UN Human Rights Treaties

United Nations E/CN.5/2002/4
Economic and Social Council Distr.: General
9 January 2002
Original: English
02-21111 (E) 070202
*0221111*
Commission for Social Development
Fortieth session
12-22 February 2002
Item 3 (b) of the provisional agenda*
Follow-up to the World Summit for Social Development and
the twenty-fourth special session of the General Assembly:
review of relevant United Nations plans and programmes of
action pertaining to the situation of social groups
Monitoring the implementation of the Standard Rules
on the Equalization of Opportunities for Persons
with Disabilities
Note by the Secretary-General
1. At its forty-eighth session, the General Assembly
adopted the Standard Rules on the Equalization of
Opportunities for Persons with Disabilities, contained
in the annex to its resolution 48/96 of 20 December
1993.1 These 22 Rules provide a framework to further
implement the goals of “equality” and “full
participation” of disabled persons in social life and
development set forth in the World Programme of
Action concerning Disabled Persons, adopted by the
General Assembly in its resolution 37/52 of 3
December 1982.2
2. In section IV, paragraph 2, of the Standard Rules,
it is stipulated that the Rules shall be monitored within
the framework of the sessions of the Commission for
Social Development. The appointment of a Special
Rapporteur to monitor their implementation within the
framework of the Commission for Social Development
was also envisaged in that paragraph.
3. In March 1994, the Secretary-General appointed
Bengt Lindqvist (Sweden) as Special Rapporteur on
Disability of the Commission for Social Development.
The Special Rapporteur prepared a report for the
consideration of the Commission for Social
Development at its thirty-fourth session in 1995.3 On
the basis of that report and the findings of a working
group established during the Commission, the
Commission adopted resolution 34/2 entitled
“Monitoring the implementation of the Standard Rules
on the Equalization of Opportunities for Persons with
Disabilities”.4 In that resolution, the Commission took
note with appreciation of the report of the Special
Rapporteur and of his recommendations and welcomed
his general approach to monitoring, including the
emphasis to be placed on advice and support to States
in the implementation of the Rules.
4. At its thirty-fifth session in 1997, the
Commission for Social Development considered the
report of the Special Rapporteur on monitoring the
implementation of the Standard Rules for the period
from 1994 to 1996.5 The Commission took note with
appreciation of the valuable work done by the Special
* E/CN.5/2002/1. Rapporteur, decided to renew his mandate for a further

E/CN.5/2002/4
three years and requested the Special Rapporteur to
prepare a report for submission to the Commission at
its thirty-eighth session in 2000.6
5. At its thirty-eighth session in 2000, the
Commission for Social Development considered the
report of the Special Rapporteur on monitoring the
implementation of the Standard Rules for the period
from 1997 to 2000.7 The Commission took note with
appreciation of the valuable work done by the Special
Rapporteur, decided to renew his mandate for a further
period through the year 2002 and requested the Special
Rapporteur to prepare a report for submission to the
Commission at its fortieth session in 2002 in which he
should, inter alia, present his views on further
developing the proposals contained in his report on his
second mission8 and on forms for complementing and
developing the Standard Rules.9
6. In section IV, paragraph 12 of the Rules, it is
further stipulated that at its session following the end
of the Special Rapporteur’s mandate, the Commission
should examine the possibility of either renewing that
mandate, appointing a new Special Rapporteur or
considering another monitoring mechanism, and should
make appropriate recommendations to the Economic
and Social Council. The present mandate of the Special
Rapporteur will come to an end in 2002. The
Commission is requested to make its recommendations
in that regard to the Economic and Social Council and
the General Assembly.
7. The Secretary-General has the honour to transmit
to the Commission the report of the Special Rapporteur
on monitoring the implementation of the Standard
Rules on the Equalization of Opportunities for Persons
with Disabilities during the period 2000-2002.
Notes
1 Available from http://www.un.org/esa/socdev/enable/
dissre00.htm.
2 A/37/351/Add.1 and Add.1/Corr.1, sect VIII. Available
from http://www.un.org/esa/socdev/enable/
diswpa00.htm.
3 A/50/374, annex.
4 Official Records of the Economic and Social Council,
1995, Supplement No. 4 (E/1995/24), chap. I, sect. E.
5 A/52/56, annex. Available from http://www.un.org/esa/
socdev/enable/dismsre0.htm.
6 Official Records of the Economic and Social Council,
1997, Supplement No. 6 (E/1997/26), chap. I, sect. A,
subsequently adopted as Economic and Social Council
resolution 1997/19 of 21 July1997.
7 E/CN.5/2000/3, annex. Available from
http://www.un.org/esa/socdev/enable/disecn003e0.htm.
8 Ibid.
9 Official Records of the Economic and Social Council,
2000, Supplement No. 6 (E/2000/26), chap. I, sect. A,
subsequently adopted as Economic and Social Council
resolution 2000/10 of 27 July 2000.

E/CN.5/2002/4
Report of the Special Rapporteur of the Commission for
Social Development on monitoring the implementation of
the Standard Rules on the Equalization of Opportunities for
Persons with Disabilities on his third mandate, 2000-2002
Contents
Paragraphs Page
I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1–4 4
II. The mandate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5–7 4
III. Activities during the period of the third mandate . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8–28 5
A. Missions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8–11 5
B. Panel of experts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12–16 6
C. Rights for disabled children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17–20 6
D. Third survey on selected Standard Rules in collaboration with the World
Health Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21–28 7
IV. Issues for the future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29–101 8
A. Complementing the Standard Rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29–37 8
B. Human rights and disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38–75 9
1. Background and update. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38–59 9
2. Strategy for the future. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60–75 12
C. Information exchange and cooperation between United Nations bodies and
organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76–80 15
1. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76–77 15
2. Virtual inter-agency meeting mechanism recommended . . . . . . . . . . . . . . 78–80 15
D. Future monitoring system for the Standard Rules . . . . . . . . . . . . . . . . . . . . . . . . 81–101 16
1. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81–84 16
2. Future monitoring mechanism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85–101 16
V. Summary and recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102–116 18
Annex
Reaching the most vulnerable: proposed supplement to the Standard Rules on the
Equalization of Opportunities for Persons with Disabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

E/CN.5/2002/4
In all societies of the world there are still obstacles preventing persons
with disabilities from exercising their rights and freedoms and making it
difficult for them to participate fully in the activities of their societies.
(General Assembly resolution 48/96 of 20 December 1993, annex,
paragraph 15)
I. Introduction
1. In my capacity as Special Rapporteur for
monitoring of the implementation of the Standard
Rules on Equalization of Opportunities for Persons
with Disabilities, I have the honour to deliver my final
report on the third period of monitoring (2000-2002) to
the Commission for Social Development. It has been a
privilege and a stimulating task to act as Special
Rapporteur in this area. I want to express my sincere
appreciation to the Economic and Social Council for
showing confidence in me by renewing my mandate for
a third period. I also would like to thank all those
Governments that have contributed financially to this
project, including the Government of Sweden, which
has provided me with office resources throughout the
entire exercise.
2. From the beginning and during the whole period
of monitoring, I have enjoyed full support from the
Under-Secretary-General of the Department of
Economic and Social Affairs, Nitin Desai, and
excellent professional advice from the Division for
Social Policy and Development. I have benefited from
the cooperation of a number of United Nations
agencies, especially the World Health Organization
(WHO), which in close collaboration with me has
conducted a global survey on the implementation of a
number of the Standard Rules. I would also like to
express my appreciation for the excellent work
performed by Eva Sagström in my Swedish office and
by Anneli Joneken, who worked as a consultant
concerning the supplement to the Standard Rules.
3. One key element in this monitoring exercise has
been the panel of experts, established in 1994 by six
major international non-governmental organizations in
the disability field. The panel members, five men and
five women representing all regions and with different
experiences of disability, have provided valuable
guidance. They have also been very understanding
when limited resources have made it impossible to
pursue all good ideas and initiatives.
4. Finally, I want to thank all those Governments
and non-governmental organizations that have
cooperated with me during my missions and who have
provided information for my work.
II. The mandate
5. My report to the Commission for Social
Development (E/CN.5/2000/3, annex) at its thirtyeighth
session contained a number of recommendations
for future action. Suggestions were made about a future
monitoring system, areas to be developed in the present
text version of the Standard Rules document, improved
information exchange and the future development of
the issue of human rights and disability.
6. These topics were discussed within the openended
working group during the Commission meeting.
The outcome of the Commission deliberations are
reflected in Economic and Social Council resolution
2000/10 of 27 July 2000. According to paragraph 7 of
that resolution regarding the tasks to be carried out by
the Special Rapporteur in the renewed, third mandate,
the Council decided to renew the mandate of the
Special Rapporteur for a further period through the
year 2002 so that the results of his continued
promotion and monitoring of the implementation of the
Standard Rules, in accordance with section IV of the
Standard Rules, would be available to the fourth
quinquennial review and appraisal of the World
Programme of Action concerning Disabled Persons,1 in
accordance with General Assembly resolution 52/82,
and to request the Special Rapporteur, assisted by the
United Nations Secretariat and in consultation with his
panel of experts, to prepare a report for submission to
the Commission for Social Development at its fortieth
session, in which he should, inter alia, present his
views on further developing the proposals contained in
his report on his second mission (E/CN.5/2000/3,
annex) and on forms for complementing and
developing the Standard Rules, and on how to enhance
the involvement of the relevant bodies and
organizations of the United Nations system and
relevant intergovernmental regional organizations
regarding the implementation of the Standard Rules.

