States must take ‘all appropriate legislative, administrative, social, educational and other measures’ to protect persons with disabilities from all forms of exploitation, violence and abuse, ‘including their gender-based aspects’, ‘both within and outside the home’; States must secure their ‘physical and mental integrity on an equal basis with others’.⁸

Under article 11, States must guarantee that all measures adopted ‘to ensure the protection and safety of persons with disabilities in situations of risk, including armed conflict and humanitarian emergencies, are ‘in accordance with their obligations under international law, including international humanitarian law and international human rights law’.⁹ To ensure that legislation criminalising sexual violence protects persons with disabilities in conflict, it must be in accordance with principles of international humanitarian law and international human rights law.

Domestic legislation. To eradicate CRSV effectively, States should incorporate the Convention into their legislation¹⁰ and ‘take all appropriate measures, including legislation, to modify or abolish existing laws, regulations, customs and practices that constitute discrimination against persons with disabilities’.¹¹

Under the CRPD, ‘discrimination on the basis of disability’ means any distinction, exclusion or restriction on the basis of disability which has the purpose or effect of impairing or nullifying persons with disabilities’ human rights and fundamental freedoms in any field, on an equal basis with others. It includes all forms of discrimination, including denial of reasonable accommodation’.¹²

States should harmonise disability-related legislation and policies with the CRPD, including by transposing into domestic law the human rights model of disability¹³ and ‘a formal definition of disability, framed in conformity with article 1 of the Convention’.¹⁴

Article 5 on equality and non-discrimination similarly requires ‘inclusive laws, policies and practices in emergency situations’. States should ‘develop a comprehensive strategy and action plan with transparent and sustainable financial resources for the implementation of the Convention, with clear timelines, in close, meaningful and fully accessible consultation with organizations of persons with disabilities’.¹⁵

Reservations. Reservations that are incompatible with the object and purpose of the CRPD are not permitted.¹⁶ An example would be a reservation to article 12(4) concerning equal recognition before the law.¹⁷

The provisions of the CRPD extend to all parts of a State without any limitations or exceptions.¹⁸ The Committee has observed that ‘the human rights model of disability’ is to be adopted ‘across all policy areas and all levels and regions of all devolved governments and jurisdictions and/or territories’ under a State’s control. Implementation of the CRPD is not limited to a State’s territory only.¹⁹

States are under an obligation ‘to take all appropriate measures to eliminate discrimination on the basis of disability by any person, organization or private enterprise’ (‘such as service providers’).²⁰ This includes ‘preventing violence or violations of human rights, protecting victims and witnesses from violations, investigating, prosecuting and punishing those responsible, including private actors, and providing access to redress and reparations where human rights violations occur’.²¹

The CRPD recognises the crucial role that inclusive environments play in enabling and empowering persons with disabilities to exercise their human rights and fundamental freedoms. The Conference of States Parties to the CRPD²² has noted that the Convention requires States parties to ensure that environments, programmes and services ‘are fully inclusive for persons with disabilities through universal design, the elimination of obstacles to accessibility, the provision of reasonable accommodation and assistive technology, the elimination of discrimination and equal recognition before the law’.²³

In accordance with article 2, ‘universal design’ requires that all environments, programmes and services ‘be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design’. However, universal design must not ‘exclude assistive devices for particular groups of persons with disabilities where this is needed’. Reasonable accommodation, on the other hand, means necessary and appropriate modification and adjustments not imposing a disproportionate or undue burden, where needed in a particular case, to ensure to persons with disabilities their human rights and fundamental freedoms on an equal basis with others. A lack of ‘universal design’ and ‘reasonable accommodation’ creates social exclusion that, in turn, ‘engenders stigma, segregation and discrimination, which can lead to violence, exploitation and abuse in addition to negative stereotypes that feed into a cycle of marginalization of persons with disabilities’.²⁴

