
SILVA, Mindy
CAMDEN, Chantal
January 2021

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Purpose: The worldwide COVID-19 pandemic has changed almost all aspects of our lives, and the field of childhood disability is no exception.

 

Methods: This article is based on an invited lecture by the first author at a conference–the eHealth Summit (“Pediatric Rehabilitation in a Digital Space”)–organized by the other authors and their colleagues in May 2020.

 

Results: The first author offers his own experiences and perspectives, supplemented by comments and observations contributed by many of the 9000+ attendees at this talk, as curated by the second and third authors. The basic messages are that while life for families of children with developmental disabilities, and for service providers who work with them, is significantly altered, many important lessons are being learned.

 

Conclusions: The comments from participants support the currency of the ideas that were presented, and encourage childhood disability professionals to reflect on what we are learning, so that we can seize the opportunities they afford to do things differently–and we believe better–moving forward.

Determining Frailty in People With IntellectualDisabilities in the COVID-19 Pandemic

FESTEN, Dederieke A M
SCHOUFOUR, Josje D
HILGENKAMP, Thessa I M
OPPEWAL, Alyt
2021

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Background: Across the world, frailty is part of the guidelines that are being developed in the COVID-19 pandemic for triaging in crisis situations. The Clinical Frailty Scale (CFS) evaluates the ability to perform daily tasks to identify frail individuals, potentially excluding those from intensive care (IC) treatment. Individuals with intellectual disabilities (ID) experience varying degrees of dependence, distinct from age-related physical deterioration. Using the CFS for triage in crisis situations could potentially unjustiably exclude individuals with ID from IC treatment. Our objective was to compare the classication of individuals with ID
into different frailty categories based on the CFS and the well-studied ID-frailty index and to determine suitability of CFS for evaluation of frailty in individuals with ID during the COVID-19 pandemic.


Methods: This retrospective analysis of the observational healthy aging and intellectual disabilities (HA-ID) study included 982 individuals with ID of ≥50 years, who were classied according to the CFS and the ID-frailty index.


Results: Of the cohort of 982 older adults with ID, 626 (63.7%) would be classifed as moderately frail (CFS score 6), but 92% of this group is not moderately frail according to the ID-frailty index. Furthermore, 199 (20.3%) would be classied as at least severely frail (CFS score 7–9), but 74.9% of this group is not severely frail according to the ID-frailty index. Overall, 730 out of 982 (74.9%) individuals would be incorrectly classied by the CFS as too frail to have a good probability of survival. The ID-frailty index predicts mortality better than the CFS in individuals with ID.


Conclusions: Our results show the CFS is not suitable to evaluate frailty in individuals with ID, with potential dramatic consequences for triage and decision-making during the COVID-19 pandemic. We strongly recommend using the ID-frailty index when assessing probability of survival for individuals with ID.

Reach the furthest behind first: Persons with disabilities must be prioritized in accessing COVID-19 vaccinations

INTERNATIONAL DISABILITY ALLIANCE (IDA)
December 2020

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International Disability Alliance call on all policy-makers and health-care planners in every region and in every country to include persons with disabilities and support networks of their choice in priority groups to receive vaccinations, and to make sure that all persons with disabilities can access vaccinations on the basis of accessible and understandable information, through informed consent

Excluded from the Excluded: People with Intellectual Disabilities in (and out of) Official Development Assistance

Inclusion International
2020

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This report from Inclusion International analyzes data available through the Organization for Economic Cooperation and Development (OECD) Development Assistance Committee (DAC)’s Creditor Reporting System (CRS), which reveals that mainstream development projects fail to include people with intellectual disabilities, and in many cases use project methodologies that promote segregation and other human rights violations.

 

Analysis of ODA data from 2014 to 2018 found that 99.98% of ODA funding did not include people with intellectual disabilities, that 36% of the ODA projects that did include people with intellectual disabilities were not CRPD-compliant, and that only 2% of aid relevant to people with intellectual disabilities and their families was delivered through OPDs.

