Inequality has many adverse consequences
by Tax Justice Network, Civil Society agencies
10:19am 4th Jul, 2023
The explosive rise in inequality, by Jayati Ghosh - Professor of Economics at the University of Massachusetts.
Recently, more than 320 economists from around the world (including myself) signed a letter to the United Nations secretary general, Antonio Guterres, and the World Bank president, Ajay Banga. The letter expressed concern about the explosive rise in inequality, which has recently grown more rapidly than at any time since the second world war.
So acute has this process been that, even as extreme wealth has increased to incredible levels, absolute poverty has also increased. Furthermore, inequality of per capita income between countries, which had been coming down, has once again started to increase.
This unprecedented increase in inequality has many adverse, even destructive, consequences. As we note in our letter, it ‘corrodes our politics, destroys trust, hamstrings our collective economic prosperity and weakens multilateralism’. It also hinders attempts to prevent climate breakdown and address the impacts of climate change.
Indeed, none of the 17 UN Sustainable Development Goals (SDGs), adopted in 2015 for realisation by 2030, is likely to be achieved without a strong focus on reducing inequality.
This is where the UN and the World Bank come in. Reducing inequality is itself one of the SDGs (10), which are all under mid-term review this year. There has been backsliding on most in the recent past but SDG 10 has been particularly badly affected. It has been an orphan even among the SDGs, marginalised by lack of champions in the multilateral system.
What makes this worse is that the metrics used to track progress on inequality are very inadequate. The World Bank is charged with monitoring this goal.
The bank does not rely on the widely recognised measures of inequality, such as the Gini coefficient (which encapsulates the dispersion of incomes across the entire distribution and ranges from 0 for total equality to 1 for infinite inequality) or the Palma ratio (the share of the top income decile (10 per cent) divided by the income share accruing to the bottom 40 per cent).
Instead, it applies a notion of ‘shared prosperity’, expressed as the need to ‘progressively achieve and sustain income growth of the bottom 40 per cent of the population at a rate higher than the national average’. This is a bizarre idea of inequality: it leaves the rich out of the equation! And it provides very misleading estimates of the extent of inequality or progress in reducing it.
Work by Development Finance International shows that, according to the bank’s indicator, of the 79 countries for which survey data were available for the period just before the pandemic, 42 (53 per cent) showed progress, nine (11 per cent) no change and 28 (35 per cent) deteriorating performance.
Yet countries can show improvement on this indicator even as incomes become more concentrated at the very top. The bank’s own Gini estimates contrastingly show that, among 78 countries, over the same period, the coefficient fell in only 34, remained unchanged in 31 and rose in 13.
Even for this, however, the World Bank relies on consumption surveys, which tend to underestimate top incomes because richer households are less likely to respond accurately, if at all, to such surveys. It therefore makes sense to incorporate other information, such as from mandatory tax returns.
Filling the gaps in knowledge to target the problems
This is what the World Inequality Database provides. Its data cover a much wider range of 172 countries and it discloses much more severe inequality. According to the WID, over the same period 2015-19, only 26 per cent of countries showed improving Gini coefficients, 37 per cent stagnated and 36 per cent worsened. So, three-quarters of countries showed no progress or even backsliding in terms of inequality.
Using the Palma ratio, which captures the difference between rich and poor, the situation is even worse. According to the WID data for this period, only 12 per cent of countries showed improvement in the ratio, while 35 per cent stagnated and the majority, 53 per cent, worsened. And it is well known that inequality increased significantly during and after the pandemic.
This is the lived experience of people across most of the world. Amid increasing divergence between rich and poor, talking of ‘shared prosperity’ looks like fudging, likely only to excite cynicism. Our letter therefore asks the UN and the World Bank to shift to the much more plausible and widely used indicators to track progress on SDG 10.
It is also critical to reduce wealth inequalities, which have increased even more than income disparities. The latest World Inequality Report revealed that the richest 10 per cent of people in the world own 76 per cent of all wealth, while the poorest half have virtually none. Indeed, many are in debt, with ‘negative wealth’. Tracking and reducing wealth inequality is therefore key.
