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World Health Organization High-Level Meeting on Disability and Development September 23, 2013 1:15 p.m.

EDT United Nations New York, NY CART Provider: Annamarie D. Jones, CBC-CCP-RPR

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(This text is being provided in a ROUGHLY EDITED format. Communication Access Realtime Translation [CART] is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings.)

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2 High-Level Meeting on Disability and Development September 23, 2013 >> Welcome, everybody. Welcome. I am the director for the World Health Organization, director for violence and injury prevention and disability. Welcome to this assistive technology open doors side event to this high level meeting. I'll do my best to scream. I refuse to do this because I know I will fail but I was obliged to. Without any further ado, I would like to give the floor to the two persons who make it an honor to be here with us to open the event. The Under-Secretary of the department of justice from the Republic of the Philippines, Lea Armamento, and Dr. Shin Young-Soo. Please. >> Thank you. On behalf of the Republic of the Philippines, head of our delegation, secretary, permanent representative of the Philippines of the United Nations, and department of social welfare and development secretary Corazon Juliano-Soliman, who is scheduled to address the side event, allow me to extend to everyone our Philippino greetings. Today's side event is a milestone and manifestation of the Philippine commitment to fulfill its obligation to the United Nations convention for the rights of persons with disabilities or CRPD. This is reflective of the significance that we give to the individual person with disabilities or PWD. Our recognition that they are major actors in the country's development, an acknowledgement that they have the ability to be enhanced for assistive technology. The Philippines recognizes the fact that over one billion people in the world today live with disability. They are the world's largest and most disadvantaged group. Aggravated by the fact that more are from the low income bracket resulting to their marginalization to their lack of equal access to lack of resources like education, employment, transportation, health care, social and legal support system. Thus assistive technology or AT becomes a necessity. AT will break barriers for children to access education and for adults to earn income. This is the first step of opportunity and independence with the consequential reduction of poverty. It will bridge the gap

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3 High-Level Meeting on Disability and Development September 23, 2013 between exclusion and inclusion. 85 to 95 percent of PWD's do not have access to assistive devices with the problem most acute in low and mid income countries like the Philippines; there is a huge disparity between AT need and access. In the last ten years the Philippines has gained tremendous grounds towards accessible, affordable AT in the field of prosthetics and orthotics. This was due to the international cooperation and strong partnership with a civil societies, a non-government organization, started by physicians for peace, walking free missions and global networking activities, undertaken with Cambodia Trust and Nippon Foundation. At this point my friends, ladies and gentlemen, join me and let us acknowledge our indispensable partners, the Cambodia Trust represented by the chair of board of trustees, Dr. John Risk, chief executive and party; the Nippon Foundation represented by Suichi Ohno; the International Disability Alliance represented by Mr. Yannis Vardakastanis; international society for prosthetics and orthotics; UNICEF represented by Ms. Rosangela Berman-Bieler; USAID represented by Mr. Rob Horvath. UNDESA, the prime movement of this event together with the Philippines mission and Philippines delegation, Dr. Shin Young-Soo and Mr. Chapal, World Health Organization in Geneva. We call on all member states to unify for full implementation of the UN CRPD. Again, thank you. (Applause) >> Ladies and gentlemen I'm pleased to join Under-Secretary Armamento in welcoming you here today. On behalf of World Health Organization it is my honor to be here to speak on how assistive technology opens doors. I would like to thank the Philippines government and UN department of economic and social affairs for co-hosting this important event and all of you for attending today. Disabilities is gaining the importance it deserves on global development agenda. Indeed, increased support is long overdue for more than one billion people

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4 High-Level Meeting on Disability and Development September 23, 2013 who experiences disabilities worldwide. Assistive technology can enable people with disabilities to lead the lives they want. In every sense assistive technologies opens doors. It opens doors to education, employment, and to community participation and other opportunities. From a human development standpoint all these doors lead away from isolation and poverty. But for many people especially in low and middle income countries, these doors stay closed and because assistive technologies are not available or not affordable. The convention on the rights of persons with disabilities specifically calls for international corporations like today's meeting to improve access to assistive technology. We must take the lead and increase collaborations to open these doors in communities worldwide. Earlier this year in world house assembly adopted resolutions calling for better health care for people with a disability. Member states encouraged to ensure that health services are inclusive of people with disabilities and provide timely access to rehabilitative services. To address these concerns, World Health Organization is developing a comprehensive global action plan on disability 2014 to 2021. The global plan is intended to improve access to health care services and strengthen and expend rehabilitation services including access to assistive technology. The ratio has already increased effort to expand access to high quality and affordable assistive technology including wheelchairs, prosthetics, orthotics, hearing aids and eyeglasses. The member states recognize disabilities are a global public health concern. We cannot accept that children with disabilities do not go to school because they lack mobility devices. We cannot accept that person with a spinal injury becomes a prisoner in his or her home and dies early just because they could not afford a wheelchair. And we cannot accept that all the people isolated without access to basic information because they cannot get hearing aids or eyeglasses. But we need more leadership and commitment. We need more constructive collaboration to tailor support to member state needs and abilities. And we need more action.

