During the last month’s Disability Summit in Buenos Aires, Argentinian disability rights activists carried signs that read “No al ajuste en discapacidad” — no to budget cuts for disability.
These protests followed a raft of drastic measures that have seen people stripped of potentially life-saving health insurance; denied rehabilitation that would allow them to live independently; and left without mental health care when they want and need it most.
How did it come to this? The full chain of events is complex. One crucial but insidious influence on the austerity policies now costing some of the most marginalized Argentinians so dearly is the conditions attached to the International Monetary Fund’s recent $56 billion loan.
Disability rights: An acid test for the health of any economy
Disability is primarily a social construct — the result of barriers that prevent persons with disabilities participating in society on an equal basis with others. These barriers range from inaccessible infrastructure, through to social stigma, and in many contexts, they leave people with disabilities disproportionately exposed to poverty in its multiple dimensions, and can even lead to institutionalization.
The U.N. Convention on the Rights of Persons with Disabilities, ratified by 177 countries, sets out a roadmap to achieving equality. But realizing the convention will be impossible unless adequate budget resources are set aside. The convention has implications across the budget process — including ensuring that education and the labor market are inclusive, making infrastructure and information accessible, ensuring that the judicial system can cater fully for persons with disabilities, and making sure that persons with disabilities can exercise their right to vote.
A decline in spending on the health rights of persons with disabilities sends a worrying sign about the budget as a whole — and signals in Argentina could not be more alarming.
Confronted with a lingering debt crisis worsened by vulture fund bailouts, Argentina turned to IMF in 2018 for a hefty $50 billion bailout loan, which came with harsh austerity strings attached. A few months later, after the first review, the austerity screws were tightened further, while the overall amount of the loan was raised to U.S. $56 billion.
The program includes measures such as wage bill reductions, pension reforms, cuts in public works, and budget cuts on both the federal and provincial level. Most health services fall under provincial authorities.
Such limited fiscal capacity poses risks for health outcomes and service delivery, which have clearly materialized in Argentina. Health organization Fundación Soberanía Sanitaria calculated that the global cut in the health sector for 2019 is about 8.1% in real terms compared to the 2018 budget. This affects the delivery of primary health care, hospitals, health care for persons with disabilities, and prevention of tropical diseases and epidemics.
All these cuts have taken a heavy toll, especially for persons with disabilities, who can have more difficulties accessing “mainstream” health services such as sexual and reproductive health care if adequate resources are not in place.
Several disability-specific programs have also been slashed, for instance, noncontributory pension schemes, health insurance, rehabilitation programs, as well as health services responding to disability-specific needs such as rights-compliant mental health care.
Austerity also affects wider socioeconomic living conditions, which can hit persons with disabilities disproportionately hard due to the extra costs that they face, and barriers in accessing an income.
Despite tough austerity, the IMF fiscal adjustment loan did not reverse negative GDP growth, and debt to gross domestic product ratios worsened. Poverty rates shot up in 2018 by 6%, leaving almost one-third of Argentinians in poverty, while unemployment increased to over 9%. Recent civil society analysis found that persons with disabilities are overrepresented among those in poverty and unemployment.
Putting people back at the heart of economic policy-making
Argentina’s IMF-supported policies have put narrow fiscal objectives ahead of the rights of marginalized people.
Argentina’s experience illustrates starkly why it’s so important that the starting point of any economic reform program be a comprehensive and participatory human rights impact assessment. This assessment should ensure reforms do not discriminate against marginalized groups — and that they are fully aligned with CRPD.
Earlier this year, the U.N. independent expert on debt and human rights presented a new set of Guiding Principles on Human Rights Impact Assessments of Economic Reforms. Crucially, the principles make clear that austerity is not the only option — that governments have an obligation to consider alternatives, and that international financial institutions must leave them the policy space to do so. In the case of Argentina, restructuring the country’s soaring debt burden would offer a fairer and more sustainable alternative to austerity.
The simple message of the protesters at the Disability Summit cannot be ignored any longer: In Argentina and beyond, it’s long past time to design an economy that delivers human rights for all.