Furthermore, while the stated goal of SDG 10 is to ‘reduce inequality within and among countries’, at the moment no indicator is used to track between-country inequality. Yet it is widely accepted that global economic processes since the pandemic, and then the war in Ukraine, have led to sharp increases in inequalities across countries. Tracking these is an essential first step to working to reduce them.
It is difficult, if not impossible, to do something about a problem if we do not even measure it properly. More and more people across the world recognise this and are demanding change. It is now up to governments and the multilateral process to respond to this demand.
Open Letter to the United Nations Secretary-General and President of the World Bank - Setting Serious Goals to Combat Inequality
Dear Secretary-General of the United Nations Antonio Guterres and President of the World Bank Ajay Banga,
RE: Setting serious goals to combat inequality
As a group of economists and leaders in the fight against extreme inequalities from around the world, we write to request your leadership towards ensuring that the United Nations Sustainable Development Goals and the World Bank back vital new strategic goals and indicators, that can redouble efforts to address rising extreme inequality.
We are living through a time of extraordinarily high economic inequality. Extreme poverty and extreme wealth have risen sharply and simultaneously for the first time in 25 years. Between 2019 and 2020, global inequality grew more rapidly than at any time since WW2.
The richest 10% of the global population currently takes 52% of global income, whereas the poorest half of the population earns 8.5% of it. Billions of people face the terrible hardship of high and rising food prices and hunger, whilst the number of billionaires has doubled in the last decade.
We know that high inequality undermines all our social and environmental goals. The 2006 World Development Report, as well as multiple other studies, have shown that extreme inequality of the kind we are observing today has a destructive effect on society.
It corrodes our politics, destroys trust, hamstrings our collective economic prosperity and weakens multilateralism. We also know that without a sharp reduction in inequality, the twin goals of ending poverty and preventing climate breakdown will be in clear conflict.
In 2015, all the governments of the world made history by setting themselves a Sustainable Development Goal to reduce inequalities – “SDG10”. Yet since then, following the COVID-19 pandemic and now the global cost of living crisis inequalities have worsened, by many measures. SDG10 remains largely ignored.
Equally troubling, the main SDG10 target, based on the World Bank’s Shared Prosperity goal, does not adequately measure or monitor key aspects of inequality. Evidence from household surveys shows that one in five countries showing a positive trend in Shared Prosperity simultaneously saw inequality by other measures, like the Palma Ratio, increase, including countries such as Mongolia, Chile and Vietnam.
We have a critical opportunity to strengthen our resolve to reduce this deep divide and send a clear signal to people around the world that the institutions designed to serve them are serious about ending this crisis of extreme inequality.
We must strengthen our existing goals. We must act this summer to secure agreement that the UN SDG 10 must also have strengthened targets and better metrics, looking at inequalities both between countries and within them by using indicators that track wealth as well as income inequality.
We are pleased that the World Bank is reviewing its Shared Prosperity goal. The new leadership of the World Bank has an opportunity to strengthen this goal to assess inequalities across the entire spectrum of the income and wealth distribution.
There have been significant advances in inequality data, such as more accurate estimates of top incomes, helping to enable a new generation of policy making rooted in a clear distributional analysis of the impact of policy changes.
These need to be systematised and pushed further, to enable high-level inequality analysis by every government. This will be the only way to ensure broad political consensus for the transformation our economies must make to a zero-carbon future.
Goals matter. Leadership matters. The Bank and UN SDGs are uniquely placed to offer the rallying call for a reduction in inequality that our divided world needs so urgently today.
We ask you to seize this opportunity to back stronger goals and better metrics for both wealth and income, as well as wage shares of national income. Also, SDG10 is not a separate, standalone goal: all economic, financial, and social policies should be assessed in terms of their likely impact on this goal. This would clearly signal our collective ambition to forge a more equal world.
http://equalshope.org/index.php/2023/07/17/setting-serious-goals-to-combat-inequality/ http://www.ips-journal.eu/topics/economy-and-ecology/taking-inequality-seriously-and-tackling-it-seriously-6874/ http://www.theguardian.com/inequality/2023/jul/17/top-economists-call-for-action-global-inequality-rich-poor-poverty-climate-breakdown-un-world-bank
* The 2022 World Inequality Report revealed that the richest 10 per cent of people in the world own 76 per cent of all wealth, while the poorest half have virtually none. Indeed, many are in debt, with ‘negative wealth’: http://wid.world/news-article/world-inequality-report-2022/
* Report of the Secretary-General: Progress towards the Sustainable Development Goals: Towards a Rescue Plan for People and Planet : http://tinyurl.com/33prnjwx
World to lose $4.7 trillion to tax havens over next decade unless UN tax convention adopted. (Tax Justice Network)
Countries are on course to lose nearly US$5 trillion in tax to multinational corporations and wealthy individuals using tax havens to underpay tax over the next 10 years, the Tax Justice Network warns.