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5 High-Level Meeting on Disability and Development September 23, 2013 People with disabilities must be given the resources to contribute to development of their communities and their countries. Indeed technology can unlock many doors but many hands starting with yours and mine still must help push the doors open. I hope this event will lead to open and fruitful discussions which pave the way to further collaborative action. Thank you. (Applause) Thank you, very much, Under-Secretary Armamento, for describing the issue as well as some of the important contributions assistive devices can make. I will continue with a very brief PowerPoint presentation to try to complement that with a few facts that come mainly from the world report on disability. One billion people live with disability. Next slide, please. Next slide, please. >> Sorry, I'm trying. >> Okay. (Laughter) >> Over one billion people live globally with disability. This is one in seven persons in the world. Next slide, please. However, most of them need assistive diseases and can't access them. For example, 70 million people today need a wheelchair in the world and only 5 to 15 percent of those have access to one. For example, 360 million people suffer moderate or profound hearing loss today in the world; however, production of hearing aids only meets ten percent of global need and that is only three percent in developing countries. These are just two examples that we could continue with other types of assistive devices. So we have a big issue today and we can expect the needs to continue to grow because the prevalence of disability is growing. Our population is aging all over the world. We expect two billion people over 60 and older by 2015 and we know with age the need for assistive devices grows. Chronic health conditions are on the rise, and some types of injuries are also increasing.

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6 High-Level Meeting on Disability and Development September 23, 2013 Why is it that the needs of those who are desperately needing those assistive devices are not met? There is insufficient funding for production and insufficient financial support for those to who need to acquire assistive devices. The services in many places are inadequate and production is too low and we also lack the human resources that have the capacity to support that production. It shouldn't be like that because we know what works. What we need to do is assess better the need and of course the unmet needs to be able to plan and face them. We need to provide more adequate funding for production and improve affordability of assistive devices. Increase the production and supply all over the world including in the poorest countries and societies. Strengthen the services that provide those assistive devices and services that help people learn how to use them. We need to educate and train personnel and health services, rehabilitations, et cetera. And establish the partnership. I would like to ask all speakers to be short and focused so to be sure that your main messages come across. I'd like to start by hearing from Raissa Laurel to understand better from her personal experience what assistive technologies means. >> I'm 26 year old and I currently live in Manila with my husband. I was an ordinary girl who wanted to be someone who could change the world, when a tragic accident happened. When I was in my second year in law school I was standing outside McDonald's waiting for my friends. Unexpectedly something exploded. Police say it was a hand grenade. I lost both my legs. I was lying on the floor when I saw a vision from God and I was entering a court room on the wheelchair, and believe it was a sign from him that I will be never -- I will never be able to walk again using my own feet but I told myself at least I would still become a lawyer. You can see my pictures there during my therapy. I was fighting for my life. They said that at that time I had 20 percent chance of survival due to blood loss. It was a painful decision for my bad to sign the form to amputate both of my legs. My parents were thinking how will I accept

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7 High-Level Meeting on Disability and Development September 23, 2013 it? I woke up knowing I lost both my legs but I never gave up. But I believe I have a purpose in this world, that's why I'm still alive and sitting here in front of you. My goal was to be able to stand again. That was the first time I tried my prosthesis. I was successful with the help of my doctor here. And onto my next goal which is to be able to walk again. I'm really blessed because with the efforts of Cambodia Trust, in less than six months I was out of my wheelchair, used my prosthesis and walked again like nothing was happening. It was really hard to train, to go to rehab. You don't know where your center of gravity was. It was baby steps. First is my belief that I have a purpose; and second, my prosthesis. I believe that everything is possible. With the use of assistive technology in my case my -- wait, there's the picture of me running. Let's wait for my pictures. There, that was our wedding last December. And then back in my physical activity such as running, boxing and working out. With assistive technology I'm doing everything I want to do. Let us make it happen that assistive technology will be available and affordable to everyone to help people to restore their confidence, to never give up on life but to continue living with it. This week I will celebrate my third week as a person with a disability. It is my hope that every Philippino with disability who needs assistive device can afford a well-fitted and functional device. That's why I'm so excited to stand here at the UN and ask you all, let's make this possible not just in the Philippines but in every country in the world. Good afternoon. Thank you. (Applause) >> Thanks, very much, Raissa, for sharing your personal experience and congratulations on your wedding. >> Thank. >> You have a beautiful dress, I have to say. >> Let's further explore the need and benefit of assistive technology. I'd like to turn to Venus Ilagan, a friend. You have the experience of using assistive technology.