E/CN.5/2002/4
7. The resolution contains a number of specific
tasks for the Special Rapporteur to carry out during the
term of his third mandate:
(a) Promote and monitor the implementation of
the Standard Rules, in accordance with section IV of
the Rules. The work during this third period should
mainly continue along the lines indicated in the
Standard Rules document, which meant continuing to
go on advisory and monitoring missions to countries,
participate in conferences and seminars promoting the
implementation of the Rules, and collect information
on the further policy development in countries and
regions;
(b) Present his views on forms for
complementing and developing the Standard Rules. In
the report on my second mandate (E/CN.5/2000/3,
annex) I pointed out a number of dimensions that
should be developed and strengthened in the light of
experiences gained since the adoption of the Standard
Rules in 1993 (annex to General Assembly resolution
48/96 of 20 December 1993). My interpretation of this
instruction was that I should develop new texts on the
basis of my observations in the report and suggest
forms for their treatment and possible adoption by the
Commission;
(c) Present his views on how to involve the
relevant bodies and organizations of the United Nations
system and relevant intergovernmental regional
organizations regarding the implementation of the
Standard Rules. In my previous reports to the
Commission I pointed out the need for improved and
more systematic information exchange and joint
planning in the disability field among United Nations
organizations and agencies. The obvious vehicle for
this would be the re-establishment of an inter-agency
mechanism. However, with regard to financial
constraints, in the present report I have presented a
simple mechanism for information exchange through
the use of modern information and communication
technologies, particularly Internet-based technologies;
(d) Present his views on further developing the
proposals contained in his report on his second
mandate. In addition to the three areas mentioned
above, my report to the Commission at its thirty-eighth
session considered a number of options for a future
monitoring mechanism. The present report reviews this
subject. In that report, I also made an analysis and
some observations concerning the issue of human
rights and disability. I continue that analysis below.
III. Activities during the period of the
third mandate
A. Missions
8. Beginning early in 2000, I continued to promote
the implementation of the Standard Rules by visiting
countries on the invitation of Governments. In
accordance with my mandate I concentrated my
missions in countries in transition and those in
developing regions. Visits to discuss and promote
disability policy were made to Belarus, Bulgaria,
China, Malawi, Mauritania and Uganda.
9. During these visits, meetings were organized with
ministers, representatives of ministries, organizations
and often international organizations, such as the
United Nations Development Programme (UNDP), the
World Health Organization (WHO), the United Nations
Children’s Fund (UNICEF) and the United Nations
Educational, Scientific and Cultural Organization
(UNESCO). National policies, programmes and
legislation were presented and discussed from a
Standard Rules perspective. One common issue was
how to integrate disability measures into general plans
and programmes. Other frequently discussed subjects
included the collection of data on living conditions and
disability statistics and how to develop cooperation
between the Government and organizations in the
disability field.
10. I was invited to deliver speeches and lectures at a
number of conferences. I visited Brazil for the XIX
Rehabilitation International World Congress (Rio de
Janeiro, 25-29 August 2000). In Canada, I participated
in the Sixth International Congress on Including
Children with Disabilities in the Community
(Edmonton, Alberta, 22-24 October 2000), which
attracted three hundred participants from over 50
nations and a number of non-governmental
organizations. In Hungary, I took part in a seminar on
the implementation of the Standard Rules with
participants from 14 countries from Eastern and
Central Europe (Budapest, 11-13 October 2000). In the
Russian Federation, a national conference on equal
opportunities for the disabled (Moscow, 2-3 October
2000) was organized jointly by the Duma (parliament),
concerned government offices and disability

E/CN.5/2002/4
organizations, with participants from 60 of the 89
regions in the Russian Federation. The conference
considered, among other topics, the application of the
Standard Rules principles in a regional setting. During
my mission to Mauritania, from 13-15 February 2001, I
had the opportunity to participate in a subregional
seminar on the implementation of the Standard Rules in
which 60 delegates participated, representing
governmental and non-governmental organizations
from several Maghreb countries.
11. In February and April 2001 I participated in and
chaired two consultations on disability and human
rights, organized by the United Nations Secretariat in
New York (9 February 2001) and the Office of the
United Nations High Commissioner for Human Rights
in Geneva (17 April 2001).
B. Panel of experts
12. The panel of experts, established in 1994 by six
major international non-governmental disability
organizations as part of the monitoring mechanism, met
in New York from 9 to 11 February 2000. The meeting
coincided with the thirty-eighth session of the
Commission for Social Development, which made it
possible for panel members to follow the deliberations
of the Commission. One important issue discussed by
the panel was the future options for United Nations
involvement in disability policy development. The
panel emphasized the importance of developing the
human rights dimension and of obtaining greater
involvement in this issue by the United Nations human
rights monitoring bodies. At the same time, disability
should remain an important commitment in the field of
social development. In both of these areas the Standard
Rules should continue to be a main tool for policy
development.
13. The panel met again in New York from 4 to 6
September 2001. The main purpose of that meeting was
to consult with me as Special Rapporteur on the issues
to be brought before the fortieth session of the
Commission for Social Development in February 2002.
14. I had prepared an extensive text presenting a
considerable number of additions and changes to the
text of the Standard Rules. Based on our interpretation
of the mandate in this respect, we agreed on the
contents of what should be put forward to the
Commission. However, it was left to me as Special
Rapporteur to find the most suitable ways to present
the recommendations to the Commission for its
consideration.
15. The panel also discussed at length options for
future monitoring. Two main alternatives were
identified: (a) appointment of a new Rapporteur and
(b) integration of the monitoring mechanism into the
United Nations Secretariat. The discussion took place
under the assumption that it would be difficult to find
funding for continuing the monitoring with a new
Rapporteur. The main discussion therefore was about
ways of integrating the different functions of the
monitoring mechanism into the work of the United
Nations Secretariat.
16. The panel of experts attached to the Standard
Rules monitoring mechanism represents a unique form
for cooperation between the non-governmental
community and the United Nations. During the seven
years it has served as a consultative body in this
monitoring exercise, it has proved to be very useful for
both the United Nations and the organizations
concerned. The panel has also been involved in
consultations with other international organizations and
such agencies as the World Health Organization, the
International Labour Organization (ILO), the World
Bank and UNESCO. In connection with the global
surveys, the more than 600 national affiliates of the six
organizations represented on the panel were invited to
reply to the same questionnaires as those submitted to
their Governments. These national disability
organizations also greatly contributed to the unusually
high response rates from Governments.
C. Rights for disabled children
17. In January 2000 four international nongovernmental
disability organizations together with
Save the Children International Alliance decided to
establish a project entitled “Rights for disabled
children”. Funding was received for a three-year period
from the Swedish International Development Agency
(Sida). The Rights for Disabled Children project
entered into an agreement with Disability Awareness in
Action (a non-governmental organization) in the
United Kingdom to coordinate and administer project
activities.
18. The purpose of the project is to assist the
Committee on the Rights of the Child, which monitors

E/CN.5/2002/4
the Convention on the Rights of the Child, in
developing the disability dimension of its monitoring.
19. Among the activities run by the Rights for
Disabled Children project the following can be
specifically mentioned:
(a) Three times per year, nine Governments are
requested by the Committee to report on their
achievements. The project decided to analyse these
reports by Governments from a disability perspective
and to present the results at “pre-sessional” meetings
before the Committee session. The three rounds of
2001 were completed, which means that 27 country
reports were analysed from a disability perspective,
and the findings presented to the Committee. The
Rights for Disabled Children project reports were well
received. The information collected in this way will
later on constitute an interesting body of material for
analysis concerning the ways in which States deal with
disability within the framework of the Convention on
the Rights of the Child;
(b) Another important Rights for Disabled
Children project activity is to conduct in-depth studies
in four selected countries. The purpose is to study the
situation of children with disabilities, to collect
information about violations of the rights of disabled
children and to identify and describe good examples. In
the second half of 2001 the first study was initiated in
South Africa.
20. The project is trying to increase the visibility of
children with disabilities, both in the documents related
to the planned special session of the General Assembly
on children and at the actual meeting. The Rights for
Disabled Children project has issued a special report on
the situation of disabled children, entitled “It is our
world, too”, which includes cartoons, pictures and
quotations by disabled children.
D. Third survey on selected Standard
Rules in collaboration with the World
Health Organization
21. The first four Rules in the Standard Rules
document state the preconditions for the equal
participation of persons with disabilities. Three of
these Rules — Rules 2-4, comprising medical care,
rehabilitation and support services respectively — are
within the mandate of the World Health Organization.
22. In 1999, WHO conducted a global survey to
collect information about these three areas as well as
selected information on personnel training (Rule 19).
In cooperation with me and the panel of experts, a
questionnaire was constructed and circulated to all 189
WHO member States, two associate member States and
more than 600 national non-governmental
organizations in the field of disability.
23. In my report to the thirty-eighth session of the
Commission for Social Development (E/CN.5/2000/3,
annex), I included a summary of the main results of
replies received from the 104 Governments responding
to the questionnaire. The final report, The UN Standard
Rules on the Equalization of Opportunities for Persons
with Disabilities: Government Responses to the
Implementation of the Rules on Medical Care,
Rehabilitation, Support Services and Personnel
Training, is now available from the World Health
Organization.2 Six regional reports (Africa — AFRO,
Americas — AMRO, Eastern Mediterranean —
EMRO, Europe — EURO, South East Asia — SEARO
and Western Pacific — WPRO) based on the same set
of data are also available from WHO.3
24. The geographical distribution of government
replies to the questionnaire is as follows: 27 from
AFRO, 17 from AMRO, 4 from SEARO, 25 from
EURO, 11 from EMRO and 20 from WPRO.
25. Similar reports are under preparation based on the
replies received from 115 non-governmental
organizations. The total number of countries covered
by the responses from Governments or nongovernmental
organizations is 130.
26. The distribution of responses from nongovernmental
organizations by region is as follows: 22
NGO responses from AFRO; 21 from AMRO; 6 from
SEARO; 42 from EURO; 10 from EMRO; and 14 from
WPRO.
27. WHO will also conduct a complementary study to
compare and interpret the differences between the
governmental and NGO responses in each country.
28. The result of the WHO survey on the selected
Standard Rules can be used in several ways. It will first
of all provide information concerning the degree of
implementation of the various provisions in the four
different Rules. The most useful comparative analysis
is probably the one based on regions, since this would
provide a more similar social, economic and cultural

E/CN.5/2002/4
context. Replies from the Government and NGOs in the
same country can often provide valuable information
on the situation of persons with disabilities.
IV. Issues for the future
A. Complementing the Standard Rules
29. In paragraphs 117 to 119 of my report to the
Commission at its thirty-eighth session
(E/CN.5/2000/3, annex) I made the following analysis
of the Standard Rules as a major international policy
document:
“It is obvious that more progress in policy
development and legislation has taken place in
the 1990s than in earlier decades. It is also
evident that the progress during the last 10 years
is clearly connected with the International Year of
Disabled Persons (1981), the World Programme
of Action (1982) and the political process
initiated at that time. A considerable number of
countries throughout the world have adopted new
legislation and developed national policies in
harmony with international guidelines. In this
process, the Standard Rules have played a
significant role. Above all the Standard Rules
have clearly defined the role of the State in
implementing measures towards full participation
and equal opportunities, strengthened the human
rights dimensions and provided an active
monitoring mechanism within the United Nations
system.
“The Standard Rules document has many
merits. It is concise and provides a concentrated
presentation of guidelines in a number of areas.
These guidelines have been used in a great
number of countries in many different ways. The
fact that the recommendations are at the
international level has created room for national
application and adjustment to regional and local
circumstances.
“There are, however, shortcomings in the
Standard Rules document. Some dimensions of
disability policy have not been treated
sufficiently. This is true concerning children with
disabilities, in the gender dimension and for
certain groups, mainly persons with
developmental and psychiatric disabilities. It has
been pointed out that the Rules do not include a
strategy for improving living conditions of
disabled people in regions with extreme poverty.
Disabled persons in refugee or emergency
situations are other areas that have not been dealt
with. As I pointed out in my previous report to
the Commission for Social Development
(A/52/56) the whole area of housing has not been
included. Among other things this means that
there is no guidance concerning the handling of
the institutions where a great number of persons
with disabilities still spend their whole lives
under miserable circumstances. The important
events in the human rights area during the 1990s
should perhaps also be more clearly reflected.”
30. The above list of areas in need of development
forms the most important basis for elaborating the
proposed supplement to the Standard Rules, which is
included as the annex to the current report. Another
important source of information comes from activities
generated by the World Health Organization. As I have
mentioned, WHO conducted a survey on the
implementation of selected Standard Rules. In addition,
in 2001 WHO, in collaboration with the Government of
Norway, organized the global Conference on
Rethinking Care (Oslo, 22-25 April 2001).4 One task
for conference participants was to identify the strengths
and weaknesses in the first four Standard Rules and
formulate conclusions and recommendations for the
future. In view of the great importance of this
conference, its adopted recommendations were taken
into account in the elaboration of the attached proposed
supplement to the Standard Rules.
31. A special grant from the Government of Sweden
made it possible to employ a consultant (Anneli
Joneken) to compile material and draft the proposals
for supplementing the Rules. At an early stage in this
project I invited organizations and individual experts to
present their views on text amendments on the basis of
the areas in the Rules identified as being in need of
development. A considerable number of valuable
suggestions and comments were received, especially
concerning the needs of children with disabilities and
their families and persons with developmental and
psychiatric disabilities.
32. With the assistance of Ms. Joneken, I have
elaborated guidelines for an adequate standard of
living.5 These guidelines provided the bases for
housing as well as those related to poverty and persons

