Building disability-inclusive health systems.

Health systems often fail people with disabilities, which might contribute to their shorter life expectancy and poorer health outcomes than people without disabilities. This Review provides an overview of the existing evidence on health inequities faced by people with disabilities and describes existing approaches to making health systems disability inclusive. Our Review documents a broad range of health-care inequities for people with disabilities (eg, lower levels of cancer screening), which probably contribute towards health differentials. We identified 90 good practice examples that illustrate current strategies to reduce inequalities. Implementing such strategies could help to ensure that health systems can expect, accept, and connect people with disabilities worldwide, deliver on their right to health, and achieve health for all.

A focus on disability is necessary to achieve HIV epidemic control.

Provision of inclusive services and reaching marginalised groups are crucial to achieving the UNAIDS 95-95-95 targets by 2030. However, people with disabilities are often left behind. This gap in HIV care provision is important because more than 1 billion people worldwide have disabilities, including a quarter of people living with HIV. The association between HIV and disability is bidirectional: HIV can cause a range of physical, sensory, and cognitive impairments and people with disabilities are at higher risk of acquiring HIV. People with disabilities often have lower levels of access and adherence to HIV treatment due to barriers with regard to the provision of services (eg, inadequate knowledge among health-care workers and inaccessibility of facilities) and the demand for services (eg, absence of autonomy and awareness of people with disabilities of HIV care needs and service availability). Ultimately, these barriers arise from failures at the system level, including poor governance, leadership, financing, and paucity of data.