 

This report urges action from donors to ensure that the commitment to disability-inclusive development under Article 32 of the CRPD is also fulfilled for people with intellectual disabilities, and sets out recommendations for funders to ensure CRPD-compliance and inclusion in the projects they support.

Funding ≠ Inclusion: Segregation and CRPD Non-Compliance in Official Development Assistance

Inclusion International
November 2020

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This two-page summary resource compiles key data on the CRPD-compliance of Official Development Assistance (ODA)-funded programmes. This analysis was originally published in Inclusion International's 2020 report, Excluded from the Excluded, which revealed that 36% of projects that included people with intellectual disabilities in 2018 used methodologies that promoted segregation.

 

This summary resource profiles key data on the CRPD compliance of ODA-funded programme methodologies by thematic area - including livelihoods, education, emergency response, and service provision programmes. The summary resource also shares key recommendations for organizations implementing programmes to ensure CRPD-compliance.

No one left behind? Exclusion of People with Intellectual Disabilities in Official Development Assistance

Inclusion International
November 2020

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This one-page factsheet presents key data from Inclusion International's 2020 report "Excluded from the Excluded," which revealed that people with intellectual disabilities are excluded from 99.98% of Official Development Assistance (ODA)-funded programmes. The factsheet also shares key recommendations for funders to ensure that no one is left behind by ODA funding.

Bridge CRPD-SDGs global training on Article 11

FLEURY, Tchaurea
UJAH, Sulayman AbdulMumuni
October 2020

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The IDA-IDDC Bridge CRPD-SDGs Global Training on Article 11 was the first-ever global training initiative on Article 11 of the Convention on the Rights of Persons with Disabilities (CRPD) to bring together Disabled Persons’ Organisations (DPOs) and humanitarian representatives. An outline of the eight day event is given and lessons learnt are reported.

Disability rights during the pandemic. A global report on findings of the COVID-19 Disability Rights Monitor

BRENNAN, Ciara Siobhan
October 2020

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This report presents the findings from a rapid global survey of persons with disabilities and other stakeholders which took place between April and August 2020. The organisations behind the study seek to “catalyse urgent action in the weeks and months to come,” as transmission rates of COVID-19 continue to rise in many countries and persons with disabilities are again subjected to restrictions which have already had severe consequences.

The report analyses over 2,100 responses to the survey from 134 countries around the world. The vast majority of responses were from individuals with disabilities and their family members. Within the questionnaire responses respondents provided more than 3,000 written testimonies documenting the experiences of persons with disabilities and their family members during the pandemic. The qualitative and quantitative data provide in-depth, comprehensive insights into the experiences of persons with disabilities and the consequences of government actions or inactions on the rights of persons with disabilities.

The report is organised around four themes which emerged during the process of analysing responses received to the survey. These themes are:

1. Inadequate measures to protect persons with disabilities in institutions

2. Significant and fatal breakdown of community supports

3. Disproportionate impact on underrepresented groups of persons with disabilities

4. Denial of access to healthcare

 

A webinar was held to mark the launch of the report

Inclusion of persons with disabilities in the COVID-19 response: Applying the IASC Guidelines

Professionals in Humanitarian Assistance and Protection (PHAP)
September 2020

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On 17 September 2020, during a webinar organized jointly by ICVA, PHAP, IASC, and the Reference Group on Inclusion of Persons with Disabilities in Humanitarian Action, we discussed how the IASC Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action can be implemented in the COVID-19 response. We started with a presentation of the recent note produced by the Reference Group and endorsed by the IASC on this topic, followed by a discussion of challenges in the current response and ways to overcome them.

The webinar shared practical examples of how response to COVID-19 in humanitarian contexts has been made more inclusive of persons with disabilities, drawing on learning from the past 6+ months to present concrete actions that humanitarian actors can take, in partnership with local organizations of persons with disabilities. The webinar aimed to provide a space for learning and exchange of experience between organizations of persons with disabilities, NGOs, UN entities, and other humanitarian actors.