E/CN.5/2002/4
with disabilities, as presented in the attached proposals
to supplement the Standard Rules.
33. In connection with housing, such issues as selfdetermination,
privacy and personal integrity are
immediately apparent. In the disability field these
concerns lead to the important issue of the institutions
where children and adults with disabilities spend their
lives. Based on information about the current situation
and recent development initiatives, I have drafted some
policy guidelines. During the process of compiling
material for the supplement, it became evident that
some areas needed more extensive development than
others. From the perspective of gender and with regard
to children’s rights, the issue of violence and abuse
needs to be pursued further. Measures to support
families with one member who is disabled need to be
elaborated in greater detail.
34. When analysing the texts of the Standard Rules
from the perspective of persons with developmental
and psychiatric disabilities, the need to develop
guidelines for issues concerning self-determination
becomes evident. Particularly in areas such as medical
care, rehabilitation and support services, additional
guidelines are needed concerning informed consent, the
right to refuse treatment and medication, and
involuntary confinement.
35. The proposed supplement to the Standard Rules
covers 15 subject areas. Each section contains a
number of recommendations that should be considered
as additions to the recommendations currently
presented in the Rules. To provide background and
context for the recommendations for new or expanded
text, some sections include an initial commentary.
There is no direct correspondence between the
structure of the 15 sections of the supplement and that
of the original Standard Rules document (annex to
General Assembly resolution 48/96).
36. Nearly 10 years have passed since the adoption of
the Standard Rules by the General Assembly. During
this time, the Rules have developed into a major
implementation tool used both by Governments and by
international and national non-governmental
organizations in the disability field. In the development
of human rights for persons with disabilities, the
Standard Rules have been recognized as a yardstick for
measures to put an end to exclusion and discrimination
of persons with disabilities.
37. To make the Standard Rules an even more
effective tool for the future development of policy,
legislation and programmes, the present text of the
Rules should be further developed and complemented.
I recommend that the attached proposed supplement to
the Standard Rules be adopted by a United Nations
body and published.
B. Human rights and disability
1. Background and update
38. International recognition of disability as a human
rights issue is increasing. There also is growing
recognition that disability and disability-related
exclusion and marginalization are concerns for the
human rights bodies of the United Nations.
39. The World Programme of Action concerning
Disabled Persons, adopted by the United Nations
General Assembly in 1982, recognized the
responsibility of organizations and bodies within the
United Nations system to address the human rights of
persons with disabilities, in the following (and related)
recommendation:
“Organizations and bodies involved in the
United Nations system responsible for the
preparation and administration of international
agreements, covenants and other instruments that
might have a direct or indirect impact on persons
with disabilities should ensure that such
instruments fully take into account the situation
of persons who are disabled.”6
40. In August 1984, the Sub-Commission on
Prevention of Discrimination and Protection of
Minorities adopted resolution 1984/20, in which it
decided to appoint a Special Rapporteur, Leandro
Despouy, to conduct a comprehensive study on the
relationship between human rights and disability. In his
report, Human Rights and Disabled Persons,7
Mr. Despouy made it clear that disability is a human
rights concern in which the United Nations monitoring
bodies should be involved. In paragraph 274 of that
report he made the following recommendation:
“After the [United Nations] Decade [of
Disabled Persons, 1983-1992] has ended, the
question of human rights and disability should be
kept on the agendas of the General Assembly, the
Economic and Social Council, the Commission

E/CN.5/2002/4
on Human Rights and the Sub-Commission [on
Prevention of Discrimination and Protection of
Minorities] as an item of constant concern and
on-going attention.”
41. The Committee on Economic, Social and Cultural
Rights in 1994 assumed the responsibility for disability
rights by issuing general comment No. 5,8 in which the
Committee analysed disability as a human rights issue.
The general comment stated:
“The Covenant [on Economic, Social and
Cultural Rights] does not refer explicitly to
persons with disabilities. Nevertheless, the
Universal Declaration of Human Rights
recognizes that all human beings are born free
and equal in dignity and rights and, since the
Covenant’s provisions apply fully to all members
of society, persons with disabilities are clearly
entitled to the full range of rights recognized in
the Covenant. In addition, insofar as special
treatment is necessary, States parties are required
to take appropriate measures, to the maximum
extent of their available resources, to enable such
persons to seek to overcome any disadvantages,
in terms of the enjoyment of the rights specified
in the Covenant, flowing from their disability.
Moreover, the requirement contained in article 2
(2) of the Covenant that the rights ‘enunciated ...
will be exercised without discrimination of any
kind’ based on certain specified grounds ‘or other
status’ clearly applies to discrimination on the
grounds of disability.”9
42. At its fifty-fourth session, in 1998, the
Commission on Human Rights adopted resolution
1998/31 of 21 April 1998, in which it made a series of
statements and recommendations for future
development in this area.10 Commission on Human
Rights resolution 1998/31 represented a major
breakthrough and general recognition of the United
Nations responsibility for human rights and persons
with disabilities. Therefore, expectations for some
progress in the area were high. However, in the two
years following the adoption of that resolution, little
follow-up occurred. This was a major concern when
the Commission on Human Rights again discussed
human rights and disability at its fifty-sixth session in
April 2000. As a result of that discussion, the
Commission adopted resolution 2000/51 of 25 April
2000,11 which incorporated and expanded upon the
recommendations contained in its resolution 1998/31.
43. In the first paragraph of resolution 2000/51, the
Commission recognized the Standard Rules as an
evaluative instrument to be used to assess the degree of
compliance with human rights standards concerning
persons with disabilities:
“[The Commission] … recognizes that any
violation of the fundamental principle of equality
or any discrimination or other negative
differential treatment of persons with disabilities
inconsistent with the Standard Rules on the
Equalization of Opportunities for Persons with
Disabilities is an infringement of the human
rights of persons with disabilities.”
44. Further, by its resolution 2000/51 the
Commission encouraged all the treaty bodies to
monitor the compliance of States with their
commitments in order to ensure full enjoyment of
rights by persons with disabilities. In paragraph 11,
Governments were urged to cover fully the question of
the human rights of persons with disabilities when
reporting under the relevant United Nations human
rights instruments:
“[The Commission] invites all the human
rights treaty monitoring bodies to respond
positively to its invitation to monitor the
compliance of States with their commitments
under the relevant human rights instruments in
order to ensure full enjoyment of those rights by
persons with disabilities, and urges Governments
to cover fully the question of the human rights of
persons with disabilities in complying with
reporting obligations under the relevant United
Nations human rights instruments.”
45. In addition, paragraph 30, added during
consideration of the draft resolution, reflected the
recognition of an urgent need for action related to the
rights of persons with disabilities:
“[The Commission] invites the United
Nations High Commissioner for Human Rights,
in cooperation with the Special Rapporteur on
disability of the Commission for Social
Development, to examine measures to strengthen
the protection and monitoring of the human rights
of persons with disabilities and solicit input and
proposals from interested parties, including
particularly the panel of experts.”

E/CN.5/2002/4
46. In my report to the thirty-eighth session of the
Commission for Social Development (E/CN.5/2000/3,
annex), I gave an account of the development of
disability as a human rights issue and reviewed various
ways to strengthen United Nations documents in the
disability field. I recommended that the Standard Rules
should be complemented and developed in specific
areas. I also considered how the issue of disability
should be developed within the United Nations human
rights system. I indicated ways to strengthen the
monitoring of the Rules through the regular system for
monitoring international instruments. Relevant
activities would include developing general comments,
special protocols, thematic studies and similar
activities on the subject of disability. Finally, I
mentioned the possibility of elaborating a special
convention on the rights of persons with disabilities.
However, I emphasized the need for clarification
concerning the role that such a convention should have
in relation to other existing conventions as well as to
the Standard Rules.
47. At the thirty-eighth session of the Commission
for Social Development, one national nongovernmental
organization in the disability field
presented a proposal for the elaboration of a special
convention on the rights of persons with disabilities.
During the meetings of the open-ended working group
convened by that session of the Commission, extensive
discussions took place on how to proceed with the
issue of disability and human rights. The discussions
resulted in a request by the Economic and Social
Council, in paragraph 7 of its resolution 2000/10 of 27
July 2000, that the Special Rapporteur present his
views on further developing the proposals contained in
his report on his second mandate and on forms for
complementing and developing the Standard Rules.
48. In early 2001, the Office of the United Nations
High Commissioner for Human Rights commissioned a
study on the current use and future potential of United
Nations human rights instruments in the context of
disability. The directors of the research, Theresia
Degener (Germany) and Gerard Quinn (Ireland), are
working with three research assistants on this project.
Six United Nations human rights treaties are to be
examined in the specific context of disability.
49. The study will examine closely the operation of
United Nations human rights instruments in the context
of disability. It will look at the nature of State
obligations under the relevant treaties in the context of
disability and at the various enforcement mechanisms
under the treaties. It will specify the various access
points for the involvement of non-governmental
organizations in the disability field.
50. It is envisaged that a key part of the research
findings will focus on the users’ perspective. A
comprehensive questionnaire has been distributed to
non-governmental organizations in the disability field
worldwide. A companion questionnaire was distributed
to national human rights institutions (e.g., human rights
commissions) worldwide to assess their level of
engagement on the rights of persons with disabilities.
51. At one level the report will function as a manual
for non-governmental organizations so that they may
become better acquainted with these instruments and
begin to use them more actively. As such the report of
study findings will help fill an important knowledge
gap. The study also has an evaluative side, assessing
current levels of usage of the treaties in the context of
disability and making practical proposals for
maximizing their potential in this regard.
52. For disability to develop into a human rights
issue, it is necessary to build capacity and structures
outside the United Nations system as well. In
November 2000, I organized a seminar in Sweden
(“Let the world know; a seminar on human rights and
disability”, Stockholm, 5-9 November 2000) whose
purpose was to develop capacities to identify and
report violations and abuses of human rights in the
disability field. Twenty-seven experts, including
representatives from the United Nations system (both
the Office of the United Nations High Commissioner in
Geneva and the United Nations Secretariat in New
York) and from major international non-governmental
disability organizations as well as experts in human
rights and disability from all over the world,
participated in the seminar.
53. The report of the Stockholm seminar, published
in early 2001,12 includes a number of recommendations
for further development concerning the rights of
persons with disabilities. Seminar participants
recommend that action be taken in the following five
areas: monitoring of individual cases, analysis of
existing legislation and legal cases, media coverage of
disability and monitoring of existing government
policies, programmes and services. During 2001, plans
were elaborated by interested parties for follow-up
action to the seminar.