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8 High-Level Meeting on Disability and Development September 23, 2013 Can you please, Venus, speak to us about the needs and benefits of assistive technology. >> Thank you. It has always be a pleasure working with World Health Organization and our partners. I would like to thank everyone on behalf of Rehabilitation International, and my boss is here, for the opportunity to join you today. And I would like to tell you as well that Rehabilitation International considers assistive technology as one of the three projects that under the precedence we are really going to work into. Well, let me start by saying that, you know, some years back my friend and mentor of the World Health Organization that really intrigued when some years back I told him my power will cherish the most important thing in my life. Sometimes even more important than my husband. (Laughter) >> And why not? I spend half of every day riding my chair. It enables me to accomplish things that I want and I need to do. It's my trusted partner in everything I do, going to work, going to church, shopping, doing the things I enjoy most and without any complaints. (Laughter) I'm saying these thanks so friends and colleagues without disability appreciate how important assistive devices are to people with disabilities. They are part of our being. So when insensitive and untrained airline ground crew say our wheelchairs are messed up during transit, users just freak out and react vehemently or sometimes even violently. When the wheelchair is broken, the user feels as if he or she similarly is broken. All of us have been broken. That's how much emotional attachment users have with their assistive devices. That said, it remains however that not every person with a disability is able to have access or is able to afford the cost of an assistive device, especially those living in developing countries where resources are lacking or all together non-existent. Who

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9 High-Level Meeting on Disability and Development September 23, 2013 provides assistive devices for those who can't afford them? By the way, I have this experience. I also came from the Philippines just like Raissa. Many of the services in disabilities are provided by non-government organizations, when we were starting. It's better now that the convention has been in place. But impact is limited because resources are not enough to address the needs. There is a big disconnect between actual demand and what is available in terms of funding. Where assistive devices are given as the nations from well-meaning groups and charities, there remains so much to be desired in the quality of products provided to persons with disabilities. Often quality is not seen as an important issue both among donors and recipients and it's the least of the concerns of many. And I hope my friend Rob Horvath of the USAID agrees because I said this many years ago and I hope, Rob, that things have changed since then. Often quality is not seen as an important issue both among donors and recipients and it's the least of the concerns of many. From my interactions with leaders of disabled peoples organizations and people who work with them, it is often said that beggars cannot be choosers. People with disabilities who have suffered decades of untold misery, discrimination and oppression simply have developed some kind of a coping mechanism, of accepting whatever is provided to them, whether good or bad products and services for as long as they are given for free, is something people are going to be grateful for, never mind if the quality is below standard. What is important is to have something that will address their more immediate need for mobility. My former colleagues in the organization I used to work for in the Philippines often said that bad quality service or product is better than not having any service or product at all, especially in regard to assistive devices. If one does not have an assistive device, chances are that he or she will never be able to participate in the activities. And what about substandard devices? I have one minute.

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10 High-Level Meeting on Disability and Development September 23, 2013 (Laughter) One concrete example of this where the wheelchairs of some years back -- they were called wheelchairs but actually they were garden chairs. They were made out of plastic, no footrest, and no cushion that goes with them. Well, for us, it does more damage than good for the user. I just would like to give some recommendations. I would like to provide you with some recommendation. Quality is a complex issue. Just like so many other things quality applies to service provided to persons with disabilities. It means different things the different people with different circumstances and different disabilities. It is a complex multi-perspective and multi-dimensional concept whose meaning depends on the perceptions and values of the person defining the term. Understandably program developer, policy makers, health care managers and products, thought it was important to define what is good quality as it relates to persons with disabilities. Some important things to remember, one, focus should be on what is important to the user, not to the one providing it. But they can, of course, work together at some extent. Another important thing is that the setting out of minimum criteria for quality assurance and to ensure continuous improvement must be insured. Manufacturers are supposed to meet but also aim to ensure that continuous improvement becomes key objective. In three, the quality framework should be a quality framework should be used to measure both manufacturer's capacity and the impact on users. After all, the user is the expert of his own situation. On that note I thank you for my participation here. (Applause) Thank you. Thanks, very much, Venus. This is a nice testimony but also very important recommendations you just made. I think that will help very much into the discussion. We stay in the Philippines for one more speaker but we move from personal

