Twenty Years After the Convention
The Health Gap for Persons with Disabilities

← Back to Latin America News

On April 30, 2026, marking twenty years since the adoption of the Convention on the Rights of Persons with Disabilities (CRPD), PAHO (the Pan American Health Organization), ECLAC (the UN Economic Commission for Latin America and the Caribbean), and RIADIS (the Latin American Network of Non-Governmental Organizations of Persons with Disabilities and their Families) jointly released a regional report. Titled "Disability Inclusion in Health Systems and Emergency Management in Latin America and the Caribbean," it lays out, alongside a series of structural challenges, just how wide the gap remains between the convention's ideals and conditions on the ground.

This is not a story told through flashy figures or headlines. Yet it is a quiet, heavy matter that decides whether tens of millions of people across the region can reach a hospital, or can evacuate when disaster strikes. As someone who has worked in assistive devices and health systems, I could not let this theme pass by.

What Happened

The report points out that persons with disabilities living in Latin America and the Caribbean face continuous barriers in both routine medical settings and emergencies. The problem is layered. It ranges from physical access to hospitals and health posts (steps, the absence of transport) to shortages in the supply of assistive devices such as prosthetics, orthotics, hearing aids, and visual aids, and on to the fact that health workers often lack sufficient knowledge and training to respond to disability (source: PAHO).

In emergencies, the situation becomes even more severe. Persons with disabilities are systematically excluded from evacuation plans for hurricanes, floods, and pandemics, and it is documented that this raises their risk of death. The COVID-19 pandemic made this gap visible in a particularly cruel way. The report was launched at a congress in Bogotá titled "Our Voice, Our Rights: 20 Years of the CRPD," where organizations of persons with disabilities, governments, and international bodies debated the priorities for the next decade (source: PAHO).

Background

The CRPD, adopted by the UN General Assembly in December 2006, was the first major human rights convention of the twenty-first century. It demanded a shift in thinking worldwide: not "granting healthcare and welfare as a favor," but "treating persons with disabilities as holders of rights." Latin American countries have ratified it almost across the board, which on paper makes the region remarkably progressive. The question is how far that ratified convention has actually been translated into domestic law, budgets, and services on the ground.

What the report stresses most is the "absence of comparable data." Because definitions of disability and survey methods differ greatly from country to country, there are surprisingly few statistics that allow the situation to be grasped across the region. The data that should serve as the foundation for designing reality-based policy is simply not in place, and this keeps generating delays in support measures and mismatches in the allocation of funding. The report calls on member states to adopt standard indicators such as WHODAS (the WHO Disability Assessment Schedule) and to build comparable survey systems, placing this among the top priorities (source: PAHO).

The Debate / The Contrast

Even calling it "a region where nearly everyone has ratified the CRPD" hides enormous variation. Take access to assistive devices: in Costa Rica, Chile, and Uruguay, a degree of public provision is taking shape, while in Haiti, Honduras, and Venezuela the supply system itself is reported to be close to collapse. Against the single yardstick of the convention, the actual destinations have split into two poles.

The common agenda for the next decade that emerged from the Bogotá congress had three points: (1) the inclusion of persons with disabilities in emergency management, (2) the building of comparable data, and (3) access to assistive devices. These three may look like separate issues, but they are in fact deeply connected. Without data on who needs what kind of support and where, both evacuation plans and assistive-device distribution plans will be full of holes. The underlying work of building data holds the key to the effectiveness of the other two.

A Note from the Author

Reading this report, the first thing I recalled was what I have seen firsthand in Costa Rica. Even in a country with a relatively solid health system by regional standards, a person who needs a prosthesis or orthosis must pass through a long sequence—assessment, prescription, casting, fitting, and repair—and if any single step gets clogged, you end up with a state of "the right exists, but the device never arrives." Translating the convention's ideals into a real supply chain is genuinely unglamorous work that genuinely takes time. From the standpoint of someone who has long researched the funding systems for assistive devices, what matters here are the financial design of those systems and the data on who needs what. I felt the report was entirely correct to put the "absence of data" at the top of its list.

And there is one more point I take especially seriously: inclusion in emergencies. Disasters and pandemics suddenly magnify the inequalities that existed in normal times. Being unable to clear a single step, information arriving only as sound or only as text, an evacuation shelter without an accessible toilet—what would be mere "inconvenience" in ordinary times becomes a matter of life and death in an emergency. From my experience on the ground as a physical therapist, I feel that the habit of building evacuation plans around the "healthy adult" as the default is a weakness shared the world over. At the twenty-year mark of the CRPD, the very fact that Latin America is trying to re-ask not "do we have the convention?" but "can we flee alongside our disabled neighbors in the midst of a disaster?" gives me hope. Closing, step by step, the distance between the rights written into the convention and the reality of reaching a hospital or a shelter—through data and through systems—is what should sit at the core of the coming decade.

Glossary

CRPD = Convention on the Rights of Persons with Disabilities, adopted in 2006; in Spanish, Convención sobre los Derechos de las Personas con Discapacidad. Órtesis (orthosis) and prótesis (prosthesis) appear constantly in regional policy documents and together correspond to "assistive and prosthetic devices." Gestión de emergencias means "emergency management"—the systems for preparing for and responding to disasters and crises.

Twenty years on, there is still a wide distance between writing a right into a convention and actually being able to reach a hospital.

※ This article is the author’s commentary based on public information. Please confirm the latest figures, dates and procedures with governments and primary sources. Quotations are kept minimal and sources are cited.