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54. To provide an update on developments in the area
of human rights and disability, two consultative
meetings were organized in 2001 in connection with
the thirty-ninth session of the Commission for Social
Development and the fifty-seventh session of the
Commission on Human Rights respectively.
Governments, intergovernmental organizations, and
United Nations bodies and organizations as well as
non-governmental organizations were invited. In
connection with the consultation organized by the
United Nations High Commissioner for Human Rights,
national human rights institutions also participated.
55. A matter of principal concern for both the
Stockholm expert meeting and the informal
consultative meeting at United Nations Headquarters
was how to proceed in order to strengthen the disability
dimension in human rights monitoring and protection.
Participants at both meetings discussed what could be
done to develop disability as a human rights issue
within the existing human rights framework. The issue
of a special convention was another important subject
during the discussions.
56. The report of the informal consultative meeting
on international norms and standards, held on 9
February 2001 at United Nations Headquarters, New
York,13 stated:
“Several Governments expressed interest in
addressing the rights of persons with disabilities
by means of a ‘twin-track’ approach, which
would involve elaboration of a convention, and
studies on options to mainstream promotion and
protection of the rights of persons with
disabilities in current international instruments. A
convention was viewed as a complement and not
as a mutually exclusive alternative to current
international instruments and the rights of persons
with disabilities. One Government expressed the
view that special attention should be directed to
the situation of intellectually disabled persons,
since this had not been adequately treated to date.
“In this connection, the representative of the
Office of the High Commissioner for Human
Rights recalled for meeting participants a 1985
resolution adopted by the Commission on Human
Rights on new international human rights
instruments, which states that new standards must
be relevant to fundamental issues and that new
standards must not be less than existing
standards.”
57. Some government representatives at the informal
consultative meeting took note of efforts by nongovernmental
organizations to promote awareness and
support for elaborating a convention on the rights of
persons with disabilities. The view was expressed that
attention and support as appropriate should be accorded
to this strong aspiration by the non-governmental
organizations.
58. Representatives of the non-governmental
organizations observed that the meeting was timely and
necessary. They expressed the view that elaboration of
a convention on the rights of persons with disabilities
was of great importance, particularly since disability
was now looked upon primarily as an issue of human
rights rather than a matter of concern for medical and
social welfare services. The representatives added that
a convention would now be considered to be a
complement to the Standard Rules and not an
alternative instrument. While non-binding, the
Standard Rules represented an essential instrument and
provided useful guidance for policy and practice.
59. The consultations held on 17 April 2001 at the
World Health Organization headquarters in Geneva
involved discussions of a similar nature. In addition,
the consultations allowed non-governmental
organizations in the disability field to affirm their
intention to work closely with human rights
mechanisms and national human rights institutions and
to reaffirm their commitment to giving appropriate
attention to the issue of the human rights of persons
with disabilities in their work. The consultations
permitted national institutions to share their national
experiences on good practices to protect and promote
the rights of persons with disabilities.
2. Strategy for the future
60. As a result of a number of important events,
beginning in the 1990s, including the publication of the
report by Leandro Despouy on Human Rights and
Disabled Persons,14 the issuance of general comment
No. 5 by the Committee on Economic, Social and
Cultural Rights15 and the adoption of relevant
resolutions by the Commission on Human Rights,16
disability has been recognized as a human rights issue.
The question now is how the recognition of this
principle can be turned into practical action. Disability

E/CN.5/2002/4
must be developed as an integral dimension of human
rights procedures within the United Nations, and
effective reporting and monitoring routines must be put
into effect.
61. While these efforts are taking place within the
United Nations system, development work must also be
carried out at national level by Governments, national
human rights institutions and national disability
organizations.
The mainstream alternative
62. General comment No. 5, issued by the Committee
on Economic, Social and Cultural Rights in 1994, is a
milestone in the process of developing disability as a
human rights issue. The message of general comment 5
is that disability-related infringements of human rights
are a responsibility for all human rights monitoring
mechanisms. The message is the same in the
resolutions adopted by the Commission on Human
Rights.17 However, up to now, disability has been
included in the way intended only to a very limited
extent in reporting and monitoring procedures.
Experience would suggest that improved reporting and
monitoring of disability-related infringements of
human rights will not develop automatically.
Consequently, concrete measures must be taken by the
Commission on Human Rights and the Office of the
High Commissioner to build the necessary competence
and to develop the needed structures within United
Nations monitoring systems.
63. The present debate to a large extent concerns the
approach to apply in order to achieve effective
protection of the rights of persons with disabilities.
Should a disability dimension be developed within the
monitoring mechanisms in connection with already
existing covenants and conventions, or is the best way
to develop a special instrument? Is there a third way,
where these two alternatives complement each other?
64. The principles of full participation and inclusion,
which are the dominant ideas in modern disability
policy, strongly favour building effective monitoring of
the human rights of persons with disabilities as an
integral part of existing monitoring mechanisms. One
important difference between disability and other areas,
such as gender and the rights of children, is that the
Standard Rules already exist in the disability field and
have proved to be a useful instrument for the
development of national policies and legislation. The
Rules would support the monitoring of human rights
within the regular United Nations monitoring systems
and would serve as a reference document when various
provisions of existing conventions were to be applied
on the basis of disability needs.
65. Furthermore, the recommendations and criticism
coming from the Committees monitoring the
International Covenant on Economic, Social and
Cultural Rights18 and the International Covenant on
Civil and Political Rights19 would probably have a
greater impact on policies in Member States than could
be achieved through a special mechanism on disability.
Another consideration in support of the development of
a disability dimension within the regular human rights
monitoring system is that elaboration of a convention
would take a long time. Reaching an agreement on
provisions to be included in a special convention that
would be accepted by a majority of the member States
and that would really make a difference in living
conditions for persons with disabilities would probably
take several years. In the meantime, the mainstream
approach must be developed to the greatest extent
possible.
The role of a convention
66. In the period since the meeting of the
Commission on Human Rights in 2000, the issue of a
special convention on the rights of persons with
disabilities has been actively promoted by international
disability organizations.20 The issue has been discussed
at many international events that I have attended.
67. During these discussions, it has been possible to
distinguish four major motives for elaborating a special
convention on the rights of persons with disabilities:
(a) Even if the Standard Rules have proved to
be a useful implementation tool and have led to
progressive policy development in a considerable
number of countries, it has often been pointed out that
their main weakness is that they are not legally
binding. Many representatives of organizations of
persons with disabilities see a convention, with its
legally binding provisions, as a more effective tool in
the struggle to achieve higher priority accorded to
disability needs at the national level;
(b) A common view exists that the measures
needed within the regular United Nations monitoring
system for effective protection of the human rights of
persons with disabilities will never really be put in

E/CN.5/2002/4
place. Many different reasons for this belief have been
mentioned in discussions: a general notion among
human rights experts that disability is a social and
medical issue and not a human rights concern; a
perceived preference to address other urgent rights
issues; and, owing to heavy workloads, an
unwillingness to develop a new human rights
dimension;
(c) Even if some development may be achieved
within the regular United Nations monitoring system,
mainstreaming will not be sufficient to strengthen the
rights of persons with disabilities;
(d) The fourth argument concerns authority and
real recognition. The argument stems from experiences
in connection with the Convention on the Political
Rights of Women21 and the Convention on the
Elimination of All Forms of Discrimination against
Women.22 This argument suggests that disability will
not really be recognized and accepted as a human
rights issue until a special convention has been
adopted.
The initiative of the Government of Mexico
68. During the second half of 2001, the Government
of Mexico raised the issue of a future convention on
the rights of persons with disabilities on two occasions.
In connection with the World Conference against
Racism, Racial Discrimination, Xenophobia and
Related Intolerance (Durban, South Africa, 31 August
to 7 September 2001)23 an initiative by Mexico24
resulted in the following paragraph in the Programme
of Action adopted by the Conference:
“Invites the United Nations General
Assembly to consider elaborating an integral and
comprehensive international convention to
protect and promote the rights and dignity of
disabled people, including, especially, provisions
that address the discriminatory practices and
treatment affecting them (para. 180).”25
69. During the deliberations of the Third Committee
at the fifty-sixth session of the General Assembly, the
delegation of Mexico raised the question of elaborating
a convention on the rights of persons with disabilities.
President Vicente Fox of Mexico underscored the
importance of this question during the general debate
on 10 November 2001.26
70. At the 52nd meeting of the Third Committee, on
29 November 2001, the representative of Mexico
introduced a draft resolution on an international
convention on the rights of persons with disabilities,
which the Committee recommended for adoption by
the General Assembly. General Assembly resolution
56/168, entitled “Comprehensive and integral
international convention to promote and protect the
rights and dignity of persons with disabilities”, was
adopted on 19 December 2001. In paragraph 1 of that
resolution, the General Assembly decided to establish
an Ad Hoc Committee open to the participation of all
Member States and observers of the United Nations to
consider proposals for elaborating such a convention,
based on the holistic approach in the work done in the
field of social development, human rights and nondiscrimination
and taking into account the
recommendations of the Commission on Human Rights
and the Commission for Social Development.
71. Pursuant to the resolution, the Ad Hoc Committee
should hold at least one meeting of ten working days
before the fifty-seventh session of the General
Assembly. United Nations entities, governmental
bodies, and non-governmental organizations with an
interest in disability and human rights were invited to
contribute to the work of the Ad Hoc Committee.
Regional seminars should be organized to contribute to
its work by making recommendations regarding the
content and practical measures that should be
considered in the international convention.
72. The adoption of General Assembly resolution
56/168 means that the process of elaborating a
convention has begun. In my opinion the first step in
this process should be to make a preparatory analysis
of a number of basic questions:
(a) What areas should a future convention
cover?
(b) What relation should it have to existing
general conventions?
(c) Should it be expressed as a set of principles,
general in nature but possible to apply in a variety of
national situations around the world?
(d) Should the main perspective be based on the
needs in developing countries?
(e) Should this future convention replace the
Standard Rules, or should the Standard Rules and the
convention complement each other?

