Foreign Policy and Disability:


Legislative Strategies and


Civil Rights Protections


To Ensure Inclusion of People


with Disabilities


National Council on Disability


September 9, 2003 
National Council on Disability 

1331 F Street, NW, Suite 850 

Washington, DC 20004 

Foreign Policy and Disability: Legislative Strategies and Civil Rights Protections To 

Ensure Inclusion of People with Disabilities 

This report is also available in alternative formats and on NCD’s award-winning Web site 

(www.ncd.gov). 

Publication date: September 9, 2003 

202-272-2004 Voice 

202-272-2074 TTY 

202-272-2022 Fax 

The views contained in the report do not necessarily represent those of the Administration as 

this and all NCD documents are not subject to the A-19 Executive Branch review process. 
NATIONAL COUNCIL ON DISABILITY


An independent federal agency working with the President and Congress to increase the 

inclusion, independence, and empowerment of all Americans with disabilities. 

September 9, 2003


The President


The White House


Washington, D.C. 20500


Dear Mr. President:


On behalf of the National Council on Disability (NCD), I am submitting a report entitled Foreign Policy and


Disability: Legislative Strategies and Civil Rights Protections To Ensure Inclusion of People with Disabilities. This


report is a follow-up to NCD’s 1996 Foreign Policy and Disability report that found continued barriers to access


for people with disabilities in U.S. foreign assistance programs. 


In the 1996 report, NCD recommended a series of policy changes to ensure inclusion of people with disabilities in


all foreign assistance programs, including the establishment of specific objectives for inclusion with a timetable for


their fulfillment. Seven years later, NCD has concluded that inclusion of people with disabilities in U.S. foreign


policy will be achieved only when specific legislation is enacted to achieve that purpose. This report reviews a


number of models that Congress has adopted for linking human rights and foreign policy that can be adapted to


ensure the inclusion of people with disabilities. This report looks primarily at the U.S. Department of State and the


United States Agency for International Development (USAID). Among the various strategies and approaches to


improve foreign assistance policies and practices, NCD recommends that Congress amend the Foreign Assistance


Act to ensure inclusion of people with disabilities in all U.S. programs by requiring every U.S. agency operating


abroad to operate in a manner that is accessible and inclusive of people with disabilities. NCD recommends that this


be accomplished by, among other reforms, amending the Foreign Assistance Act to create a Disability Advisor at


the State Department and creating an office on Disability and Development at USAID. 


NCD also calls on your Administration to recognize that all U.S. government operations abroad should be brought


into compliance with Section 504 of the Rehabilitation Act and the Americans with Disabilities Act. 


The principles of non-discrimination, access, and inclusion of people with disabilities have been established as


civil rights. The reforms discussed in this report are needed to ensure that people with disabilities can fully


contribute to U.S. foreign policies and programs abroad as they have done so effectively at home. 


Sincerely, 

Chairperson 

(The same letter of transmittal was sent to the President Pro Tempore of the U.S. Senate and the Speaker of the


U.S. House of Representatives.)


1331 F Street, NW ■ Suite 850 ■ Washington, DC 20004 

202-272-2004 Voice ■ 202-272-2074 TTY ■ 202-272-2022 Fax ■ www.ncd.gov 
iiÄ
National Council on Disability Members and Staff 

Members 

Lex Frieden, Chairperson, TexasÄ

Patricia Pound, First Vice Chairperson, TexasÄ

Glenn Anderson, Ph.D., Second Vice Chairperson, ArkansasÄ

Milton Aponte, FloridaÄ

Robert R. Davila, Ph.D., New YorkÄ

Barbara Gillcrist, New MexicoÄ

Graham Hill, VirginiaÄ

Joel I. Kahn, OhioÄ

Young Woo Kang, Ph.D., IndianaÄ

Kathleen Martinez, CaliforniaÄ

Carol Novak, FloridaÄ

Anne M. Rader, New YorkÄ

Marco Rodriguez, CaliforniaÄ

David Wenzel, PennsylvaniaÄ

Linda Wetters, OhioÄ

Staff 

Ethel D. Briggs, Executive DirectorÄ

Jeffrey T. Rosen, General Counsel and Director of PolicyÄ

Mark S. Quigley, Director of CommunicationsÄ

Allan W. Holland, Chief Financial OfficerÄ

Julie Carroll, Attorney AdvisorÄ

Joan M. Durocher, Attorney AdvisorÄ

Martin Gould, Ed.D., Senior Research SpecialistÄ

Gerrie Drake Hawkins, Ph.D., Program SpecialistÄ

Pamela OíLeary, InterpreterÄ

Brenda Bratton, Executive AssistantÄ

Stacey S. Brown, Staff AssistantÄ

Carla Nelson, Office Automation ClerkÄ

iii 
ivÄ
Acknowledgments 

The National Council on Disability (NCD) wishes to express its appreciation to Eric Rosenthal, 

