From 1979, the World Health Organization has advocated Community Based Rehabilitation (CBR) as an integral component of healthcare.
The COVID-19 pandemic has more than ever before highlighted the need to strengthen rehabilitation services for the most vulnerable sections of society, which include the elderly and persons with disabilities. While communities have come forward and offered support, the pandemic has also exposed grave limitations in several low- and middle-income countries where there are little to no health or rehabilitation services available for those living in poverty.
Balakrishna Venkatesh, Voluntary Convenor, Indian Forum for Rehabilitation and Assistive Technology (IFRA), says that CBR is the only comprehensive United Nations model that has stood the test of time to reach persons with disabilities in remote areas using barefoot and community development approaches. The recent exclusion, therefore, of CBR from two important WHO policy documents is worrying.
In 2017, WHO launched ‘Rehab 2030: Call for Action’ under the new leadership of their disability unit, and CBR was found to not have a central focus here. Additionally, the absence of CBR in the World Health Assembly Resolution in January 2021 on ‘Highest attainable standard of health for persons with disabilities’ is not only conspicuous, but of grave concern. In the last 43 years, CBR has been central in all WHO and WHA discussions and documents concerning disability. The absence of CBR will be detrimental to people living in poverty and the impact on disabled persons will be even greater. If we allow this to continue, CBR will be forgotten. There will be no government support and aid agencies will not step in with financial assistance for such rehabilitation programmes.