‘Universal design’ and ‘reasonable accommodation’ are crucial in conflicts, as persons with disabilities are ‘disproportionately affected in shocks and their aftermaths, disasters and other emergencies. They may face more obstacles when evacuating owing to a lack of accessible transportation, shelters or communications’. In this sense, accessibility can be ‘a matter of life and death’.²⁵ Under CRPD article 9, States must take measures to promote the accessibility of facilities and services that are open to the public. They may do so by transmitting ‘alarm signals through alternative modes of communication and information’,²⁶ recognising ‘sign language as an official language of the State party’,²⁷ providing ‘signage in Braille and easy to read forms’, facilitating the accessibility of buildings and promoting ‘the design and production of accessible information and communication technologies, including the Internet’.²⁸

Further, States must ensure that persons with disabilities have access, on an equal basis with others, to the physical environment, including ‘buildings, roads, transportation and other indoor and outdoor facilities, including schools, housing, medical facilities and workplaces’, and in information, communications and other services, ‘including electronic services and emergency services’.²⁹

Institutions. The Committee has noted that ‘those deprived of their liberty in places such as psychiatric institutions, on the basis of actual or perceived impairment, are subject to higher levels of violence, as well as to cruel, inhuman or degrading treatment or punishment and are segregated and exposed to the risk of sexual violence and trafficking within care and special education institutions’.³⁰ Women, in particular, face ‘involuntary undressing by male staff against the will of the woman concerned; forced administration of psychiatric medication; and overmedication, which can reduce the ability to describe and/or remember sexual violence’.³¹ States should recognise institutionalisation as a form of violence against persons with disabilities, and abolish all forms of institutionalisation, end new placements in institutions and refrain from investing in institutions.³²

In conflict, it is crucial that States ensure ‘that all persons with disabilities living in residential care institutions for persons with disabilities are accounted for and prioritize their evacuation from institutions located in places of armed hostilities’.³³ States should continue and accelerate efforts to close institutions, and include accelerated deinstitutionalisation in recovery efforts immediately, in meaningful collaboration with persons with disabilities and their representatives.³⁴ States should ensure that institutions are not rebuilt or repopulated after emergencies. States should provide adequate financial and human resources to ensure that persons with disabilities are not left behind in response and recovery processes; measures to do so include transferring funding from institutions to community support and services.³⁵

‘Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity’ is one of the principles of the CRPD.³⁶ States should care for the specific needs of persons with disabilities and be mindful of the multiple, intersecting ways in which certain individuals are discriminated against,³⁷ including on the grounds of ‘age, disability, ethnic, Indigenous, national or social origin, gender identity, political or other opinion, race, refugee, migrant or asylum seeker status, religion, sex and sexual orientation’.³⁸

Women. In its Preamble, the CRPD emphasises the need to incorporate a gender perspective in all efforts to promote persons with disabilities’ human rights and fundamental freedoms (such as their right to freedom from violence). States must also take all appropriate measures to ensure the full development, advancement and empowerment of women, to guarantee their human rights and fundamental freedoms, as set out in the Convention, including allocating appropriate human, technical and budgetary resources to that end.³⁹

To ensure that all measures are implemented in a gender-inclusive manner, States should ‘mainstream gender perspective in all general legislation, public policies and programmes, and in all frameworks’.⁴⁰ Further, they should reach out directly to women and girls with disabilities, fully take their perspectives into account and ensure that they will not be subjected to any reprisals for expressing their views and concerns, ‘especially in relation to sexual and reproductive health and rights, as well as gender-based violence, including sexual violence’.⁴¹

In conflict, women and girls with disabilities are at a heightened risk of sexual and gender-based violence compared with other women and girls.⁴² To ensure that women and girls with disabilities are not excluded ‘from access to humanitarian support and services to keep them safe from violence and exploitation’,⁴³ States should take an intersectional approach to disability inclusion in legislation, policies and programmes concerning emergency preparedness, response and recovery.⁴⁴ This includes, but is not limited to, ‘prioritized access to disability-inclusive relief programmes, health services, sexual and reproductive health services, habilitation and rehabilitation, assistive devices, personal assistance, housing, employment and community-based services’.⁴⁵

Children. Under article 7, States must take all necessary measures to ensure children with disabilities’ human rights and fundamental freedoms, ‘on an equal basis with other children’. In all actions concerning children with disabilities, the best interests of the child must be a primary consideration. Further, States must ensure ‘that children with disabilities have the right to express their views freely on all matters affecting them’, that their views are given due weight ‘in accordance with their age and maturity, on an equal basis with other children’, and that they are provided ‘with disability and age-appropriate assistance to realize that right’.