Executive Director, Mental Disability Rights International, and Professor Arlene Kanter, 

Syracuse University College of Law, who conducted research and coauthored this report. NCD 

would also like to acknowledge the contributions of Einat Hurwitz, New Israel Fund Fellow and 

LL.M. student at the Washington College of Law, who contributed to writing this report. 

v 
viÄ
Contents�

I. Executive Summary and Conclusions .................................................................................... 1Ä

II. Right to Inclusion in Foreign Policy and Assistance Programs ............................................. 11Ä

1. Background: Discrimination and Development .......................................................... 11Ä

2. History of Efforts to Ensure Inclusion ........................................................................ 17Ä

III. Current Foreign Assistance Legislation Regarding Human Rights ....................................... 29Ä

1. General Legislation ..................................................................................................... 31Ä

2. Rights-Specific Legislation ......................................................................................... 35Ä

IV. Current Civil Rights Protections ........................................................................................... 45Ä

1. Extraterritorial Application of the Disability Discrimination Laws ........................... 45Ä

V. Recommendations .................................................................................................................. 51Ä

1. GAO Should Conduct a Study of Current Practices ................................................... 51Ä

2. Amend the Foreign Assistance Act ............................................................................. 52Ä

3. Enforce the Application of the Rehabilitation Act of 1973 to U.S. GovernmentÄ

Programs Overseas ..................................................................................................... 57Ä

VI. Looking Ahead: The UN Disability Rights Convention ....................................................... 59Ä

VII. Appendix .............................................................................................................................. 61Ä

VIII. Endnotes .............................................................................................................................. 65Ä

vii 
viiiÄ
PART I. 

Executive Summary and Conclusions 

More than 600 million people, almost 10 percent of the worldís population, have a disability. 

This number will rise dramatically in the coming years as the population ages and as more people 

become disabled by AIDS. Rates of disability are particularly high in post-conflict societies, 

among refugee populations, and in countries with histories of political violence. Even in stable 

societies, however, people with disabilities make up the poorest of the poor. In some of the 

worldís poorest countries, according to the United Nations (UN), up to 20 percent of the 

population has a disability. 

Individuals with disabilities are subject to a broad pattern of discrimination and segregation in 

almost every part of the world. In most countries, people with disabilities and their families are 

socially stigmatized, politically marginalized, and economically disadvantaged. The economic 

cost to society of excluding people with disabilities is enormous. No nation in the world will 

achieve its full potential for economic development while it leaves out people with disabilities. 

No society will be a complete democracy unless people with disabilities can participate in public 

life. Failure to respond to the concerns of people with disabilities ignores one of the great 

humanitarian and human rights challenges of the world today. 

The United States is well positioned to lead the world in demonstrating how to build on the 

tremendous human potential of people with disabilities. It is among the world leaders in 

protecting the civil rights of people with disabilities, with legislation that seeks to ensure their 

full participation in society, and in supporting their independent living. The Americans with 

Disabilities Act (ADA) represents a sweeping commitment on the part of the U.S. government 

to abolish discrimination against people with disabilities in all walks of life. Since the adoption 

of the Rehabilitation Act in 1973, U.S. civil rights laws have required all U.S. government 

programs to be inclusive of and accessible to people with disabilities. As they have exercised 

1Ä
their rights over the past 30 years, Americans with disabilities have broken barriers to inclusion, 

shattered stereotypes about their limitations, and contributed to the economic, cultural, and 

political life of the nation. 

At present, U.S. foreign policy does not reflect the great accomplishments of people with 

disabilities within the United States. U.S. citizens with disabilities cannot serve in many 

embassies abroad because these buildings are physically inaccessible. Qualified and talented 

individuals may be excluded from U.S. government service abroad based on their medical 

history. In addition to failing to protect U.S. citizens with disabilities in foreign operations, U.S. 

foreign policies and programs have generally not been designed to respond to the concerns of 

individuals with disabilities abroad. While the Foreign Assistance Act has long established that 

ìa principal goal of the foreign policy of the United States shall be to promote the increased 

observance of internationally recognized human rights by all countries,î1

 the rights of people 

with disabilities have been long ignored. 