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11 High-Level Meeting on Disability and Development September 23, 2013 experience into what can be done and the Philippines as an important example of what can be done to improve in lower middle income country context. We would like to hear from Josephine Bundoc. >> The partnership did not prosper because timing and logistics were not right and ripe. The second opportunity occurred in 2005 when physicians for peace initiated walking with Philippines. A ten year old map was developed where phase one revealed the four challenges of cost, disability, local sources and training. The most difficult strategy was collaborative innovation and adaptation by doing screening and prosthetic missions. The missions contacted by workshops with local technicians. Three years into implementation walking free failed to reach the finish line because recipients were going to school and worked in non-productive and joining mountain climbing. But they were jolted back to the realization that what we need that was a victory rose into new problems and we were stuck with the fact that what we really need was professional training to make it truly sustainable. They sent me to attend conferences and one faithful day. This time the timing was right and the logistics was right. The Philippines school of prosthetics and orthotics opened its door in 2010. Aligned with the UN CRPD it was inclusive with members of the advisor board that insures disability in underserved areas, aligned with WHO and SBO guidelines. Collaborating with other providers that are in partnership with the department of health, social welfare and local government, it serves as an encore for development and upgrade of prosthetics and services in medical and allied health training. Amputee screening through cellar networking is a tool. Only two years after its inception the Philippines school has made us achieve what we have been trying to achieve in the past 20 years. The mobility, rehabilitation prosthesis health package. This is the first ever benefit package for persons with disabilities in the country. In public, private partnerships for three prosthetic orthotic

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12 High-Level Meeting on Disability and Development September 23, 2013 workshops, two multi-national and three local companies are negotiating and more importantly our local government units are already actively enrolling persons with disabilities into the field and collaborating with NGO's and GO's. The Article 32 which calls for international cooperation for the objectives regarding access to assistive technology made all this happen in the Philippines. As a low income country, having the right heart and mind is ideal scenario to jump start assistive technology. But the best way to keep the gears going is global and local cooperation, collaboration and linkages. Thanks you. (Applause) >> Thank you, very much, for the description of what is happening in the Philippines showing that it is possible even in low income contexts to make progress. And, of course, the primary responsibility for the development of assistive technology programs lays with governments with the governments of the countries in the lower and middle income countries but development agencies can play an important role so we are going to hear now from two development agencies and first the Nippon Foundation about your activities. Mr. Suichi Ohno. >> Thank you, very much, Mr. Chairman. Excellencies, ladies and gentleman, the Nippon Foundation is the largest private donor foundation with a special emphasis on supporting persons with disability. Programs associated with promotion of Daisy, accessible information standard, screen reader development for the blind, and as you may have noticed today the documentation package for this high level meeting has been published in accessible format facilitated by our financial support. Assistive technology is something Nippon Foundation takes very seriously. And we have supported the supply of prosthetics and orthotics for the past 20 years. We are, therefore, pleased to be asked to speak as an example of good practice at this important side event today. As an example of good practice. We have been working closely with the Republic of the Philippines to

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13 High-Level Meeting on Disability and Development September 23, 2013 develop a Bachelor of Science course in prosthetics and orthotics in Manila. This is one of our six schools of prosthetics and orthotics currently supported by the Nippon Foundation. The first Cambodia, then followed by Thailand, Sri Lanka. Working in partnership with the Cambodia Trust we have taken the many lessons learned internationally and specifically in Cambodia and with our partner, who is here today, 12 years ago. Key to our strategy, other international training standards, laid out in documents published by WHO and the international society for the prosthetic and orthotics and audited regularly by ISBO. These documents of set the standards and have given us as a donor the confidence in the work we have knowing that the international implementers are doing a good job. In the countries we work we are supporting an international advisory board to support the schools and to allow realistic and valued input from all stakeholders, especially the end users persons with disabilities themselves. We believe our ongoing work with our partners brings a reality to their aspirations of the UN convention of rights of persons with disability, especially Article 32 which calls for access international collaboration technology transfer and high standards in support of persons with disabilities through assistive technology. We have seen not just collaboration from the north to south, but active and fruitful collaboration from Cambodia, Sri Lanka, where technology transfer is not just bilateral but also triangular. The Nippon Foundation has been proud to support the Philippines government, UNDESA and WHO in the fulfillment of this side event and fully support the call for global movement on assistive technology accessible to all. Thank you, very much. (Applause) >> Thank you, very much. If we stay in the dark I'm going to need assistive technology to read, a flashlight to read my notes. But luckily I know by heart that the next speaker is Rob Horvath from USAID.