How can we ensure the safety and wellbeing of children with disabilities during humanitarian crises? - Evidence brief

QURESHI, Onaiza
September 2020

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This brief reviewed evidence-based recommendations on how to ensure the safety and wellbeing of children with disabilities in humanitarian settings. The right to safety for all is enshrined in Article 11 of the CRPD, yet this population has been consistently neglected in the global literature around children affected by disaster and crises, and as such the recommendations made are limited to specific humanitarian settings (e.g., natural disasters, war and conflict) and towards children with physical and mobility challenges. There is a need to further explore their diverse needs and experiences by recognising them as independent actors who can meaningfully participate in and contribute to the development of services and policies targeted towards them

Pivoting to inclusion : Leveraging lessons from the COVID-19 crisis for learners with disabilities

McCLAIN-NHALPO,Charlotte Vuyiswa
KULBIR SINGH,Ruchi
MARTIN,Anna Hill
et al
August 2020

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As governments respond to the Coronavirus 2019 (COVID-19) pandemic, the global community must ensure that persons with disabilities are included. This will require disability inclusion to be considered in all interconnected sectors; education, health, social protection, and inclusion from the planning stage all the way through to delivery and recovery efforts that are inclusive of all and are sufficiently differentiated to meet the specific needs of children with disabilities. The issues paper focuses on the following objectives: (1) addressing education, social needs, barriers, and issues for learners with disabilities at a global, regional, and country-level during the COVID-19 crisis; and (2) recommending practices for education and social inclusion, and reasonable accommodations utilizing the twin track approach and principles of universal design for learning.

Towards healthier homes in humanitarian settings

WEBB, Sue
WEINSTEIN SHEFFIELD, Emma
FLINN, Bill
August 2020

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Proceedings of the Multi-sectoral Shelter & Health Learning Day 14th May 2020

The Shelter and Health Multi-sectoral Learning Day was hosted online by Oxford Brookes University’s Centre for Development and Emergency Practice (CENDEP) and CARE International UK, on 14th May 2020. Instigated and led by the ‘Self-recovery from Humanitarian Crisis’ research group, the Learning Day aimed to facilitate the sharing of knowledge about the connections between housing and health, in order to inform humanitarian action and enhance the wellbeing of crisis-affected populations. 

What do we know about how to support mental health and wellbeing during the COVID-19 pandemic from past infectious disease epidemics?

QURESH, Onaiza
SCHERER, Nathaniel
July 2020

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The question and the problem:

Symptoms of mental ill-health are common during widespread outbreak of an infectious disease, with high rates of depression, anxiety and post-traumatic stress disorder (PTSD) reported during recent epidemics, such as the recent Ebola crises and SARS-CoV-1. Elevated symptoms of mental ill-health are not limited to patients only, and are seen in healthcare workers, family members and indeed more widely across the general population. Early evidence coming from the COVID-19 pandemic demonstrates high rates of mental ill-health and mental health service provision is needed. This evidence brief summarises evidence on mental health support during COVID-19 and other recent pandemics, informing policy and practice during this crisis.

Gap Analysis: the inclusion of people with disability and older people in humanitarian response

ROBINSON, Alex
MARELLA, Manjula
LOGAM, Lana
July 2020

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To build the evidence base on inclusion, and inform our priorities for innovation, the Elrha Humanitarian Innovation Fund (HIF) commissioned a Gap Analysis on the Inclusion of People with Disability and Older People in Humanitarian Response. This is the first of two reports from the Gap Analysis and summarises findings from the literature review components of this work. The Gap Analysis has been led by the Nossal Institute for Global Health at the University of Melbourne. The Nossal Institute team was supported by Arbeiter-Samariter-Bund’s Office for Indonesia and the Philippines (ASB) in the review of grey literature.  This report begins by outlining the approach taken to the academic and grey literature reviews. This is followed by an overview of findings, which maps evidence from different sectors against thematic areas based on the Humanitarian Inclusion Standards for Older People and People with Disabilities (HIS).

 

Supplementary information is available as a separate accompanying annex. The annex includes a summary of each article identified in the review arranged by HIS and sector; graphs showing the distribution of articles, including by year, humanitarian context, and geographical region; and a list of guidelines on the inclusion of people with disability and older people in humanitarian response

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