E/CN.5/2002/4
73. In my view, these are some of the questions that
should be answered in order to take a final decision on
the terms of reference for the elaboration of a
convention and on the contents of such an international
instrument.
Twin-track approach recommended
74. With the adoption of General Assembly
resolution 56/168, the process of elaborating a
convention on the rights of persons with disabilities
has entered its first phase. At this stage, a number of
fundamental questions concerning the role and contents
of such a convention should be considered. In addition
to the recommendations by the Commission for Social
Development and the Commission on Human Rights,
contributions received from entities of the United
Nations system as well as from governmental bodies
and non-governmental organizations should be taken
into account before an agreement is made on the terms
of reference for the actual elaboration of a convention.
75. The process of elaborating a convention may take
several years. In the meantime, it is important to use
the momentum created by the Commission on Human
Rights to develop the disability dimension within the
existing United Nations human rights monitoring
system. In this sense, a twin-track approach is
recommended.
C. Information exchange and cooperation
between United Nations bodies and
organizations
1. Background
76. A growing number of United Nations bodies and
organizations have disability-related content and
activities in their respective programmes, even if many
of these activities are small and require additional
resources in relation to their needs and potential
activities. During recent years, the Office of the United
Nations High Commissioner for Human Rights has
started to incorporate the disability dimension in its
various activities. The World Bank has recently
initiated efforts to expand its involvement in disability
matters, and informal contacts and ad hoc meetings
have also taken place between United Nations
organizations and specialized agencies, such as ILO,
UNESCO, WHO and UNICEF. UNDP and the Office
of the United Nations High Commissioner for Refugees
(UNHCR) should, in my opinion, increase their
disability involvement in their programmes.
77. Two previous reports (A/52/56, annex, and
E/CN.5/2000/3, annex) to the Commission for Social
Development have highlighted the need for more
systematic exchanges of experiences and ideas between
the United Nations bodies and organizations with
programmes in the disability field. In this effort, the
Programme on Disability of the Department of
Economic and Social Affairs should have a
coordinating role. I have suggested that the interagency
mechanism that existed during the United
Nations Decade of Disabled Persons (1983-1992)
should be re-established. Unfortunately, no initiative
has been taken. Nevertheless, the number of United
Nations organizations and agencies with an
involvement in the disability field has increased;
consequently there is an even stronger reason for such
a mechanism today.
2. Virtual inter-agency meeting mechanism
recommended
78. My contacts with United Nations bodies and
organizations have made it clear that there is a need for
a more systematic exchange of information,
experiences and ideas. These entities, particularly the
ones that have recently begun to involve themselves in
disability issues, could benefit from the experiences of
other members of the United Nations system. All
would gain from mutual dialogue and information
exchange. Budgetary constraints are the main reason
for the absence of an initiative on improved
cooperation.
79. Modern information and communication
technologies offer new possibilities for the type of
systematic exchanges that are urgently needed. The
cost of using such a mechanism would be low. The
United Nations Secretariat already has experience in
conducting virtual meetings for exchanges of
information. Every participating body and organization
could present a short summary of its activities in order
to inform others. Agreements for dealing with special
topics could be made. An additional advantage of
organizing such virtual meetings on an annual basis
would be that the information could be used as input
for the reports that the Secretary-General submits to the
General Assembly on progress in the field of disability.

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80. I suggest that the Programme on Disability of the
Department of Economic and Social Affairs should
organize annually a virtual inter-agency meeting, based
on accessible Internet communication technologies.
D. Future monitoring system for the
Standard Rules
1. Background
81. The present monitoring mechanism in connection
with the Standard Rules will end in December 2002.
Even if considerable emphasis will be put on the
human rights development and the role of the
Commission on Human Rights, it is necessary to
maintain disability as a development issue within the
United Nations system and as a responsibility for the
Commission for Social Development.
82. The first paragraph of chapter IV of the Standard
Rules expresses the purpose of the monitoring as
follows:
“The purpose of a monitoring mechanism is
to further the effective implementation of the
Rules. It will assist each State in assessing its
level of implementation of the Rules and in
measuring its progress. The monitoring should
identify obstacles and suggest suitable measures
that would contribute to the successful
implementation of the Rules. … An important
element should also be the provision of advisory
services and the exchange of experience and
information between States.”27
83. In the work done since 1994, all these elements of
the monitoring mechanism have been present. With
some simplification one could say that its two main
elements are to promote the implementation of the
Rules by Member States and to assess the degree of
development in Member States and on a global basis.
84. There is no doubt that much happened during the
1990s in the area of international policy development
in the disability field. Even if there are many reasons
for this encouraging trend, it is obvious that the
activities created through the special monitoring
mechanism in connection with the Rules have
contributed to the present state of affairs. The fact that
resources were available for a considerable number of
missions and for conducting international surveys on
the situation of persons with disabilities was of great
value. The creation of an advisory panel, established by
the major international non-governmental organizations
in the disability field, provided expertise throughout
the work and led to the mobilization of a large network
of national disability organizations around the world.
2. Future monitoring mechanism
85. With regard to the experience gained since 1994,
the point of departure for discussions on what should
happen from 2003 onward is that an active monitoring
mechanism for the implementation of the Standard
Rules should remain in place for the future. The two
main functions — assessment and promotion — should
be kept. One question is if these two functions should
be applied separately.
Measures to assess the situation
86. One important part of the monitoring mechanism
is to assess the degree of progress made in Member
States in implementing the Rules. Since 1994 this has
been done three times by conducting global surveys.
The results of the third survey, carried out by WHO in
cooperation with the Special Rapporteur, are mentioned
in chapter III of the present report. As a parallel
exercise, the World Programme of Action concerning
Disabled Persons has been monitored through
quinquennial reviews and appraisals, also based mainly
on information obtained from Member States. The
Programme of Action and the Standard Rules are based
on the same disability philosophy and contain very
similar guidelines. Therefore, these two monitoring
exercises, both intended to assess progress worldwide,
should be merged and carried out as one activity in the
future.
87. The system with quinquennial surveys should be
kept and the surveys should be made in cooperation
with the major international non-governmental
organizations in the disability field. One part of the
questionnaire could be standardized to ensure the
future possibility of comparison over time. A second
part of the questionnaire could be used for ad hoc
studies of special aspects. The system of mobilizing
national affiliates of international non-governmental
organizations, both to prepare replies and to assist in
obtaining replies from Governments, should be copied
from the routine practised with success in the Standard
Rules monitoring mechanisms of the current Special
Rapporteur.

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Measures for promotion and advice
88. In paragraph 12 of chapter IV of the Rules, the
Commission for Social Development is given the
following instructions:
“... The Commission should examine the
possibility of either renewing the Special
Rapporteur’s mandate, appointing a new Special
Rapporteur or considering another monitoring
mechanism, and should make appropriate
recommendations to the Economic and Social
Council.”
89. The first of these three alternatives — renewal of
the mandate — can be ruled out, as the current
Rapporteur is retiring after three terms of office. When
considering the two remaining alternatives, some
important aspects must be taken into account. Are the
two alternatives equal when it comes to obtaining
regular funding and attracting extrabudgetary resources
from Governments or other sources? Are the two
alternatives equal with regard to the recruitment and
appointment of persons who are really suitable for the
function?
90. Based on the experience gained, the most rational
way to proceed would be to appoint a new Special
Rapporteur. This would mean that the work could
continue within the same framework and with the same
guidelines as it has up to now. This alternative,
however, is largely dependent on finding a suitable
person for the function and on the provision of
extrabudgetary funding from a number of
Governments. In relation to other alternatives, the
advantage is the great degree of independence for the
Special Rapporteur, who may act freely within the
framework indicated in chapter IV of the Standard
Rules.
91. The other main alternative is to integrate the
promotional function into the Programme on Disability
of the Department of Economic and Social Affairs. If
so, a senior position as technical advisor should be
added to the disability staff. As in the case of a Special
Rapporteur, such a person must have a good
professional background, experience in government
work concerning disability matters and the respect and
trust of the international disability movement. A
prerequisite for this alternative would be the
availability of sufficient resources particularly for
missions to countries and related activities.
92. In my previous report (E/CN.5/2000/3, annex) I
introduced the idea of establishing a monitoring system
with regional advisers. Recent discussions have
clarified that such a system could be achieved in two
different ways. One possibility would be to establish
full-time positions as regional advisers in the
developing regions and in countries with economies in
transition in Central and Eastern Europe. A natural
location for such positions would be in an office of a
regional intergovernmental body. Apart from
strengthening the advisory services considerably, the
advantage is that regional advisers would be closer to
the economic, political and cultural conditions in the
countries concerned. It would be natural to look for
funding of such advisers through UNDP or other major
donors of development cooperation resources.
93. Another way of implementing regional advisory
services would be to recruit a group of experts from the
different regions who are all qualified for the function,
but with different specialties. They should be willing to
accept ad hoc missions of limited duration to countries
in their region. Such missions could be supported and
funded, resources permitting, either by the United
Nations Secretariat or by regional sources.
94. These alternatives for regional advisory services
would probably be needed to support the work of a
technical adviser based in the United Nations
Secretariat. The proposed regional advisers could also
supplement and strengthen the work of a future Special
Rapporteur.
The panel of experts
95. One of the most unique contributions to the social
development work within the United Nations system is
the advisory panel of experts, established by the major
international non-governmental organizations in the
disability field. The basis for this is contained in
chapter IV, paragraph 3, of the Standard Rules:
“International organizations of persons with
disabilities having consultative status with the
Economic and Social Council and organizations
representing persons with disabilities who have
not yet formed their own organizations should be
invited to create among themselves a panel of
experts, on which organizations of persons with
disabilities shall have a majority, taking into
account the different kinds of disabilities and
necessary equitable geographical distribution, to