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14 High-Level Meeting on Disability and Development September 23, 2013 >> Thank you, very much, Madam Under-Secretary and other guests. Thank you very much for inviting me to speak here today. My children told me to get into the 21st century so I've traded my old assistive devices, my glasses for an iPod where I can increase the font size and not have to worry about it. So it's quite marvelous. Like Venus, I'm slowly becoming attached to it and I can't do anything without it. >> At USAID my job focuses on preventing, promoting and protecting the human rights of vulnerable populations. We often find that people with disabilities are more vulnerable in comparison to others, especially in crisis or conflict situations. The world report on disability reinforces this fact. I'm proud of the leadership that USAID has demonstrated in this area, especially in trying to ensure that disability ace cross all of our broad development objectives from democracy and government to economic growth and security to education and of course in health. Proudly two of those initiatives that I manage, the war victims fund and the wheelchair program, are supporters of many of the activities related to this side event. USAID is proud of the association with the World Health Organization, with the international society for prosthetics and orthotics and others to promote access to assistive technology. We recognize that assistive technology has two equally important components, the product, the devices themselves, but also the service provision. And we realize that besides the non-availability of assistive devices, there is also a great scarcity of appropriately trained human resources who can ensure quality service provision especially in low income countries. As a result, we have invested heavily over the past 15 years positive to facilitate consensus conferences, development human resources, capacity building much training institutes and trained personnel to improve service provision related to AT with one goal, people with disabilities have access to social, economic, cultural and political equality. After all, it's not about the technology, it's about the person. I'm proud of the strong USAID-WHO relationship and I believe that it is the World Health Organization

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15 High-Level Meeting on Disability and Development September 23, 2013 who can bring various stakeholders together like this event, and influence and support member states to insure greater access to high quality affordable assistive technology. I understand that insuring the availability of high quality affordable technology health technology is one of WHO's key priority areas in the coming years so we are at the right place at the right time. It is my great privilege and honor to be here at this event and I believe that we need to development a global initiative to improve access to assistive technology. Several articles of the convention on the rights of persons with disabilities ask that member states ensure greater access to assistive devices and the 134 countries that have ratified the convention are no morally and legally obligated to insure access to assistive devices as a fundamental right but to realize this the member states especially low and mid-income countries need support from the international community. Article 32 of the convention specifically notes the importance of international cooperation to improve access to assistive technology and I think this event is an ideal platform to lay the foundation for more global cooperation. Perhaps it's a bit presumptuous but I believe that WHO has the proven leadership to spearhead such global cooperation and I'd like to say that USAID stands beside you and will do all we can to help or realize a world where everyone as access to needed assistive technology. Thank you. (Applause) >> Thanks, very much, Rob. I'd like now to move to our last speaker on the program who was going to be Yannis Vardakastanis, sorry, something like that. But he couldn't be with us right now on behalf of IDA, so we will replace him. IDA is a key player in the field and I'd like to ask you to talk a little bit about the role of persons with disabilities, their families and organization increasing access to assistive technology. >> Thank you, very much. Our contribution will be read by my interpreter. Assistive technology is full participation of people with disabilities. Already the UN

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16 High-Level Meeting on Disability and Development September 23, 2013 standard rules of equalization in 1988 recognize assistive technology as a precondition for participation yet even after 15 years according to the WHO only 5 to 15 percent of people who require AT actually have access to AT. The CRPD adopted in 2006 and ratified by 134 countries signed by 156 formalized states dues to insure universal access to assistive technology which means all persons with disabilities including poor people and people living in rural and remote areas should have the access to affordable and quality assistive technology that they need. Duties include promoting research, raising awareness of assisting assistive technology, data collection about needs and insuring access to affordable and quality devices that facilitate access to communication, mobile and overall personal autonomy. As smart phones are reaching a growing part of the world's population, simple things such as adaptive spoon which can increase autonomy of many people with disabilities is ignored by most. Some key issues faced by countries in insuring access includes availability and high costs of AT. The diverse needs create a fragmented market demand which appears unattractive for manufacturers who do not see a business case. Low production brings costs high. This demand could only be consolidated by an adequate national policy. In the large number of low and middle income countries there is a combination of absence of production and very limited public finances and delivery mechanisms both in range of devices and geographic coverage. This makes people with disabilities dependent on well-intended but random and uncoordinated NGO's, and very often recycled AT. At the end the majority of persons with disabilities have to self-finance. In these situations the reach is very limited and most people with disabilities do not get what is best suited for them. Often AT available are limited to some mobility devices while other types of AT for access information or daily living activities are not available. Quality of AT is a major concern. While on one hand some manufacturer as controls the market globally by monopolizing, on the other hand many do not have standards. With limited and poor