To prevent concealment, abandonment, neglect and segregation, States:

• Must undertake to provide ‘early and comprehensive information, services and support to children with disabilities and their families’;⁴⁶
• Should ensure that all children with disabilities are registered at birth;⁴⁷
• Must ensure that a child is not separated from their parents against their will, except when competent authorities subject to judicial review determine that it is in the best interests of the child. In no case can a child be separated from parents ‘on the basis of a disability of either the child or one or both of the parents’.⁴⁸ This is particularly important ‘in humanitarian contexts, where children are more likely to be separated from their carers and other support networks’.⁴⁹

Migrants. States are required to ‘mainstream disability into migration and refugee policies and into all humanitarian aid channels’, and provide all civil defence staff, rescue and emergency personnel and all potential actors involved in humanitarian emergencies’ with disability-awareness training.⁵⁰

States should ensure accessibility, reasonable accommodations and support measures for asylum seekers and refugees with disabilities at border crossings and in reception and accommodation facilities, including ‘accessible and understandable modes of information and communication’.⁵¹

The Conference of States Parties has stated that ‘the Convention applies in the territorial jurisdiction of a State Party irrespective of the nationality of the individuals with disabilities in need of protection, and the obligations of States Parties under the Convention therefore extend to persons with disabilities on the move’.⁵²

Detainees. In all settings, detention exposes persons with disabilities to a heightened risk of sexual violence. In accordance with article 14, States must ensure that persons with disabilities, on an equal basis with others, enjoy the right to liberty and security of person and are not deprived of their liberty unlawfully or arbitrarily. Any deprivation of liberty must be in conformity with the law, and the existence of a disability can never justify a deprivation of liberty.

States should ‘take immediate action to eliminate the use of solitary confinement, seclusion, physical and chemical restraints and other restrictive practices in places of detention’.⁵³

Under article 8(1), to create an environment that welcomes and protects persons with disabilities, States undertake to adopt immediate, effective and appropriate measures:

• To raise awareness throughout society, including at the family level, regarding persons with disabilities, and to foster respect for their rights and dignity;
• ‘To combat stereotypes, prejudices and harmful practices relating to persons with disabilities, including those based on sex and age, in all areas of life’. Women with disabilities are particularly exposed to compounded stereotypes that can be harmful.⁵⁴ Education plays a vital role ‘in combating traditional notions of gender that perpetuate patriarchal and paternalistic societal frameworks’. States parties must ensure access for and the retention of girls and women with disabilities in education and rehabilitation services, including by eliminating ‘harmful gender and/or disability stereotypes in textbooks and curricula’;⁵⁵
• To promote awareness of the capabilities and contributions of persons with disabilities.

Measures to this end include:

• Initiating and maintaining effective public awareness campaigns designed ‘to nurture receptiveness to the rights of persons with disabilities’, ‘promote positive perceptions and greater social awareness towards persons with disabilities’ and ‘promote recognition of the skills, merits and abilities of persons with disabilities’. States should ‘eliminate the use of offensive and pejorative language when reference is made to persons with disabilities’ and ‘increase the visibility of persons with disabilities in society’;⁵⁶
• Fostering at all levels of the education system, including in all children from an early age, an attitude of respect for the rights of persons with disabilities. States should also translate the Convention and its Optional Protocol and the Committee’s work into the local languages and disseminate it widely in accessible formats;⁵⁷
• Encouraging media to portray persons with disabilities in a respectful manner ;
• Promoting awareness-training programmes regarding persons with disabilities and the rights of persons with disabilities.