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be consulted by the Special Rapporteur and, when
appropriate, by the Secretariat.”
96. In September 1994 the following six
organizations agreed on the composition of the panel:
Disabled People’s International, Inclusion
International, Rehabilitation International, World Blind
Union, World Federation of the Deaf, and World
Network of Users and Survivors of Psychiatry. The
panel consists of ten members, five women and five
men, who have different disabilities and come from
different parts of the world. As mentioned above, the
panel has functioned well and has provided excellent
support to my work. In addition, there are more than
600 national affiliates of the six international nongovernmental
disability organizations that have formed
a powerful network for obtaining information and
contacts in countries. This has been useful both during
my missions to individual countries and in the conduct
of global surveys. An additional advantage is that the
panel has brought the international organizations
together and facilitated communication between the
organizations and the United Nations.
97. Whatever form the monitoring takes, it is
important to maintain the system of a panel of experts
attached to the monitoring mechanism. The panel
would be able to play an important advisory role in
connection with future periodic surveys to Member
States by participating in the formulation of questions
as well as by interpreting the results. Naturally, the
panel could also provide support and advice to a future
Special Rapporteur or technical adviser in their various
activities.
Continued monitoring recommended
98. The Standard Rules should continue to play a role
as an international tool for policy development in the
disability field. A precondition for this is the existence
of an active monitoring mechanism, promoting the
further implementation of the Rules and assessing the
degree of progress. If a solution can be found, the best
way to proceed is to appoint a new Special Rapporteur,
who will continue to work along the lines indicated in
chapter IV of the Standard Rules. If this cannot be
achieved within a foreseeable time, the monitoring
mechanism should be integrated into the United
Nations Secretariat and a senior post of technical
adviser should be established. In either case, a system
with a panel of experts, established in the same way as
it is now, should provide advice and support to the
various activities within the monitoring effort.
99. In addition, a system with regional advisory
services should be developed to supplement and
support the work performed by the Special Rapporteur
or technical adviser.
100. The two monitoring and evaluation processes,
carried out in connection with the World Programme of
Action concerning Disabled Persons and the Standard
Rules to assess progress worldwide, should be merged
into a single, periodic exercise, carried out by the
Programme on Disability of the Department of
Economic and Social Affairs.
101. A prerequisite for a well-functioning monitoring
mechanism is that sufficient funding — regular and
extrabudgetary — can be made available for the
different monitoring functions.
V. Summary and recommendations
102. In its resolution 2000/10 of 27 July 2000, the
Economic and Social Council decided to renew my
mandate for a third period, from 2000 to 2002. In
addition to the monitoring activities outlined in chapter
IV of the Standard Rules, I was requested to provide
further analyses in a number of areas.
103. This report contains a brief account of the
missions and other activities carried out during the
period. It describes the activities within the project
“Rights for disabled children” and refers to the global
survey on the implementation of certain Rules carried
out by the World Health Organization.
104. Based on information received during missions to
countries, participation in conferences and in
international consultations, it is evident that the
Standard Rules play a major role, assisting in policy
development and serving as a tool for advocacy. The
recognition by the Commission on Human Rights of
the Standard Rules as a yardstick for measures to
combat exclusion and discrimination has further
strengthened the position of the present document.
105. Based on its commitments, the United Nations
must strengthen its leading role in the struggle against
social exclusion and human rights abuse in the
disability field. On the basis of my current mandate, I
identified four areas for further analysis, which would
be carried out in order to:

E/CN.5/2002/4
(a) Complement the Standard Rules;
(b) Suggest measures for further development
of disability as a human rights issue;
(c) Improve cooperation within the United
Nations system in the field of disability;
(d) Examine forms for future monitoring of the
Standard Rules.
106. With respect to complementing the Standard
Rules, attached to the present report is a proposed
supplement to the Rules that I have drafted for
consideration by the Commission.
107. The recommendations for future action that I
wish to submit are outlined below.
A. Supplement to the Standard Rules
108. Nearly ten years have passed since the adoption
of the United Nations Standard Rules. During this time,
the Rules have developed into a major tool for policy
making and action, used by Governments and by
international and national non-governmental
organizations in the disability field. In human rights
development, the Standard Rules have been recognized
as a yardstick for ways to put an end to exclusion and
discrimination.
109. To make the Standard Rules an even more
effective tool for future development of policy,
legislation and programmes, a complement to the Rules
should be created. I recommend that the attached
proposed supplement to the Standard Rules be adopted
and published by the United Nations.
B. Twin-track approach in human rights
110. Adoption by the General Assembly of its
resolution 56/168 on the “Comprehensive and integral
international convention to promote and protect the
rights and dignity of persons with disabilities”, signals
the beginning of the process of elaborating a
convention on the rights of persons with disabilities.
During the first phase of this work a number of
fundamental questions concerning the role and contents
of such a convention should be considered. The
recommendations by the Commission for Social
Development and the Commission on Human Rights
should be taken into account, and contributions
received from entities of the United Nations system,
governmental bodies and non-governmental
organizations should be considered before an
agreement is made on the terms of reference for the
actual elaboration of a convention on the rights of
persons with disabilities.
111. The process of elaborating a convention may take
several years. In the meantime, it is important to use
the momentum created by the Commission on Human
Rights to develop the disability dimension within the
existing United Nations human rights monitoring
system. In this sense, a twin-track approach is
recommended.
C. Improved cooperation between United
Nations bodies and organizations in the
field of disability
112. As a result of my contacts with United Nations
bodies and organizations, I can clearly see the need for
a more systematic exchange of information,
experiences and ideas. United Nations bodies and
organizations that have recently started to involve
themselves in disability issues could benefit from the
experiences of others. All would gain from mutual
dialogue and information exchange. Budgetary
constraints are the main reason for the absence of an
initiative to date to improve inter-agency cooperation.
113. Modern information and communication
technologies offer new and low-cost possibilities for
the types of exchange needed. The Programme on
Disability of the Department of Economic and Social
Affairs should organize an annual “virtual inter-agency
meeting” based on accessible Internet technologies.
D. Continued monitoring
114. The Standard Rules should continue to play a role
as an international instrument for policy development
in the disability field. A precondition for this is the
existence of an active monitoring mechanism to
promote the further implementation of the Rules and
assess the degree of progress. If a solution can be
found, the best way to proceed is to appoint a new
Special Rapporteur, who will continue to work along
the lines indicated in chapter IV of the Standard Rules.
If this cannot be achieved within the foreseeable future,
the monitoring mechanism should be integrated into
the Secretariat and a senior post of technical adviser

E/CN.5/2002/4
should be established. In either case, a system with a
panel of experts, established in the same way as it is
now, should provide advice and support to the various
activities within the monitoring effort. A prerequisite
for a well-functioning monitoring mechanism is to
ensure is the availability of sufficient funding, regular
or extrabudgetary, for the different functions of
monitoring.
115. The two monitoring and evaluation processes
now carried out in connection with the Programme of
Action and the Standard Rules to assess progress
worldwide should be merged into one periodic
exercise, carried out by the Programme on Disability of
the Department of Economic and Social Affairs.
116. A system with regional advisory services should
be developed to supplement and support the work
performed by the Special Rapporteur or the technical
adviser.
Notes
1 A/37/351/Add.1 and Corr.1, annex, sect. VIII,
recommendation I (iv).
2 World Health Organization, The UN Standard Rules on
the Equalization of Opportunities for Persons with
Disabilities: Government Responses to the
Implementation of the Rules on Medical Care,
Rehabilitation, Support Services and Personnel
Training: Summary, vol. I (WHO/DAR/01.1) and Main
Report, vol. II (WHO/DAR/01.2).
3 Ibid., Regional report AFRO (WHO/DAR/01.3);
Regional report AMRO (WHO/DAR/01.4); Regional
report EMRO (WHO/DAR/01.5); Regional report EURO
(WHO/DAR/01.6); Regional report SEARO
(WHO/DAR/01.7); Regional report WPRO
(WHO/DAR/01.8).
4 World Health Organization, Report of the Conference on
Rethinking Care (WHO/DAR/01.11). Available from
http://www.rethinkingcare.org/.
5 The right to an “adequate standard of living” is set forth
in a number of international human rights instruments
(see Office of the United Nations High Commissioner
for Human Rights, International Human Rights
Instruments [Geneva, n.d.], available from
http://www.unhchr.ch/html/intlinst.htm). These include
the Universal Declaration of Human Rights, article 25
(1) (General Assembly resolution 217 A (III) of 10
December 1948); the International Covenant on
Economic, Social and Cultural Rights, article 11 (1)
(General Assembly resolution 2200 A (XXI) of 16
December 1966); the Convention on the Rights of the
Child, article 27 (1) (General Assembly resolution 44/25
of 20 November 1989); the Convention on the
Elimination of All Forms of Discrimination against
Women, article 14, sect. 2 (h) (General Assembly
resolution 34/180 of 18 December 1979); and the
International Convention on the Elimination of All
Forms of Racial Discrimination, article 5 (e) (General
Assembly resolution 2106 (XX) of 21 December 1965).
See also General Assembly resolution 48/96 of 20
December 1993, annex, chap. II.
6 A/37/351/Add.1 and Add.1/Corr.1, annex, sect. VIII,
para. 164. Available from http://www.un.org/esa/socdev/
enable/diswpa00.htm.
7 Leandro Despouy, Human Rights and Disabled Persons,
Human Rights Study Series No. 6 (United Nations
publication, Sales No. E.92.XIV.4).
8 Official Records of the Economic and Social Council,
1995, Supplement No. 3 (E/1995/22), annex IV.
9 Ibid., para. 5.
10 See Official Records of the Economic and Social
Council, 1998, Supplement No. 3 (E/1998/23).
11 See Official Records of the Economic and Social
Council, 2000, Supplement No. 3 (E/2000/23).
12 Office of the Special Rapporteur on Disability,
Commission for Social Development, “Let the world
know: report of a seminar on human rights and
disability”, Stockholm, 5-9 November 2000 (New York,
Division for Social Policy and Development, 2001), last
update 28 August 2001, available from http://www.un.
org/esa/socdev/enable/stockholmnov2000.htm.
13 Report of the informal consultative meeting on
international norms and standards for persons with
disabilities, New York, 9 February 2001 (New York,
Division for Social Policy and Development, 2001),
para. 22, available from http://www.un.
org/esa/socdev/enable/consultnyfeb2001.htm.
14 Despouy, op. cit.
15 Official Records of the Economic and Social Council,
1995, Supplement No. 3 (E/1995/22), annex IV.
16 See, in particular, Commission on Human Rights
resolutions 1998/31 of 21 April 1998 and 2000/51 of 25
April 2000.
17 Ibid.
18 General Assembly resolution 2200 A (XXI) of 16
December 1966.
19 Ibid.
20 See, for example, the Beijing declaration on the rights of
people with disabilities in the new century (A/54/861-
E/2000/47, annex).

E/CN.5/2002/4
21 General Assembly resolution 640 (VII) of 20 December
1952.
22 General Assembly resolution 34/180 of 18 December
1979.
23 World Conference against Racism, Racial
Discrimination, Xenophobia and Related Intolerance,
Durban, South Africa, 31 August-7 September 2001
(A/CONF.189/5).
24 Statement of Gilberto Rincón Gallardo, representative of
Mexico (2 September 2001), available from
http://www.un.org/WCAR/statements/
mexicoE.htm.
25 See World Conference against Racism, Racial
Discrimination, Xenophobia and Related Intolerance,
Durban, South Africa, 31 August-7 September 2001
(A/CONF.189/5), chap. I.
26 Statement available (in Spanish) from http://www.un.
org/webcast/ga/56/statements/011110mexicoS.htm.
27 General Assembly resolution 48/96, annex, chap. IV,
para. 1. Available from http://www.un.org/esa/socdev/
enable/dissre06.htm.