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17 High-Level Meeting on Disability and Development September 23, 2013 quality attracting buyers who suffer from the adverse effects of it. Not only low and middle income countries are having these challenges. Increasing co-payments for outrageously expensive devices. The rise in the number of elderly people globally should be a huge incentive to rethink globally what states to have do to insure access to AT. All countries would have significant gains in supporting the development of low cost quality assistive technology for all people with disability and elderly people. While a number of countries would make sincere efforts to fulfill their obligations the challenges that block access to quality and affordable AT require international cooperation in line with Article 32 of the CRPD. Like for access to essential medicine, access to AT requires global, regional and public private cooperation to boost overall availability as well as to insure universal coverage. We believe that this cooperation must be going beyond north/south cooperation, building on lessons learned from the global fight against HIV and AIDS or access to essential medicines and fostering fruitful public private partnerships as well as South South Corporation. This global effort should include governments, UN agency, and World Bank standard setting organization, both in the developed as well as in the developing countries. Disabled peoples organizations as well as international NGO's which have experience in underserved areas and difficult environments. Those stakeholders should create a global alliance to support access to AT. The cooperation should be framed by the principals and provisions of the CRPD and support plans and priorities geared to guarantee access to AT by all persons with disabilities in need. The areas of incorporations are numerous. For instance we need further data on these for AT to give the overview of an aggregated demand that can trigger more investments by both public and private stakeholders. We need to engage with private sectors, companies to see what would motivate them to produce more at lower costs. We need to learn more for universal health coverages

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18 High-Level Meeting on Disability and Development September 23, 2013 and experience on design of delivery mechanisms to ensure universal coverage. We need to access the proven mechanism to ensure medicine to be adaptive to AT as well as simplified rules of trading including tariffs and intellectual properties. It's crucial to set standards both to insure minimal quality and safety in assistive technology as well as to insure accessibilities of mainstream devices such as smart phones that can be great assistive technology. We should encourage regional corporation between countries. AT such as prosthetics, wheelchairs and hearing aids. Air travel, tax levy, and health global fund. Those are only a few issues. Not of them is out of reach. Ensuring access to AT globally must be a prior to entire irrespective of what the post 2015 agenda highlights to enable people with disability to benefit equally from development agenda and sharing access to assisting technology it's a very concrete and achievable relevant goal that could have tremendous impact on lives of millions of people with disabilities. Thank you. (Applause) >> Thank you, very much, to both of you and to IDA in general for the fantastic work which brings us to the end of our program of speakers and we are going to open now for discussion. I do already have a long list of people who want to participate in the discussion. Did you want to say something? >> I already have the association for tad advancement of assistive technology in Europe, the chair of the Papa New Guinea and disability forum, rehab international, the Cambodia Trust, ISBO, Katie, you, too and we have about 12 minutes left. (Laughter) So an important decision to take, either you all speed for one or two minutes or only the first three or so will be able to speak, what do we do? >> One or two minutes? >> One minute each.

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19 High-Level Meeting on Disability and Development September 23, 2013 >> One minute each? Is that okay? Is that acceptable to you? It's your decision. >> One and a half minutes. So you allow me then to make a little sign when one and a half minutes is past. We will start with the association of advancement of assistive technology in Europe. >> Yes, thank you, chairman, for the opportunity. Happy to represent not only that organization but also sister organizations in Japan and Australian, and you find the logo and the key message we have left for members of the assembly. I'll skip everything just to mention that we would like to -- there is a policy framework on disability and development. Upon having such a framework actions can be undertaken to increase awareness on all aspects of technology, among stakeholders including end users, provide access to markets by stimulating the product and independent advice centers. And to support research and innovation to which is reliable and affordable assistive technology solutions including interactions with mainstream IT devices. In our view these are all activities that have to be implemented, locally with a bottom up approach highlighting the role years can have in this. At the international level following up on Article 32 of the convention that calls for international collaboration we should continue increase the space on the interactive processes, increase understanding of political socioeconomic and social factors that impact on AT, facilitate knowledge sharing, investigate the role of AT for emergent pathologies and aging societies. As networks use to international collaboration we confirm or support and active participation in all these initiatives. I look forward to working with you. (Applause) >> Thanks, very much. One minute, 53 seconds. Perfect. I move straight to chair of the Papa New Guinea association of persons with disabilities. >> Thank you, for giving me this opportunity to speak on behalf of people with