Conflict situations ‘have a disproportionate impact on the right to inclusive education’. States should adopt ‘inclusive disaster risk reduction strategies for comprehensive school safety and security in emergencies that are sensitive to learners with disabilities’. In accordance with article 11 on situations of risk and humanitarian emergencies, ‘and given the heightened risk of sexual violence in such settings’, States must take measures to ensure that learning environments are safe and accessible for women and girls with disabilities. Learners with disabilities ‘must not be denied access to educational establishments on the basis that evacuating them in emergency situations would be impossible, and reasonable accommodation must be provided’.⁵⁸

Training. States should promote the training of professionals and staff working with persons with disabilities in the rights recognised in the CRPD ‘so as to better provide the assistance and services guaranteed by those rights’.⁵⁹

Training ‘on recognizing all forms of exploitation, violence and abuse’ is essential.⁶⁰ In particular, States must ‘promote appropriate training for those working in the field of administration of justice, including police and prison staff’.⁶¹ The Committee has recommended that ‘awareness-raising should be provided for authorities, civil servants, professionals, the media, the general public and persons with disabilities and their families. All awareness-raising activities should be carried out in close cooperation with persons with disabilities through their representative organizations’.⁶²

States must ‘closely consult with and actively involve persons with disabilities, including children with disabilities, through their representative organizations’, ‘in the development and implementation of legislation and policies to implement the [CRPD], and in other decision-making processes concerning issues relating to persons with disabilities’.⁶³ The phrase ‘issues relating to persons with disabilities’ covers ‘the full range of legislative, administrative and other measures that may directly or indirectly impact the rights of persons with disabilities’.⁶⁴

Further, States must undertake to actively promote ‘an environment in which persons with disabilities can effectively and fully participate in the conduct of public affairs, without discrimination and on an equal basis with others, and encourage their participation in public affairs’.⁶⁵

States should give particular importance to the views of persons with disabilities through their representative organisations, support the capacity and empowerment of such organisations and ‘ensure that priority is given to ascertaining their views in decision-making processes’.⁶⁶ States should create an environment that enables the establishment and functioning of those organisations ‘by adopting a policy framework favourable to their establishment and sustained operation. This includes guaranteeing their independence and autonomy from the State, the establishment, implementation of and access to adequate funding mechanisms, including public funding and international cooperation, and the provision of support, including technical assistance, for empowerment and capacity-building’.⁶⁷

Consultations with persons with disabilities should begin ‘in the early stages and provide an input to the final product in all decision-making processes’, and include organisations representing ‘the wide diversity of persons with disabilities, at the local, national, regional and international levels’.⁶⁸ It is crucial that women and girls be involved, through their representative organisations, with ‘the design, implementation and monitoring of all programmes that have an impact on their lives’.⁶⁹ To that end, States should repeal ‘any law or policy that prevents women with disabilities from effectively and fully participating in political and public life on an equal basis with others’,⁷⁰ such as practices of ‘intimidation, harassment or reprisals against individuals and organizations promoting their rights under the Convention at the national and international levels’.⁷¹

As regards conflict situations, the Committee has urged States ‘to reform emergency response plans and protocols, in consultation with organizations of persons with disabilities, to make them inclusive of and accessible to persons with disabilities in their design and implementation’.⁷² Post-conflict, persons with disabilities are ‘largely excluded from peacebuilding efforts, often owing to prejudice’. The Conference of States Parties has stated that persons with disabilities ‘must be intentionally included in peace processes to enable them to actively participate in the formulation and implementation of agreements, to share knowledge and skills, to form movements and associations, and to become part of the peacebuilding process’.⁷³

‘To prevent the occurrence of all forms of exploitation, violence and abuse’, States must ‘ensure that all facilities and programmes designed to serve persons with disabilities are effectively monitored by independent authorities’.⁷⁴ States must ‘ maintain, strengthen, designate or establish within the State Party, a framework, including one or more independent mechanisms, as appropriate’, to promote, protect and monitor implementation of the CRPD.⁷⁵

When establishing such a mechanism, States must take into account ‘the principles relating to the status and functioning of national institutions for protection and promotion of human rights’ (the Paris Principles). Importantly, and in accordance with article 33(3), ‘civil society, in particular persons with disabilities and their representative organizations’, must be involved and ‘participate fully in the monitoring process’.