The future losses of public money would be equivalent to losing a year of worldwide spending on public health. Campaigners are urging countries to vote this winter in favour of beginning negotiations on a UN tax convention at the UN General Assembly to avert the astronomic losses.
“Countries have a choice to make at the UN this year end. Forfeit our future now by staying the course, or democratise global tax rules so we can hold on to the public money we need for the challenges ahead,” said Alex Cobham, chief executive at the Tax Justice Network.
The State of Tax Justice 2023 published today by the Tax Justice Network reports that countries around the world are losing US$472 billion in tax a year to global tax abuse. Of this annual loss, US$301 billion is lost to multinational corporations shifting profit into tax havens and US$171 billion is lost to wealthy individuals hiding wealth offshore.
Lower income countries, which have historically had little to no say on global tax rules, continue to be hit harder by global tax abuse. While most annual tax losses are suffered by higher income countries ($426 billion), these losses are equivalent to 9 per cent of higher income countries’ public health budgets. Lower incomes countries’ tax losses ($46 billion) are equivalent to more than half (56 per cent) of their public health budgets.
If countries stay the course followed for the past 10 years on international tax rules, countries will lose US$4.7 trillion over the next 10 years, the report estimates. In comparison, countries around the world collectively spent $4.66 trillion on public health in a single year.
Comparing further, the 2007-2009 Great Recession is estimated to have led to a loss of US$2 trillion in global economic growth. Tax losses over the next 10 years would be twice the scale of the impact of the Great Recession on the global economy.
No progress made on global tax abuse over past decade
The 10-year projection is based on the impact of the OECD’s efforts since 2013 to reform international tax architecture and curb losses to global tax abuse. The Organisation for Economic Co-operation and Development (OECD), a club of rich countries that has set global tax rules for the past sixty years, ran its first reform process, the Domestic tax base erosion and profit shifting (BEPS) process, from 2013 to 2015.
The process failed to deliver a significant reduction in global tax abuse and necessitated a second reform process, BEPS 2.0, to begin shortly after, which has so far only produced drafts of policy proposals.
No significant reductions have been made in the amount of tax countries lose to global tax abuse since the start of the OECD’s efforts to reform global tax 10 years ago. Looking to the next 10 years, studies by several bodies, including the IMF and the BEPS Monitoring Group, conclude that the current draft proposals the OECD has prepared under BEPS 2.0 will make little to no impact on the scale of tax losses. Even then, it is widely expected that many OECD members will not implement the proposals.
The 10-year projection thus assumes global tax losses will not drop below current levels over the next decade under OECD leadership on global tax.
The failure of the OECD process to curb global tax abuse is largely attributed to the inability of the body to agree policy solutions without its member countries, which are home to most multinational corporations’ headquarters, watering down the policies to redundancy.
Most of the meaningful solutions that the OECD has attempted or is attempting to push through are based on the tax justice policy platform – eg country by country reporting, automatic exchange of financial account information, unitary taxation and a minimum effective tax rate.
However, in all cases these policies have been rendered largely toothless under the pervasive influence of some OECD members who are also among the world’s biggest tax havens.
OECD member countries, together with their territorial dependencies, are estimated to be responsible for over three-fourths (77 per cent) of the US$472 billion in tax losses countries suffer a year, according to the report.
Countries poised to vote for UN tax leadership
To avert astronomic tax losses over the next 10 years, and free up trillions of dollars to support the off-track Sustainable Development Goals, the Tax Justice Network is urging countries to support moving leadership on global tax from the OECD to the UN, where global membership, public transparency and the UN’s human rights legal frameworks and technical expertise can provide a more viable forum for securing effective tax solutions.