The U.S. National Council on Disability (NCD) calls on the Executive Branch and Congress to 

create a new foreign policy that ensures access by people with disabilities to the benefits of 

democracy and economic development around the world. All U.S. foreign operations abroad 

(including foreign assistance efforts) would be greatly improved if the principles established in 

U.S. civil rights lawóunder the Rehabilitation Act and the ADAówere applied to U.S. 

operations abroad. Such a policy would require U.S. foreign assistance funding to be used in a 

manner that is accessible to people with disabilities. Such protections would also ensure that U.S. 

citizens and contractors with disabilities would be protected against discrimination in the 

implementation of U.S. programs abroad. Leadership by U.S. citizens with disabilities in our 

foreign operations would greatly improve our ability to respond to the concerns of people with 

disabilities in other countries. 

In 1996, NCD issued a report on foreign policy and disability that found that U.S. programs abroad 

did not conform to the letter or spirit of U.S. disability rights law. On the basis of recent legal 

2Ä
developments, this paper demonstrates that current U.S. disability discrimination laws may now 

be found to apply to U.S. foreign programs operating abroad. NCD recommends that Congress 

instruct the State Department and United States Agency for International Development (USAID) 

to apply the protections of the Rehabilitation Act and the ADA to U.S. operations abroad. 

In addition to extending civil rights protections that would govern the operation of all U.S. agencies 

abroad, NCD recommends the adoption of specialized new legislation to ensure the inclusion of 

people with disabilities in foreign assistance. Such legislation would also greatly improve the 

effectiveness of U.S. efforts to promote human rights and economic development worldwide. 

One major source of evidence that guides U.S. human rights policy is the State Department 

Country Reports on Human Rights Practices. In recent years, the State Department Bureau of 

Democracy, Human Rights and Labor (DRL), has made an important step in the right direction 

by adding a section on disability rights to the Country Reports. This documentation has already 

had a valuable impact on promoting the rights of people with disabilities.2 But the information 

about disability rights in Country Reports is extremely limited and does not begin to paint a full 

picture of the scope of human rights violations to which people with disabilities are subjected 

throughout the world today: de jure discrimination against people with disabilities that excludes 

them from jobs; de facto discrimination that permits exclusion from inaccessible public services 

or transportation systems; physical and linguistic barriers to participation in public life; denial of 

public education to people with developmental disabilities; failure to provide medical care to 

children with disabilities; and arbitrary detention in psychiatric or social facilities where people 

with disabilities are left to languish in some of the most inhuman and degrading conditions 

known to humankind. 

State Department DRL staff have explained that the lack of information about human rights 

violations against people with disabilities in the Country Reports is a product of the fact that 

there are so few nongovernmental human rights or disability rights organizations conducting 

investigations and documenting abuses. DRL relies extensively on such information for its 

3Ä
reports. Both DRL and USAID provide funding and assistance to support civil society and 

human rights programs abroad. To date, these programs have not sought to fill the gap in human 

rights documentation or advocacy for people with disabilities. 

Despite the tremendous hardships faced by people with disabilities around the world, a 1991 

investigation by the General Accounting Office (GAO) found that the major U.S. foreign 

assistance agencies do not include the concerns of people with disabilities as a priority or as a 

goal of specific programs. In 1996, NCD issued a report on U.S. foreign policy and disability and 

found continued barriers to access for people with disabilities. The 1996 NCD Report 

recommended a series of policy changes to ensure inclusion of people with disabilities in all 

foreign assistance programs, including the establishment of specific objectives for inclusion with 

a timetable for their fulfillment. 

In response to the 1996 NCD Report, USAID adopted a Disability Policy. USAID accepted 

NCDís recommendation to include people with disabilities in all its programs, but it dedicated no 

resources for this purpose. The USAID Disability Policy includes no specific objectives or 

timetables, creates no new initiatives to reach out to people with disabilities, and does not require 

U.S. Missions abroad to change their practices. Disability experts working abroad have reported 

that the vast majority of staff at U.S. Missions abroad are unaware of USAIDís Disability Policy. 