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20 High-Level Meeting on Disability and Development September 23, 2013 disabilities in the pacific. For people with disabilities living in the pacific region, assistive technology is extremely limited. What is currently available is for the most part an appropriate and expensive and of poor quality. The vast majority of people who receive a device do so as recipients of donors of service providers with limited say in the choice of device, how well it fits them and how well it meets their needs. This is the case whether the device is a wheelchair, hearing aid, et cetera. Overall, the devices are distributed. Very much governments in the region include assistive technology in their budgets. Where they are included in budgets there are serious limits. Wheelchairs maybe provided in a limited way however no prosthetic limbs. There is often very little oversight regarding the quality, the availability and affordability and choice of assistive devices. In Fiji a new very low cost technology has been introduced however there has been no formal evaluation to see whether the devices are working. In the pacific is for access for people with disabilities in what can be called essential assistive technologies, those devices or technologies that are essential for living just as essential medicines are to maintaining the health of citizens of every country. This means hearing aids and essential visual aids. An essential assistive device list would be a very useful tool to provide guidance for governments regarding what assistive diseases or technologies should be available. Most importantly, people with disabilities and their representative organizations need to be more involved and must be consulted in the decisions regarding what assistive devices are to be provided and made available in our country. Thank you. (Applause) >> Thank you, very much. We continue with Rehabilitation International. >> Thank you, very much. I will use my 90 seconds to address what WHO has asked me to address, which is the role of international NGO's related to this issue. And I will start out by saying that without civil society and civil society working, the

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21 High-Level Meeting on Disability and Development September 23, 2013 world will not move forward. The role of the civil society is to move the world in the right direction. Both nationally and internationally. And while we are able to do that is due to commitment, to strategic lobbying, to hard work and innovative approaches. There's been no such thing as CRPD without civil society. No UN country would really have been able to portray this issue without this strong commitment and hard work and wise decisions and advice from the disability movement and other civil society as associations. I had planned to speak for three minutes. I'll only now speak for 90 seconds which means that I will drop all the rest I had planned to say which was of course very brilliant but -- (laughter) -- but I will finalize my speech by only saying one thing. I think that to move this issue forward, WHO as soon as possible should ask for a world summit on this issue inviting civil society, inviting private corporation, inviting governments, inviting disabled people's organization, inviting all good forces that can move this obvious question forward because not investing in assistive technology for people with disability is stupid. Period. (Applause) >> I'm glad you told you 90 seconds because it was almost three minutes. (Laughter) We can talk afterwards because I'm curious about that summit to discuss more what is the real objective of the summit. But let's move to Cambodia Trust. Karlson. >> You'll be pleased to know I don't want three minutes I want one minute because the presentation made by the International Disability Alliance really stole my thunder and took everything I wanted to say. And I think most of us in this room would agree was an excellent presentation. I would just like to add one thought that had occurred during that presentation. As we have all acknowledged the need for higher standards in those professionals who apply and use assistive technology with people with disability, and also as we look for greater investment in new technologies and better technologies and more affordable technologies. I would just like to add one

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22 High-Level Meeting on Disability and Development September 23, 2013 thing to this room, which I have not heard discussed, and that is creating a market, because I think we all accept that sustainability can often be hand in hand with something that looks profitable. At least as we say in Britain, washes its own face. So as we move forward and developing strategies towards assistive technology, I think as the pharmaceutical companies and the pharmaceutical researchers did during the movement towards anti-retro virals in the HIV high level meetings, we must also do something similar in assistive technology and try to develop strategies that work with the private sector, the public sector, the not-for-profit sector and the government sector. And these partnerships are working all over the world and are working well and certainly if we are going for some kind of world congress on assistive technology, I would really like to see the private companies there as well. Thank you, very much. (Applause) >> Thanks, very much. ISBO. Thank. >> Thank you, very much. I was asked to answer a question and the question was more practical. How we can insure that assistive technology is appropriate and useful to the user. And I have three points and three answers to that. The thing think is setting global standards which we all already do. Use involvement, which we said many times today. And as number three, follow up. I just want to say something about setting global standards. If we set the global standards, it's highly important that the local government also certify and recognize this standard. And recognize the profession and the professionals. The user involvement is so natural, so I don't need to say anything more about that. But the last point is follow-up. That is also highly important. And again, the local government needs to support and enforce the need of follow-ups. And actually that's the only three points I have. I kept it down to one minute. Huh? (Laughter) (Applause)