Countries unanimously agreed at the UN last year to open the door to negotiations on a UN tax convention, which would move tax leadership to the UN.8 The historic resolution was adopted despite unprecedentedly aggressive attempts by the OECD to prevent the resolution from coming before the UN General Assembly.
The UN Secretary General will present a report this September on possible options for a UN tax convention which the UN General Assembly will then debate. Countries are then expected to vote on a UN General Assembly resolution by the end of the year on whether to formally begin negotiations on a UN tax convention.
Robust, undiluted versions of tax justice policy solutions that the OECD has been unable to land have already been endorsed by the UN High-Level Panel on International Financial Accountability, Transparency and Integrity, and included in early proposed drafts for a possible UN tax convention.
Regional bodies in Europe, Africa and Latin America recently announced or are preparing shortly to announce support for UN tax leadership.
The European Parliament recently backed negotiations on a UN tax convention. Support for a UN tax convention has been led by African countries for years. The historic resolution adopted at the UN last year on a UN tax convention was put forward by the Africa Group at the UN, and the influential African Union Commission reaffirmed that commitment to UN tax leadership earlier this month.
Latin American and Caribbean nations are meeting at a first-of-its-kind regional summit this week to discuss international tax rules. The countries are expected to agree regional consensus and negotiation positions largely in favour of moving leadership on global tax to the UN.
Supporters of the UN tax convention have pointed to the OECD’s failure to deliver tangible progress on rampant global tax abuse as well as to the OECD’s failure to meaningfully include most countries in its rulemaking process – a criticism the European Parliament upheld in its backing of a UN tax convention.
Democratic revolution in global tax
The current lack of democratic process on global tax rules was put into sharp focus this month when the Financial Times confirmed that the OECD had intervened to deter Australia from adopting measures on curbing tax abuse, and also confirmed that the IMF was using debt renegotiations to coerce countries to adopt OECD tax rules which the IMF’s own research shows will make it harder for fiscally stressed countries to collect tax.
Tax justice campaigners are hailing the potential shift to UN tax leadership as a “democratic revolution” in global tax.
Alex Cobham, chief executive at the Tax Justice Network, said:
“We’re on the cusp of a global democratic revolution in tax that could reclaim literally trillions of dollars in public money. For sixty years, global tax rules were decided behind closed doors at the OECD where a handful of countries and lobbyists saw tax policy as something to cater to the interests of the wealthiest corporations and billionaires. We now have a real shot at bringing this process into the daylight of democracy at the UN, where all countries will finally get a real say, and where governments will finally have to answer to their people on tax policy.
“The UN tax convention can trigger a more just economic era. The hold of multinational corporations and billionaires on global tax policy must be reined in by global democratic governance at the UN.”
Hon. Irene Ovonji-Odida, a panellist of the UN High Level Panel on International Financial Accountability, Transparency and Integrity, a member of the African Union/Economic Commission for Africa High Level Panel on Illicit Financial Flows out of Africa (the ‘Mbeki panel’) and chair of the Tax Justice Network board, writes in the report’s foreword:
“The negotiations at the UN offer a historic chance, for the first time, of a globally inclusive tax body. This could finally allow the less powerful individual states to protect themselves from cross-border tax abuse and set their own tax rules, finally having the space to exercise the full fiscal sovereignty that is the right of all states. And that would in turn allow all of us, and not just the uber wealthy and global corporations to benefit from the positive power of tax.
With this all states – especially lower and middle income ones -could raise sufficient revenues for inclusive public services, to end the inequalities within and between countries that scar our societies, and to strengthen the bonds of political representation and government accountability. “We must seize this moment, in every country and region of the world – because we all suffer the costs of tax abuse.”
http://taxjustice.net/press/world-to-lose-4-7-trillion-to-tax-havens-over-next-decade-unless-un-tax-convention-adopted-countries-warned/ http://taxjustice.net/reports/the-state-of-tax-justice-2023/ http://www.icrict.com/press-release/2023/3/20/icrict-letter-to-united-nations-secretary-general-antnio-guterres http://www.icij.org/investigations/paradise-papers/australia-spikes-plan-to-force-companies-to-disclose-global-tax-data/ http://www.icij.org/investigations/paradise-papers/african-nations-win-un-tussle-over-paving-the-way-for-global-tax-reforms/ http://www.icij.org/tags/tax-havens/ http://www.icij.org/investigations/ http://factipanel.org/press-release/un-panel-end-financial-abuses-to-save-people-and-planet.html
Sick Development: How rich-country government and World Bank funding to for-profit private hospitals causes harm, and why it should be stopped. (Oxfam International)
Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with some even imprisoning patients who cannot afford their bills.