Recognising the importance of international cooperation and its support of national efforts for the CRPD’s implementation, States Parties should undertake measures between one another, and partner with relevant international and regional organisations and civil society, ‘in particular organizations of persons with disabilities’. Such measures may include:⁷⁶

• Ensuring that international cooperation, including international development programmes, is inclusive of and accessible to all persons with disabilities;⁷⁷
• Facilitating and supporting capacity-building, including through the exchange and sharing of information, experiences, training programmes and best practices;
• Facilitating cooperation in research and access to scientific and technical knowledge;
• Providing, as appropriate, technical and economic assistance, including by facilitating access to and sharing of accessible and assistive technologies, and through the transfer of technologies.

Occupying powers. In conflict, occupying powers should ensure that representatives and staff of international human rights and humanitarian institutions, ‘including United Nations specialized agencies’, have timely, unrestricted and safe access to persons with disabilities who are held in their territory or areas they have occupied, and share with such institutions a comprehensive list of transferred persons and their whereabouts.⁷⁸

The Committee has recommended that States ratify, among others:

• ‘Other international human rights treaties, including the Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment’;⁷⁹
• ‘The Convention relating to the Status of Stateless Persons (1954) and the Convention on the Reduction of Statelessness (1961)’;⁸⁰
• ‘The International Covenant on Civil and Political Rights and the Second Optional Protocol thereto’;⁸¹
• The Convention on the Elimination of All Forms of Discrimination against Women and its Optional Protocol;
• The Marrakesh Treaty;⁸²
• The Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence (the Istanbul Convention), where applicable.⁸³

In accordance with article 31(1), States ‘undertake to collect appropriate information, including statistical and research data, to enable them to formulate and implement policies to give effect to the [CRPD]’, including data ‘on cases of violence and abuse against persons with disabilities, particularly women and children’.⁸⁴

The process of collecting and maintaining this information must ensure confidentiality and respect for the privacy of persons with disabilities. Further, it must ‘comply with internationally accepted norms to protect human rights and fundamental freedoms and ethical principles in the collection and use of statistics’.⁸⁵

The information collected must be disaggregated, including ‘by sex, age, ethnicity, rural/urban population, impairment type and socioeconomic status’.⁸⁶ It must be used to help assess States Parties’ implementation of the CRPD and ‘to identify and address the barriers faced by persons with disabilities in exercising their rights’. States must also disseminate these statistics and ensure their accessibility to persons with disabilities.⁸⁷

In conflict, the Committee has recommended that States:

• Ensure that all persons with disabilities are accounted for, and collect and share data disaggregated by sex, age and disability;
• Ensure that all sectors integrate the collection of data disaggregated by sex, age and disability ‘into their interventions, and seek the input of all population groups affected by the conflict, including women and children with disabilities’;
• Require the use of ‘gender and disability markers in the allocation of funds for humanitarian interventions’.⁸⁸

States may include all data they have collected in their reports to the Committee. Under article 35, States must submit to the Committee ‘a comprehensive report on measures taken to give effect to its obligations under the [CRPD] and on the progress made in that regard, within two years after the entry into force of the [CRPD] for the State Party concerned’. After, States must submit subsequent reports ‘at least every four years and further whenever the Committee so requests’.

Recognising that ‘persons with disabilities have the right to recognition everywhere as persons before the law’ and ‘enjoy legal capacity on an equal basis with others in all aspects of life’,⁸⁹ States must enact effective legislation and policies, including women- and child-focused legislation and policies, to identify, investigate and, where appropriate, prosecute and properly sanction instances of exploitation, violence and abuse against persons with disabilities.⁹⁰

States must guarantee ‘appropriate forms of gender- and age-sensitive assistance and support for persons with disabilities and their families and caregivers, including through the provision of information and education on how to avoid, recognize and report instances of exploitation, violence and abuse’. Protection services must be age, gender, and disability sensitive.⁹¹

Additionally, independent and confidential complaints mechanisms should be made available to all persons with disabilities in all settings.⁹²

Under article 13, States ‘must ensure that all persons with disabilities have legal capacity and standing in courts’ and enjoy effective access to justice on an equal basis with others, ‘including through the provision of procedural and age-appropriate accommodations’, to facilitate their effective role as direct and indirect participants, including as witnesses, in all legal proceedings, including at investigative and other preliminary stages.⁹³