E/CN.5/2002/4
Annex
Reaching the most vulnerable; proposed supplement to the
Standard Rules on the Equalization of Opportunities for
Persons with Disabilities
Contents
Paragraphs Page
I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1–7 23
II. Proposed supplement to the Standard Rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8–94 23
A. Fundamental concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8–10 23
B. Adequate standard of living and poverty alleviation. . . . . . . . . . . . . . . . . . . . . . 11–19 24
C. Housing, including the issue of residential institutions . . . . . . . . . . . . . . . . . . . 20–26 24
D. Health and medical care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27–34 25
E. Emergency situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35–37 25
F. Access to the social environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38–41 26
G. Communication issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42–50 26
H. Personnel training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51–55 26
I. Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56–60 27
J. Children with disabilities and the family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61–70 27
K. Violence and abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71–77 28
L. Older persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78–83 28
M. Development and psychiatric disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84–90 28
N. Invisible disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91–93 29
O. Suggested further initiatives in national policy and legislation . . . . . . . . . . . . . 94 29

E/CN.5/2002/4
I. Introduction
1. The 1990s brought more progress in disability
policy and legislation than earlier decades. This
development was initiated through the activities in
connection with the observance of the International
Year of Disabled Persons (1981), the adoption of the
World Programme of Action concerning Disabled
Persons (A/37/351/Add.1 and Add.1/Corr.1, annex,
sect. VIII) and the activities during the International
Decade of Disabled Persons (1983-1992).
2. Since the adoption of the Standard Rules on the
Equalization of Opportunities for Persons with
Disabilities by the General Assembly in its resolution
48/96 (annex) of 20 December 1993, and the
establishment of its monitoring mechanism in 1994, the
Rules have played a significant role worldwide in the
elaboration of national policies and legislation in the
disability field. This active and practical application of
the Rules has provided new and valuable experience on
how to use the Rules in the future. At the same time, it
has revealed certain weaknesses and omissions in the
present text.
3. Throughout the entire Standard Rules text, the
term “persons with disabilities” is used to refer to
persons of all ages with disabilities. In the text of the
proposed supplement the term should always be
understood as meaning “girls, boys, women and men
with disabilities” when no other qualifying term is
indicated.
4. The purpose of preparing the proposed
supplement to the United Nations Standard Rules is to
complement and develop the text in certain areas. The
work is based on the analysis of gaps and shortcomings
presented by the Special Rapporteur on Disability in
his report to the thirty-sixth session of the Commission
for Social Development (E/CN.5/2000/3, annex). In
that analysis the following were pointed out: gender
concerns; housing and communication issues; the needs
of children and older persons; the needs of persons
with developmental and psychiatric disabilities; and the
needs of persons with disabilities in poverty situations.
5. In the process of elaborating this supplement,
several international organizations and individual
experts have contributed, particularly those
representing the interests of persons with
developmental and psychiatric disabilities and children.
The panel of experts, attached to the Standard Rules
monitoring mechanism, has worked with the text and
made many valuable suggestions. Finally, the outcome
of the global Conference on Rethinking Care (Oslo, 22-
25 April 2001), organized by the World Health
Organization in cooperation with the Government of
Norway, has been taken into account.
6. The text of this supplement does not follow the
structure of the Standard Rules. The order of sections
has been chosen to avoid unnecessary repetition. The
mode of presentation combines a commentary and
explanation of the text with a set of recommendations,
presented in the same way as in the Rules.
7. The most obvious common feature of the
comments and recommendations in this supplement is
that they bring into focus the needs of the most
vulnerable among children and adults with disabilities.
II. Proposed supplement to the
Standard Rules
A. Fundamental concepts
8. The Standard Rules include a presentation of the
International Classification of Impairment, Disabilities
and Handicaps, which was adopted by the World
Health Assembly of the World Health Organization
(WHO) in 1980. This classification has now been
revised. In 2001 the World Health Assembly endorsed
the International Classification of Functioning,
Disability and Health, in which functioning and
disability are understood to occur in a context
characterized by personal and environmental factors:
physical, social and attitudinal. Functioning and
disability are classified at the levels of the body, the
person and the society. The Classification can be used
to describe an individual’s capacity to execute simple
and complex actions, which can be employed to
determine appropriate health interventions and other
changes to the person. In addition, the Classification
can be used to describe actual performance in an
individual’s current environment. It is then possible to
identify the environmental factors that facilitate or
hinder that performance so as to determine appropriate
environmental modifications or health-related
interventions to improve it. In this supplement,
however, the terminology used in the Standard Rules
has been retained in order to avoid confusion.

E/CN.5/2002/4
9. It should be noted that considerable confusion has
arisen concerning the use of the word “handicap”. Even
if the term is established in many languages, it has
acquired a derogatory, negative and even insulting
connotation in several languages, and should therefore
be used with great care.
10. It should also be emphasized that the term
“prevention”, as outlined in the Standard Rules, must
never be used to justify the denial of the right to life or
to equal participation in society for persons who have
disabilities.
B. Adequate standard of living and
poverty alleviation
11. It is obvious that in developing countries, as in
more developed areas, persons with disabilities and
their families are more likely than the rest of the
population to live in poverty. It is a two-way
relationship: disability adds to the risk of poverty, and
conditions of poverty increase the risk of disability.
Prejudice and social stigma affect the lives of both
children and adults with disabilities and lead to
isolation and exclusion from the life of their
communities.
12. The attainment of an adequate standard of living
by persons with disabilities is implied in the principle
of equal rights for all and in the process of equalization
of opportunities for persons with disabilities.
13. States should ensure that persons with disabilities
receive the support they need within the ordinary
systems of society, such as education, health,
employment and social services.
14. When taking measures to combat poverty, States
should include programmes to support empowerment
of persons with disabilities and promote their active
participation in society.
15. As part of their development programmes, States
should also ensure access to adequate and safe housing,
food and nutrition, water and clothing for persons with
disabilities.
16. In the framework of community-based services,
States should provide education, rehabilitation,
assistive devices and employment services to persons
with disabilities.
17. States should encourage the collection and
dissemination of information on the living conditions
of persons with disabilities and promote comprehensive
research on all conditions affecting the lives of persons
with disabilities.
18. In cooperation with local and regional authorities,
the Office of the United Nations High Commissioner
for Refugees (UNHCR) and other actors, States should
provide the necessary assistance to homeless persons,
displaced persons and refugees with disabilities,
enabling them to attain self-sufficiency and promoting
sustainable solutions to their problems.
19. Organizations of persons with disabilities should
be consulted at all levels in programmes affecting the
standard of living of persons with disabilities.
C. Housing, including the issue of
residential institutions
20. A prerequisite for full participation and equality
is that persons with disabilities can grow up, live and
develop their potential in the community they belong
to. In this context the provision of suitable housing is
crucial.
21. States should ensure safe, habitable, accessible,
affordable housing and shelter for all persons with
disabilities, adequate for their health and well-being.
Such housing conditions, including the social and
physical infrastructure, should enable children with
disabilities to grow up with their parents and should
enable adults with disabilities to be part of the
community.
22. Measures should also include awareness-raising
campaigns to combat negative attitudes among
neighbours as well as the local population.
23. In countries where the policy has been to house
many groups of persons with disabilities in separate
and large institutions States should reorient their
policies towards community-based services and family
support. In this way it should be possible to initiate
programmes to stop admissions to such facilities as
well as plan for their ultimate closure.
24. For orphans with disabilities and for other groups
of disabled children without family or other personal
support, substitute families should be found. For adults
in the same situation, small family-like facilities (group

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homes), situated in the community, should replace
large institutions.
25. States should ensure that appropriate support is
provided for residents with disabilities when they leave
their residential institutions to rejoin the community,
and that the support services continue for as long as
required.
26. With regard to persons still living in institutions,
States must ensure that their basic needs are met, and
ensure respect for their right to a private space where
they may receive visitors as well as keep their files,
correspondence and other personal belongings. The
treatment of every person should be directed to
preserving and enhancing personal autonomy. States
must also ensure that opportunities for meaningful
participation and involvement in community life occur.
D. Health and medical care
27. Recognizing that health is a human right, States
must ensure access to high quality and safe medical
services and facilities for all people, regardless of the
nature and/or severity of impairment, age, gender, race,
ethnicity and sexual orientation. States should
recognize that persons with disabilities have the same
right to self-determination as other citizens, including
the right to accept or refuse treatment. States must
ensure that the right to life is paramount in the delivery
of medical and health services.
28. States should ensure that persons with disabilities
get the same level of medical care within the same
system as other members of society, and do not face
discrimination on the grounds of presumptions of their
quality of life and potential.
29. States should ensure that all medical, paramedical
and related personnel are adequately trained and
equipped to give medical care to persons with
disabilities and that they have access to relevant
treatment methods and technology. To understand fully
what it means to live with a disability, future
professionals should meet and learn from persons with
disabilities.
30. Medical and paramedical personnel should give
full and balanced information and advice concerning
diagnosis and treatment to persons with disabilities.
This is particularly important in the situation of
prenatal diagnosis. In the case of children, information
should be given to parents and, when appropriate, to
other family members.
31. States should design and implement programmes
with the full involvement of women and men with
disabilities to give them appropriate and fully
accessible education, information and services to
address their reproductive and sexual health needs.
32. States should raise awareness of, prevent and
treat sexually transmitted infections, including
HIV/AIDS.
33. States should ensure that medical facilities and
personnel inform people with disabilities of their right
to self-determination, including the requirement of
informed consent, the right to refuse treatment and the
right not to comply with forced admission to
institutional facilities. States should also prevent
unwanted medical and related interventions and/or
corrective surgeries from being imposed on persons
with disabilities.
34. States should develop national rehabilitation
programmes for all groups of persons with disabilities.
Such programmes should be based on the actual
individual needs of persons with disabilities. The
training should be based on the principles of full
participation and equality, and aim at the removal of
barriers for their participation in the mainstream of
community life.
E. Emergency situations
35. It has often been recognized that the needs of
persons with disabilities are forgotten or neglected in
general relief programmes.
36. In cooperation with concerned United Nations
agencies such as UNHCR and the United Nations
Development Programme (UNDP), States should
develop policies and guidelines for the inclusion of
support measures with regard to persons with
disabilities in emergency situations. Their emergency
services should be adequately equipped and prepared to
provide medical treatment and support to persons with
disabilities and their families.
37. Special attention should be paid to the fact that
persons with disabilities are particularly vulnerable to
abuse in emergency situations.