At the height of the COVID-19 pandemic, some of these same hospitals denied entry to patients suffering from the virus or sold intensive care beds at eyewatering prices to the highest bidder. These development institutions have woefully inadequate safeguards, invest via a complex web of tax-avoiding financial intermediaries, and offer little to zero evidence on the impacts their investments are having. Oxfam is calling on rich-country governments and the World Bank Group to immediately halt their spending on for-profit private healthcare, and for an urgent independent investigation to be conducted into all active and historic investments.
Creating conditions necessary for peace, justice and inclusion. (Joint Civil Society Coalition)
Halfway to 2030, Report on Sustainable Development Goal 16 (SDG16) represents a joint civil society effort to assess progress towards peaceful, just and inclusive societies at this critical halfway point to the 2030 target date for the implementation of the SDGs in 2023.
In addition to providing in-depth analysis around key SDG16+ issues, this report is also intended to provide key recommendations to governments and the international community on where action and ambition must be directed in the second half of SDG implementation to 2030. The report also provides insights into the leadership role of civil society in advancing SDG16+ at all levels to-date, showcasing best practices and case studies around civil society action.
A central feature of the Sustainable Development Goals (SDGs) is interlinkages; the goals, targets and indicators are interconnected, with the implementation of each supporting the attainment of the others. Given this interconnectivity, when working towards implementation, various goals, targets, and indicators should be considered in tandem, to safeguard against the potential undermining of essential objectives and the effectiveness of the broader agenda.
The preamble of the 2030 Agenda affirms that “the interlinkages and integrated nature of the Sustainable Development Goals are of crucial importance in ensuring that the purpose of the new Agenda is realized.” In other words, all 17 SDGs depend upon one another; no single goal can be fully realised alone.
SDG16 was designed to be an enabler, or in other words, to provide support for the achievement of other Goals. SDG16 targets critically important issues that have significant implications for people worldwide, including violence, insecurity, conflict, injustice, exclusion, inequality, discrimination, weak institutions and poor governance.
These issues also undermine government capacities to achieve sustainable development across numerous fronts: ensuring identity and reducing bribery and corruption to remove barriers to accessing education and essential services; ensuring public participation to give people a voice and a role in decision making; ensuring access to information to facilitate oversight and transparency; ensuring people’s fundamental freedoms to give them the opportunity to challenge decisions; ensuring access to justice for people to protect and assert their rights.
SDG16 is rooted in a human rights-based framework to address issues of universal relevance, significant to individuals in all nations. Sustained peace and non-violence, access to justice, rule of law, effective and accountable institutions, inclusive governance, participatory decision making and respect for human rights are all needed in order to advance other areas of sustainable development.
They are all key elements of SDG16 that ensure that the foundational objectives of ‘leaving no one behind’ and ‘reaching the furthest behind first’ are upheld.
The success of SDG16 is equally reliant on the other goals. Progress on targets for peace, justice and inclusion directly affects outcomes for all other SDGs, while social, economic and environmental progress plays an equally important role in creating the conditions necessary for peace, justice and inclusion.
We cannot continue to look away as inequality soars, and those struggling are left to suffer, by Agnes Callamard - Secretary General, Amnesty International
Amnesty International is today calling for social security to be made available to everyone worldwide after a series of crises exposed huge gaps in state support and protection systems, leaving hundreds of millions facing hunger or trapped in a cycle of poverty and deprivation.
In a briefing issued today, Rising Prices, Growing Protests: The Case for Universal Social Protection, the human rights organization also calls for international debt relief, and urges states to enact tax reforms and clampdown on tax abuse, to free up substantial funding to pay for social protection.
