The Laws Exist, but the Access Does Not
What a New PAHO Report Reveals About Disability and Health Care in Latin America

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On July 20, 2026, the Pan American Health Organization (PAHO) announced in a news release the publication of a joint report with the UN Economic Commission for Latin America and the Caribbean (ECLAC) and the Latin American Network of Organizations of Persons with Disabilities and their Families (RIADIS), titled "Disability Inclusion in Health Systems and Emergency Management in Latin America and the Caribbean." The report itself was launched on April 30 of the same year at the RIADIS congress in Bogotá, Colombia. Based on a study covering ten countries in the region, its conclusion is unambiguous: while laws and policies have advanced, persons with disabilities still cannot use health services and emergency support on an equal basis with others.

Four Structural Barriers

The report distills the problem into four points. First, fragmented information systems: data on disability is not collected or shared in an integrated way across institutions, making it hard even to grasp the realities that policy should respond to. Second, health services are organized around the logic of providers rather than the needs of people—the schedules and convenience of facilities and programs take precedence over the diverse situations of users.

Third, training for health workers on disability inclusion is scarce and unsystematic. And fourth, emergency management plans may "mention" disability, but they lack concrete measures for accessibility and continuity of care. In a region highly exposed to earthquakes, floods, and hurricanes, that last point carries real weight: the people who struggle to access care in ordinary times are the ones most likely to be left behind in a disaster.

The Urban-Rural Divide

The report also stresses a geographic imbalance. While large cities show measurable progress in disability-inclusive services, rural and remote areas offer far less support. Between the rights guaranteed on paper and what a rural health center can actually provide, the gap is wide—a structural pattern that recurs across the region, not only in health care but in rehabilitation and social services as well.

The Stage After Lawmaking

Most countries in Latin America have ratified the Convention on the Rights of Persons with Disabilities (CRPD) and worked it into domestic law. In terms of codifying rights, the progress of the past two decades is real. What this report confronts is the distance between legal frameworks and actual access: staff who never received training, facilities a wheelchair cannot enter, evacuation plans drafted without the perspective of those most affected. These details accumulate into a situation where the system exists but does not reach people. And as we saw in the battle over disability benefits in Argentina (covered earlier), the systems that support persons with disabilities are also exposed to fiscal pressure—the region's challenge is shifting from building institutions to making them deliver, and defending them.

My Take

That "fragmented information systems" tops the list of four barriers struck a chord with me—because this is not a Latin American problem alone. In Japan, too, data on disability certificates, publicly funded assistive devices, and long-term care insurance is managed separately by each program and each municipality, and grasping nationwide who receives what support, and where, is anything but simple. Researching Japan's assistive-device subsidy system, I have run into this wall many times. When data does not connect, policy ends up being made on experience and intuition. The report's critique rebounds directly onto Japan's own institutions.

The finding on urban concentration also matches scenes I remember. When I worked in rehabilitation in Costa Rica, specialists and services clustered in the capital region, and patients from rural areas bore the burden of long journeys and long waits. Costa Rica is a country where the social security fund (CCSS) directly provides health care—one of the region's stronger health systems. If even there this was true, the rural conditions the report describes are likely more pressing than any number conveys.

And the observation that services are organized around the provider's logic stings, speaking from my own experience as a physical therapist. The structure in which users are asked to fit the timetable of a training program or the convenience of a facility creeps into clinical settings in any country unless you consciously resist it. The report names this not as a failing of individual attitudes but as a flaw in system design—and that, I think, is its most honest contribution.

Two indicators are worth watching for follow-up. First, how the governments of the ten surveyed countries translate the findings into concrete action plans. Second, how these insights feed into the region's disaster-preparedness and health policies after the meetings marking twenty years since the adoption of the CRPD—the RIADIS congress in Bogotá in April 2026, where the report was launched, was one of them.

Glossary

inclusión de la discapacidad (disability inclusion) = the principle that persons with disabilities participate in society and services on an equal basis with others. OPS/PAHO = the Pan American Health Organization, the international health agency of the Americas and WHO's regional office. CEPAL/ECLAC = the UN Economic Commission for Latin America and the Caribbean. RIADIS = the Latin American Network of Organizations of Persons with Disabilities and their Families. CRPD = the UN Convention on the Rights of Persons with Disabilities, adopted in 2006 and ratified by most countries in the region.

The distance between a right written into law and a right that reaches the clinic floor—closing it is work still under way across the region.

※ 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.