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23 High-Level Meeting on Disability and Development September 23, 2013 >> Thank you, very much. >> Which leaves us time for our two last speakers. I'll give the floor very briefly to Janis from hearing access program and finish with Katie before we wrap up. >> Thank you for agreeing to give me a minute. >> Sorry. >> We need to discuss assistive technology not just at the poverty level but for the entire economic spectrum. If we do not, assistive technology will always be about charity rather affective access. Assistive technology for people with hearing loss is more than hearing aids. Hearing aids alone are not sufficient. Just as in this room there's an assistive listening system such as I believe an FM or infrared. We need to insure that we have that or induction loops around the world. These systems are critical for effective access for people who are hard of hearing especially in employment, museums, theaters and my organization is the one that did it all over New York. Just so you know who I am since I know this is unorthodox. Thank you. >> Thanks, very much. I'd like to move to our last speaker from the floor and very happy this can be somebody who actually uses assistive technology. This is Katie from Michigan State University. Katie. >> Can you move one chair, please? Sorry. >> As a former intern, I would just like to say it's a great honor to be here today as port of such an important event. As I enter into my senior year at Michigan State University I realize that my personal academic success would not have been possible in the absence of specialized products and services which have allowed me to effectively and successfully compete in the sighted world. For persons with disabilities access to the necessary and proper assistive technology tools with mean the difference to independent, dependent, inclusion, good health and poor health. For me assistive technology as paved this world of opportunity for participating to higher education and economic and social constraints. As my independence is my most

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24 High-Level Meeting on Disability and Development September 23, 2013 important thing my life I'm important to have been born in the right time and right place having access to most advanced products and services known to man. I have seen firsthand this is not necessarily the case for all persons with disabilities around the world. After spending an afternoon with a group of high school students at the institute nor the blind in Brazil it became painfully clear to me that assistive technology was a mere privilege for few, not a right for the many this. Was downright heart-breaking and clearly needs to change. While efforts must continue to be made in both the developing and even more so in the developing world 124 this cannot be achieved without recognizing, acknowledging and acting upon the notion that assistive technology bridges the gap between inclusion and exclusion and should know longer be viewed as a privilege for the view but as an essential right for the many. From a personal standpoint I can honestly say I'm one of the privileged few who have been given the opportunity to be successful in independent by means of access to higher education made possible by the availability of assistive technology tools. Therefore we must all commit to providing essential assistive technology products and services to persons with disability under around the world to turn distant dreams to reality. Thank you. (Applause)

>> Thanks, very much, Katie. And I never thought it would be possible but we more or less are going to be finishing on time so I want to thank all of you because I know I pressed you hard to stick to a short time frame. I know we can continue for hours and hours because there's so much wealth and experience in the room so thanks and forgive me if I was too harsh on me. I want to make sure we will have a few minutes left for Dr. Keeny. We are fortunate to have her here with us. She's WHO assistive director for health and information which means he oversees all of our activities, also on behalf of the director general.

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25 High-Level Meeting on Disability and Development September 23, 2013 >> Thank you, very much. Actually I'm assistive director for health systems and innovation, which is more relevant to this meeting. Ladies and gentleman, I'm honored to be here to deliver closing remarks on behalf of World Health Organization. Today we have heard important messages about the importance of assistive technology, based on personal accounts as well as on global and national statistics. The obstacles faced by people with disability when they do not have access to AT as well as the again benefits when they do. The gaps in access and quality of AT as well as a potential for improvements. The efforts that development agencies are making and will be making in the future. And finally, importantly, we have listened to ideas and commitment contributed by many of the speakers including from my own agency in WHO we are firmly committed to scale up our efforts in the area of AT. AT is a great enabler and a game changer. But have a potential to make great progress in the coming years. This side event is definitely an important complement to the high level meetings. It resonates and should need to new global collaborations and initiatives of the lives of one billion people. We have to insure that everybody has access to assistive technology I'd like to join Dr. Shin to thank our co-hosts, the Philippines governments, all the supporting organizations and individuals who made this side event a success. I would also like to especially thank the Nippon Foundation and USAID for supporting these events, the speakers who have shared with us their experience, work and plans and finally, I thank all the participants to this important side event. Thanks a lot. (Applause) (Meeting concludes at 2:30 p.m.)

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