Recalling the International Principles and Guidelines on Access to Justice for Persons with Disabilities (2020),⁹⁴ accommodations include:

• Repealing all laws denying the legal capacity of persons with disabilities;⁹⁵
• ‘Substantial rights to legal aid, support and procedural and age-appropriate accommodations’;⁹⁶
• Eliminating barriers faced by women and girls with disabilities due to harmful stereotypes, discrimination and lack of procedural and reasonable accommodations such as ‘the absence of, or complicated or degrading reporting procedures, the referral of survivors to social services rather than the provision of legal remedies’ and restrictive procedural rules concerning witnesses and survivors.⁹⁷ States must abolish laws, regulations, customs and practices that discriminate against women with disabilities;
• Tackling the inaccessibility of legal information and procedures to report violations and abuses. For example, women and girls with disabilities who are subjected to gender-based violence ‘are often unaware of their rights and the remedies available to them’. States should ‘adopt measures to increase the legal awareness of persons with disabilities’ and provide information in accessible formats, ‘including Braille, tactile media, plain language, Easy Read and sign language’;⁹⁸
• Ensuring that persons with disabilities participate in the justice system as claimants, victims, defendants, judges, jurors and lawyers.⁹⁹

States must take ensure the protection and safety of persons with disabilities in situations of risk, including armed conflict.¹⁰⁰ This means:¹⁰¹

• ‘To include on an equal basis persons with disabilities in national emergency protocols’. The Committee has urged States to reform emergency response plans and protocols, in consultation with organizations of persons with disabilities, so that they have access to safe, voluntary evacuation to the area of their choice;¹⁰²
• ‘To fully recognize persons with disabilities in evacuation scenarios’, ‘in particular children with disabilities residing in institutions’¹⁰³ and ‘women and girls with disabilities, both civilians and former combatants, who were the victims of sexual violence during the conflict’.¹⁰⁴ States should prioritise persons with disabilities during emergency evacuations, ensuring that they are able to take their assistive devices and equipment with them during evacuation or, if not possible, to have them replaced;¹⁰⁵
• To provide for accessible information and communication helplines and hotlines. States should ensure that all emergency-related information is made available in their official languages, including those used by Indigenous communities,¹⁰⁶ and ‘in formats accessible to all persons with disabilities, regardless of type of impairment, including to deaf persons through sign language, and to persons with intellectual disabilities and persons with psychosocial disabilities through Easy Read and plain language’;¹⁰⁷
• To ensure that humanitarian aid relief is distributed in an accessible, non-discriminatory way to persons with disabilities in humanitarian emergencies;¹⁰⁸
• To systematically register internally displaced persons with disabilities and ensure an adequate standard of living for them for the duration of the conflict, including by safeguarding their access to social protection schemes (particularly for ‘women and girls with disabilities and older persons with disabilities’) and providing victims/survivors of sexual violence with accessible shelters;¹⁰⁹
• To ensure that water, sanitation and hygiene facilities are available and accessible for persons with disabilities in emergency shelters and refugee camps ‘or other communal shelters and informal settlements’ in accordance with articles 28 (on adequate standards of living and social protection) and 9 (on accessibility);¹¹⁰
• To ensure accessibility through universal design in all post-war reconstruction and rebuilding plans and strategies.¹¹¹

Health. In accordance with article 25, States recognise that persons with disabilities have the right to ‘the highest attainable standard of health without discrimination on the basis of disability. States must take all appropriate measures to ensure access for persons with disabilities to health services ‘that are gender-sensitive, including health-related rehabilitation’. In particular, they must:¹¹²