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F. Access to the social environment
38. Two dimensions of accessibility are pointed out
in Rule 5 of the Standard Rules: access to the physical
environment and access to information and
communication. Experience has shown that it is
necessary to include a third dimension — access to the
social environment — in national disability
programmes.
39. States should encourage measures to remove all
obstacles resulting from ignorance and negative
attitudes towards persons with disabilities.
40. Measures to combat prejudice should be taken
through public education and information campaigns,
awareness-raising and encouragement of a positive
portrayal of persons with disabilities in the media.
Particular emphasis should be given to the gender
dimension, to persons with developmental and
psychiatric disabilities, to children with disabilities and
to persons with multiple or invisible disabilities.
41. When planning measures to combat social
prejudice, it is of particular importance for States to
ensure the involvement of organizations of persons
with disabilities.
G. Communication issues
1. Information and communication technology
42. Information and communication technologies and
infrastructures are rapidly growing in importance in the
provision of information and services to the population.
These technologies must therefore be made accessible
and their great potential to assist and support persons
with disabilities must be utilized.
43. States should ensure that information and
communication technologies and service systems
offered to the general public are either made initially
accessible or adapted to be made accessible to persons
with disabilities. It is also important to create
opportunities for special training courses as well as
access to affordable equipment and software and to
distance learning through these technologies for
persons with disabilities.
44. States should consider presenting accessibility
and usability standards and guidelines as a
precondition for public funding and recognize public
procurement as a tool to achieve accessibility.
45. States should initiate the development and use of
special technical and legal arrangements to make
information and communication technologies
accessible to persons with disabilities.
2. Sign language
46. During the 1990s an increasing number of States
recognized sign language as the main means of
communication for deaf people. In view of the decisive
importance of sign language in the personal
development of deaf people, such recognition must be
encouraged worldwide.
47. States should recognize sign language as a natural
language and as the medium of communication among
deaf people. It should be used in the education of deaf
children, in their families and in the communities.
48. Sign language interpretation services should be
provided to facilitate communication between deaf
persons and others.
3. Other communication needs
49. Consideration should be given to the needs of
people with other communication disabilities, such as
the speech-impaired, the hard-of-hearing, the deafblind
and persons with developmental and psychiatric
disabilities, who require specific forms of assistance.
50. In addition to information and communication
technologies, special assistive devices and interpreter
services may be needed.
H. Personnel training
51. A key element in all programmes and services for
persons with disabilities is to have well-trained and
informed personnel. Furthermore, information on
disability and the living conditions of persons with
disabilities should be provided to professional groups
serving the general population, such as medical
doctors, teachers and social workers as part of their
basic training. In addition to technical information,
professionals should have knowledge of the prevailing
attitudes towards persons with disabilities.
52. States should ensure that all authorities providing
services in the disability field give adequate training to
their personnel and that an understanding of the
substance of the United Nations Standard Rules is an
outcome of such training.

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53. States should ensure that personnel are educated
to recognize acts of discrimination based on gender,
ethnicity, race, age and/or sexual orientation against
children and adults with disabilities.
54. States should facilitate training for persons with
various types of disabilities so they may work as
professionals in the disability field and serve as role
models.
55. Access to continuing education on a regular basis
should be available and encouraged for all persons,
groups and institutions concerned with disabilities.
I. Gender
56. Women with disabilities are often exposed to
double, or even triple, discrimination. They suffer
discrimination as women, as disabled persons and on
the grounds of their economic status.
57. In many cultures, the status of women with
disabilities is negatively affected by the fact that they
less frequently get married and have children. They are
often exposed to discrimination in medical care and
rehabilitation, education, vocational rehabilitation and
employment.
58. The initial sentence of every Rule in the Standard
Rules document contains the term “persons with
disabilities”. This should always be understood as
referring to “girls, boys, women and men with
disabilities”. It is important to emphasize both gender
equality and the inclusion of children and youth,
wherever appropriate.
59. In gender-sensitive development programmes,
women and girls with disabilities should be identified
as target beneficiaries.
60. Organizations of persons with disabilities should
take action to get the concerns of women and girls with
disabilities onto their agenda, and onto the agendas of
women’s organizations and organizations representing
children.
J. Children with disabilities and the
family
61. In some cultures, a disability is often seen as a
punishment and is connected with feelings of fear and
shame. Owing to this, children with disabilities may be
hidden away or neglected by the rest of the community.
As a consequence it is not possible for them to live a
decent life, and they are sometimes even denied the
right to survival.
62. Children with disabilities are often neglected by
the school system. Obstacles in the physical
environment prevent the children from moving around
freely, from playing and from sharing the company of
other children.
63. States should initiate programmes for early
detection and intervention and ensure that children
with disabilities, including children with severe and/or
multiple disabilities, have access to medical care and
rehabilitation services. These services should be
provided without any bias based on gender, age or
other status.
64. Training and rehabilitation programmes should
not disrupt the disabled child’s right to family life and
social interaction with their non-disabled peers.
65. All children with disabilities, including those
with severe disabilities, should have access to
education. Special attention should be given to very
young children, girls and young women with
disabilities.
66. States should encourage measures that enable
children with disabilities to play and to be together
with other children in the community.
67. States should ensure that children, adolescents
and youth with disabilities are entitled freely to express
their views on matters of concern to them and to have
their views taken seriously in accordance with their age
and maturity.
68. States should develop adequate support to
families who have children with disabilities, including
disability-specific assistance and information, access to
mainstream parent support and possibilities for parentto-
parent exchanges.
69. States should encourage employers to make
reasonable adjustments to accommodate family
members responsible for the care of children and adults
with disabilities.
70. States should support women and men with
disabilities wanting to pursue a separation or a divorce
owing to abuse or violence.

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K. Violence and abuse
71. Studies during recent years have shown that
experience of sexual abuse and of other forms of
violence and abuse are frequent among persons with
disabilities. Owing to the special circumstances, such
problems are often difficult to discover, as they may
occur in closed environments and are sometimes
committed against children and adults who have
difficulty explaining what has happened.
72. States should develop programmes to recognize
and eradicate abuse and violations of girls, boys,
women and men with disabilities. It may occur in the
family, in the community, in institutions and/or in
emergency situations.
73. Persons with disabilities need to be educated
about how to avoid the occurrence of abuse, how to
recognize when abuse has occurred and how to report
it.
74. States should provide information to persons with
disabilities and their families about ways to take
precautions against sexual and other forms of abuse.
75. Professionals should be trained how to identify
conditions leading to possible victimization, how to
avoid such situations, how to recognize when abuse has
occurred, how to support a victim with a disability and
how to report on such acts.
76. Police and judicial authorities should be trained
to work with persons with disabilities so that they can
receive testimonies from such persons and treat
instances of abuse seriously. Perpetrators of abuse
should be identified and brought to justice.
77. Special legislative measures may be needed to
protect the right to personal integrity and privacy for
children and adults with disabilities, in order to avoid
their exploitation and abuse.
L. Older persons
78. There are two main categories of older persons
with disabilities. For those who experienced their
disabilities earlier in life, the needs may change with
advancing age. The other group consists of people who
lose physical, sensory or mental functions due to
ageing. With the increase in life expectancy, owing to
the general improvement in the standard of living, this
group is growing in number.
79. The Standard Rules do not make any age
distinctions. The term “persons with disabilities” refers
to persons of all ages. However, experience has shown
that the needs of older persons with disabilities are
often not included in national disability policies and
programmes, and therefore some clarification may be
appropriate.
80. States should ensure that the needs of older
persons with disabilities are included in the policies,
programmes and services designed to meet the needs of
persons with disabilities.
81. Special attention should be paid to the needs of
older persons with disabilities in the provision of
health and medical care services, rehabilitation,
assistive devices and other forms of support services.
82. The situation of older persons with disabilities
should be included in research, in the collection of
statistics and in the general monitoring of the living
conditions of persons with disabilities.
83. Public information and awareness-raising
campaigns should pay attention to the situation of older
persons with disabilities.
M. Developmental and psychiatric
disabilities
84. The two groups of persons, those with
developmental and those with psychiatric disabilities,
are different in regard to both the origin and the
character of their problems. However, both groups
belong to the most vulnerable among citizens of
society. Their disabilities are surrounded with more
negative attitudes and prejudice than most other groups
of persons with disabilities. Particularly in developing
regions and in countries with economies in transition,
the voice of persons with developmental and
psychiatric disabilities is seldom heard. Consequently,
their needs are often forgotten or neglected when plans
are made to improve the living conditions of persons
with disabilities.
85. One of the more serious weaknesses of the
Standard Rules is that the needs of persons with
developmental and psychiatric disabilities are not dealt
with in a satisfactory way. Areas such as health and
medical care, rehabilitation, support services, housing
conditions, family life and personal integrity are of
vital importance for both these groups. Their needs

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constituted an important perspective when these policy
areas were elaborated for this supplement.
86. States should ensure that the special needs of
persons with developmental and psychiatric disabilities
are respected in health and medical care, and in
rehabilitation and support services. Particular emphasis
should be given to issues of self-determination.
87. States should develop forms of support for
families who have children or adult family members
with developmental or psychiatric disabilities. Such
support may be necessary to make it possible for the
disabled person to live with the family.
88. Many adults with developmental or psychiatric
disabilities need special housing arrangements to be
able to cope with their situation. Small family-like
facilities (group homes) with sufficient support
services, sometimes provided within the framework of
independent living schemes, may be useful
alternatives.
89. States should ensure that the situation of persons
with developmental and psychiatric disabilities is
included in research, data collection and general
monitoring of the disability field.
90. States should encourage and support the
development of organizations representing the interests
of persons with developmental and psychiatric
disabilities, including self-advocacy groups and parent
action groups.
N. Invisible disabilities
91. An important group of persons with disabilities
are those who have disabilities that are not easily
discovered by others. This often leads to
misunderstandings and wrong conclusions. Among
such groups with invisible disabilities, the following
may be mentioned: persons with psychiatric or
developmental disabilities; those with disabilities from
chronic diseases; and those who are hard of hearing or
deaf.
92. In public awareness programmes, it is important
to include information about persons with invisible
disabilities and the special problems they may
experience.
93. It is also important to include the unique
characteristics of invisible disabilities when taking
measures towards full participation and equal
opportunities for persons with disabilities.
O. Suggested further initiatives in
national policy and legislation
94. As a result of the experience gained in the use of
the Standard Rules for a number of years and as a
consequence of the development in the human rights
area, the following general recommendations
concerning governmental policy can be made:
(a) States should introduce comprehensive
mandatory anti-discrimination laws to secure the
removal of obstacles to equal participation in
mainstream community life by persons with
disabilities. They should ensure the inclusion of
persons with disabilities among indigenous peoples and
other minorities in this process;
(b) States should consider the introduction of
mandatory legislation to ensure the provision of
assistive technologies, personal assistance and
interpreter services, according to the needs of persons
with disabilities, and those of their family caregivers,
as important measures to achieve equal opportunities;
(c) States should consider the use of public
procurement as a tool to obtain accessibility.
Accessibility requirements should be included in the
design and construction of the physical environment
from the beginning of the designing process;
(d) Legislative measures should also be
considered to encourage and support the development
of accessibility in transportation systems, housing, and
information and communication services;
(e) States should support and promote the
international exchange of research findings and
experiences and the dissemination of best practices in
all sectors of society;
(f) States should take action to include
reporting on the situation regarding persons with
disabilities in their periodic reports to the committees
of the various human rights conventions to which they
are parties. Information should be gathered and
submitted whether or not articles in each convention
refer specifically to persons with disabilities. States
should support the participation of organizations of
persons with disabilities and encourage them to express
their views during the review process;

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(g) Before making decisions on policies,
programmes and legislation that affect the lives of the
population generally, consequence analyses concerning
the effects on persons with disabilities should be made.