“A combination of crises has revealed how ill-prepared many states are to provide essential help to people. It is shocking that over 4 billion people, or about 55% of the world’s population, have no recourse to even the most basic social protection, despite the right to social security being enshrined since 1948 in the Universal Declaration of Human Rights,” said Agnes Callamard, Amnesty International’s Secretary General.
The briefing shows how rising food prices, climate change, and the economic fallout from the Covid-19 pandemic and Russia’s invasion of Ukraine, are driving a catastrophic humanitarian crisis, and leading to increased social unrest and protests.
It urges states to ensure that social security coverage — such as sickness and disability payments, healthcare provision, pensions for older people, child support, family benefits and income support — is available to every person who may need it.
The briefing shows how the lack of social security in many states has left communities more exposed to sudden economic shocks, the consequences of conflict, climate change, or other upheaval. The fallout from these crises, including widespread hunger, higher unemployment and anger at falling living standards, has motivated protests around the world, which have often been brutally suppressed.
“Universal social protection can address the violations of economic and social rights that are often at the heart of grievances and protest. Instead of viewing peaceful protest as an expression of people’s attempts to claim their rights, authorities have frequently responded to demonstrations with unnecessary or excessive use of force. Peaceful protest is a human right and Amnesty International campaigns to Protect the Protest,” said Agnes Callamard.
The briefing calls for international creditors to reschedule or cancel debts to enable them to better fund social protection. It also highlights that the cost of offering basic social security protection in all low income and low-to-middle income states is estimated at US$440.8 billion a year, according to the International Labour Organization (ILO), an amount that is less than the US$500 billion the Tax Justice Network estimated is lost annually by states to tax havens around the world.
Amnesty International urges states to work together and to use all their resources, as well as reform of their taxation systems to stop evasion and loss of critical revenues, to help ensure funds are available to improve social protection.
“People have been brought to their knees by these crises, and when it comes to fixing the problems in the world, the solutions are rarely simple, but we do know that states should get serious about clamping down on tax abuse,” said Agnes Callamard.
To guarantee the right to social security, Amnesty International supports the establishment of an internationally administered Global Fund for Social Protection, a program supported by UN Special Rapporteur on Extreme Poverty and Human Rights, the UN Secretary-General and the ILO.
The creation of a fund would offer states technical and financial support to provide social security and would aim to build the capacity of national social protection systems to scale up their responses in times of crisis.
The lack of adequate social security can be catastrophic for the growing numbers of people struggling to afford food.
The World Food Programme (WFP) says 349 million people around the world are in immediate danger from a shortage of food, and 828 million go to bed hungry every night.
Furthermore, according to the Sustainable Development Goals Report 2022, the Covid-19 pandemic has wiped out almost four years of progress in poverty reduction and pushed an additional 93 million people into extreme poverty, living on less than US$ 2.15 a day.
The lack of effective measures to mitigate inflation and shortages has led to a downward spiral in people’s living standards. This has contributed to protests around the world recently, including in Iran, Sierra Leone, and Sri Lanka.
The rising price of food and other essential items has hit people living in low-income countries the hardest, but the increased use of food banks in wealthier countries shows that the cost-of-living and food affordability crisis is widespread.
Russia’s invasion of Ukraine, a major grain producer, has dealt a devastating blow to global food supplies, and pushed the Food and Agriculture Organization’s (FAO) food price index to its highest point since records began in 1990.Climate change, and spiralling fertilizer prices, have hit agricultural production too. Drought is the greatest single contributor to reduced harvests, according to the FAO.
Amnesty International is part of a growing coalition of experts and civil society organizations calling on states to progressively deliver universal social protection, and to realize the benefits it will bring.
Agnes Callamard said: “Protecting people against losses due to shocks, from disasters or economic reversals, can be transformational, both for society and the state that provides the support, by reducing social tension and conflict, and promoting recovery. It enables children to stay in education, improves healthcare, reduces poverty and income inequality, and ultimately benefits societies economically.
“We cannot continue to look away as inequality soars, and those struggling are left to suffer. Tax evasion and aggressive tax avoidance by individuals and corporations are depriving states and particularly lower income countries of the resources they need.”
High levels of debt, and the cost of servicing it, mean that heavily indebted states often lack the financial capacity to realize social security aspirations. Low-income countries spend four times more on debt repayments than they do on health service provision, and 12 times more on debt payments than on social protection, according to Oxfam.