• Provide persons with disabilities with the same range, quality and standard of free or affordable health care and programmes ‘as provided to other persons, including in the area of sexual and reproductive health and population-based public health programmes’. As lack of access to sexual and reproductive health information can increase women’s risk of being subjected to sexual violence, health care and programmes should include information about ‘maternal health, contraceptives, family planning, sexually transmitted infections, HIV prevention, safe abortion and post-abortion care, infertility and fertility options, and reproductive cancer’, in accordance with the revised International Technical Guidance on Sexuality Education (2018) of the United Nations Educational, Scientific and Cultural Organization;¹¹³
• Provide ’emergency medical services for persons with disabilities who are victims of sexual violence’¹¹⁴ and ‘take the measures necessary to ensure that the autonomy and decisions of women with disabilities are respected, that women’s rights in relation to reproductive health are secured, that access to safe abortion is provided, and that women with disabilities are protected from forced sterilization and forced abortion’;¹¹⁵
• Build accessible gender violence recovery centres for women with disabilities;¹¹⁶
• Provide those health services needed by persons with disabilities specifically because of their disabilities, ‘including early identification and intervention as appropriate, and services designed to minimize and prevent further disabilities, including among children and older persons’;¹¹⁷
• Provide health services ‘as close as possible to people’s own communities, including in rural areas’ and in a ‘culturally adequate’ manner;¹¹⁸
• Require health professionals to provide care of the same quality to persons with disabilities as to others, including on the basis of free and informed consent by ‘raising awareness of the human rights, dignity, autonomy and needs of persons with disabilities through training and the promulgation of ethical standards for public and private health care’.¹¹⁹ All persons with disabilities, especially women and children, must be able to make their own decisions, with support when desired, ‘with regard to medical and/or therapeutic treatment’.¹²⁰ To that end, sign language interpreters should be made available in health centres;¹²¹
• Prohibit discrimination against persons with disabilities in the provision of health insurance and life insurance;
• ‘Prevent discriminatory denial of health care or health services or food and fluids on the basis of disability’.

In situations of conflict, State should also:

• As suggested by the Conference of States Parties, provide persons with disabilities with ‘critical public health information in alternative and appropriate formats, such as sign language interpretation, captioning, plain language and easy-read format, in accordance with articles 9 (Accessibility), 21 (Freedom of expression and opinion, and access to information) and 25 (Health)’;¹²²
• Ensure survivors of conflict have access to ‘health and rehabilitation services’, including additional health care as a result of acquired disabilities, ‘especially those with mental health and psychological needs’;¹²³
• In accordance with the Basic Principles for the Protection of Civilian Populations in Armed Conflicts and international humanitarian law, immediately cease attacks against civilians and civilian infrastructure, ‘including hospitals, clinics, rehabilitation centres, maternity units, ambulances and health-care workers’.¹²⁴

The Committee has consistently recommended that States provide remedies to victims/survivors of sexual violence,¹²⁵ including appropriate compensation.¹²⁶ Remedies also encompass rehabilitation.¹²⁷ Under article 16(4), States must ‘take all appropriate measures to promote the physical, cognitive and psychological recovery, rehabilitation and social reintegration of persons with disabilities who become victims of any form of exploitation, violence or abuse, including through the provision of protection services’. Such recovery and reintegration must take place ‘in an environment that fosters the health, welfare, self-respect, dignity and autonomy of the person and takes into account gender- and age-specific needs’.

Under article 26, States must organise, strengthen and extend habilitation (i.e., enabling persons with disabilities ‘to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life’) and rehabilitation services and programmes, ‘particularly in the areas of health, employment, education and social services’. These services and programmes must:

• Begin at the earliest possible stage;
• Be based on the multidisciplinary assessment of individual needs and strengths;
• Support participation and inclusion ‘in the community and all aspects of society;
• Be voluntary;
• Be available to persons with disabilities as close as possible to their own communities, including in rural areas.¹²⁸

Survivors of institutionalisation. In the provision of redress, States should acknowledge all human rights violations caused by the institutionalisation of persons with disabilities. States should adopt measures that are responsive to such violations and their impact on an individual’s life during and after institutionalisation, including ongoing, consequential and intersectional harm, in collaboration with survivors of institutionalisations.¹²⁹ Measures include:

• Formal apologies to survivors;
• Automatic compensation to survivors that is proportionate to the harm and consequential damages suffered and does not undermine survivors’ right to litigation or access to other forms of justice;
• Legal and social services to assist survivors’ reintegration in the community, including health services;
• The criminalisation of institutionalisation;
• Tailoring redress to survivors’ needs, losses, deprivation and longer-term desires and aspirations;
• The establishment of truth commissions to investigate and promote understanding of institutionalisations and the harm cause to all survivors.¹³⁰