World Health Assembly commits to boosting global access to rehabilitation

Rehabilitation needs are “largely unmet globally” and in many countries less than 50% of people receive the services they require, according to a “landmark” resolution adopted by the World Health Assembly in Geneva on Friday.

At the 76th World Health Assembly, World Health Organization (WHO) member states made a non-binding commitment to expand rehabilitation services to all levels of healthcare and to strengthen their financing mechanisms. Demand for the services is expected to grow as the burden of noncommunicable diseases rises globally, says the document.

This is the first time rehabilitation has been the subject of a World Health Assembly resolution, and public health advocates and patients called it a key moment.

“Today, there are 2.4 billion people living with conditions that may require rehabilitation. We may all require rehabilitation during our lives due to injuries or health conditions like cancer or diabetes,” said Valentina Pomatto from Humanity & Inclusion, a global organisation that supports people with disabilities.

“But rehabilitation services have been under-prioritised and not recognised as essential, especially in low and middle-income countries where resources are scarce.”

Rehabilitation, as defined by the WHO, includes assistive technology such as hearing aids, wheelchairs and prosthesis, as well as physical and psychological therapies and other interventions designed to help someone be “as independent as possible in everyday activities and enable participation in education, work, recreation and meaningful life roles”.

“Rehabilitation has played a huge role in my life – everyone who needs it should be able to benefit,” the 27-yearold Chanthou Thol from Cambodia told the Guardian. Thol was six when she was dragged under a petrol truck on her way to school. She lost a leg, her left arm and three fingers on her right hand.

Thol received physical therapy and prostheses at a rehabilitation centre run by Humanity & Inclusion. “I will never forget the day I received my leg. I felt I was born again,” she said. “I went back to school and I was much more independent.”

Today, Thol has a bachelor’s degree in English literature and hopes to find employment in Cambodia’s civil service, something she says she would have been unable to achieve without rehabilitation.

As in other low and middle-income countries, road traffic accidents in Cambodia are one of the leading causes of injuries and consequent demand for rehabilitation. More than 90% of the world’s fatal traffic accidents occur in low and middle-income countries, despite these countries having only 60% of the world’s motor vehicles.

Despite this, access to rehabilitative services in Cambodia is limited, mainly due to lack of funding and resources.

Pomatto hopes the resolution will prompt government and global funders to boost resources for rehabilitation in countries like Cambodia.

“Rehabilitation is not something people think about unless they need it,” said RaksmeyMutta Nguon, a young prosthetist and orthotist from Cambodia. Most young people in Cambodia

don’t know that a career in prosthetics is even possible, she said, and those who train in the profession usually hear about it through personal experience or word of mouth.

“We don’t have many prosthetists and orthotists in Cambodia – it’s hard and tiring work,” she added.

But Nguon is optimistic that things are slowly changing. Responsibility for rehabilitation is being shifted from the social affairs ministry to the health ministry – a small but important step, Nguon said. She hopes this will mean expanded services as well as more scholarships for young people hoping to train as prosthetists.

Thol said: “An accident like mine can happen anywhere to anyone. We need rehabilitation support over a lifetime, not as a one-off.”

Photograph: Suliane Favennec/AFP/Getty Images The WHO says that in many countries less than half of the people have access to the rehabilitation services they need.