According to the IMF’s annual report around 60% of low-income countries are in debt distress or at a high risk of debt distress, and risk defaulting on repayments. Debt cancellation or rescheduling would free up substantial funding in many countries to pay for social protection.
http://www.amnesty.org/en/latest/news/2023/05/global-amnesty-international-calls-for-universal-social-protection-as-overlapping-crises-leave-hundreds-of-millions-facing-disaster/ http://www.amnesty.org/en/latest/news/2023/06/global-paris-finance-summit-must-deliver-urgent-assistance-to-states-struggling-with-debt-and-climate-crises/ http://www.amnesty.org/en/documents/pol40/6589/2023/en/ http://www.amnesty.org/en/documents/ior10/6825/2023/en/ http://www.socialprotectionfloorscoalition.org/civil-society-call/
Health inequities lead to diminished life expectancy for many persons with disabilities
A new report by the World Health Organization shows evidence of a higher risk of premature death and illness among many persons with disabilities compared to others in the society.
The Global report on health equity for persons with disabilities shows that because of the systemic and persistent health inequities, many persons with disabilities face the risk of dying much earlier—even up to 20 years earlier—than persons without disabilities.
They have an increased risk of developing chronic conditions, with up to double the risk of asthma, depression, diabetes, obesity, oral diseases, and stroke. Many of the differences in health outcomes cannot be explained by the underlying health condition or impairment, but by avoidable, unfair and unjust factors.
Launched ahead of the International Day of Persons with Disabilities, the report shows the number of people with significant disabilities worldwide has risen to 1.3 billion (or 1 in 6 people). This number reinforces the importance of achieving full and effective participation of persons with disabilities in all aspects of society and embedding the principles of inclusion, accessibility and non-discrimination in the health sector.
The report stresses the need for urgent action to address the vast inequities in health caused by unjust and unfair factors within health systems. These factors—which account for many of the differences in health outcomes between persons with and without disabilities—could take the form of:
Negative attitudes of healthcare providers, health information in formats that cannot be understood, or difficulties accessing a health centre due to the physical environment, lack of transport or financial barriers.
“Health systems should be alleviating the challenges that people with disabilities face, not adding to them,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus.
“This report shines a light on the inequities that people with disabilities face in trying to access the care they need. WHO is committed to supporting countries with the guidance and tools they need to ensure all people with disabilities have access to quality health services.”
With an estimated 80% of persons with disabilities living in low- and middle-income countries where health services are limited, addressing health inequities could be challenging. Yet even with limited resources, much can be achieved.
Recognizing that everyone has the same right to the highest attainable standard of health, the report provides important economic analysis of adopting a disability-inclusive approach. It shows investing in a disability-inclusive health sector is cost-effective.
The report outlines 40 actions across the health sector for governments to take, drawing on the latest evidence from academic studies as well as consultations with countries and civil society, including organizations representing persons with disabilities.
Ensuring health equity for persons with disabilities will also have wider benefits and can advance global health priorities in a number of ways.
Health equity for all is critical towards achieving universal health coverage; inclusive public health interventions that are administered equitably across different sectors can contribute to healthier populations; and advancing health equity for persons with disabilities is a central component in all efforts to protect everyone in health emergencies.
“Addressing health inequities for persons with disabilities benefits everyone,” said Dr Bente Mikkelsen, WHO Director for Noncommunicable Diseases. “Older persons, people with noncommunicable diseases, migrants and refugees, or other frequently unreached populations, can benefit from approaches that target the persistent challenges to disability inclusion in the health sector.”
“We urge governments, health partners and civil society to ensure all health sector actions are inclusive of persons with disabilities so that they can enjoy their right to the highest standard of health.”
http://www.who.int/news/item/02-12-2022-health-inequities-lead-to-early-death-in-many-persons-with-disabilities http://www.who.int/activities/global-report-on-health-equity-for-persons-with-disabilities http://www.hi.org/en/news/hi-has-contributed-to-the-who-report-on-health-equity-for-people-with-disabilities http://www.hi.org/en/news/index http://www.unicef-irc.org/children-with-disabilities http://bit.ly/3UmdENa http://www.ohchr.org/en/disabilities
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