USAID has issued a series of three valuable self-evaluations on its own efforts to include people 

with disabilities. These reports provide documentation of USAIDís implementation of its 

Disability Policyóor the lack thereof. The most recent survey of activities by USAID Missions 

finds ìinclusion of PWDs in significantly more projects than in the 2000 and 2002 reports.î The 

2003 report concludes that ì[a]lmost all USAID programs have the potential to prevent disability 

or to enhance the lives of people living with disability. Except where there is specific legislation, 

however, relatively few programs give systematic thought to including people with disabilities in 

their design and implementation. The Congress has expressed interest in programs to assist the 

4Ä
disabled and USAID has been responsive, for example, through the Leahy War Victims Fund and 

the Victims of Torture Fund.î 

The 2003 USAID report describes a number of important programs for people with disabilities 

and finds ìan increasing variety of activities that target or include people with disabilities.î These 

programs demonstrate how disability issues can be incorporated into USAIDís existing work 

where there is a will to do so. When U.S. agencies operating abroad have focused on the 

concerns of people with disabilities, they have demonstrated that it is both practical and costeffective to create appropriate accommodationsóeven in some of the poorest countries of the 

world. In the post-war reconstruction of Afghanistan, for example, USAID adopted a policy of 

making new structures accessible to people with disabilities. This program has reportedly helped 

people with disabilities in Afghanistan at little additional cost to the United States. By planning 

ahead, U.S. assistance programs in Afghanistan avoided the future costs of retro-fitting buildings 

and public thoroughfares for people with disabilities. All Afghanis benefit because this policy 

ensures that the human potential of people with disabilities contributes to the growth of the 

society as a whole. Without legislation to ensure an approach like the one adopted in 

Afghanistan, however, there is no guarantee that rebuilding efforts in other countriesósuch as 

Iraqówill follow the same pattern. Indeed, the U.S. contracts that have been awarded to large 

American construction companies to rebuild the infrastructure in Iraq do not require that new 

construction be accessible to people with disabilities. As this report goes to press, it is not too 

late for Congress to act to require that all reconstruction efforts by the U.S. military as well as by 

private U.S. contractors in Iraq be accessible to and inclusive of people with disabilities. 

Seven years after NCDís initial Report on Foreign Policy and Disability, NCD issues this followup paper to examine legislative options and civil rights protections to ensure inclusion of people 

with disabilities in U.S. foreign policy. NCD has come to the conclusion that legislation is 

necessary to ensure the inclusion of people with disabilities in foreign affairs. This report reviews 

5Ä
a number of models that Congress has adopted for linking human rights and foreign policy. 

These laws provide models that can be adapted to ensure the inclusion of people with disabilities. 

The legislative reforms and new foreign assistance programs proposed by NCD do not amount to 

special privileges for people with disabilities. The principles of nondiscrimination, access, and 

inclusion of people with disabilities have been established as civil rights. The new initiatives 

NCD proposes are similar to programs already established by the United States for women and 

vulnerable populations. These reforms are needed to ensure that people with disabilities can fully 

contribute to U.S. foreign policies and programs abroad as they have done so effectively at home. 

Summary of Recommendations 

The following is a summary of NCDís recommendations. More detailed recommendations 

appear in Part V of the report. While NCDís recommendations are primarily directed at 

Congress, the Department of State, and USAID, the Department of Defense and other agencies 

operating abroad can take up many of these recommendations immediately without further action 

by Congress. 

NCD calls on the Bush Administration to recognize the extraterritorial application of Titles II 

and III of the Americans with Disabilities Act and Sections 501, 503, and 504 of the 

Rehabilitation Act. All U.S. government operations abroad should be brought into compliance 

with these laws. 

NCD recommends that Congress: 

Instruct the State Department and USAID that Sections 501, 503, and 504 of the 

Rehabilitation Act apply to overseas operations of the U.S. government. This will ensure 

that civil rights protections against discrimination on the basis of disability apply to U.S. 

government employees and contractors working abroad. It will also ensure that all U.S.-

funded programs are used in a manner that is accessible to and inclusive of people with 

6Ä
disabilities. Similarly, the ADA is intended to ensure that U.S. corporations operating 

abroad are prohibited from discriminating against U.S. citizens with disabilities. 

NCD recommends that Congress amend the Foreign Assistance Act or adapt other 

legislation to: 

Create a Disability Advisor at the U.S. Department of State to serve as a leader in the 

development of U.S. international disability policy and to ensure that respect for disability 

rights is included in U.S. bilateral and multilateral policies and programs, complete with a 

staff and resources to carry out the work of this advisor. The advisor and staff should be 

composed of a strong contingent of people who have personal experience with disability 

and disability advocacy as well as the necessary technical expertise. 

Require documentation of disability rights violations in Department of State 

Country Reports–Congress should act to ensure that reliable and detailed 

documentation of the full scope of worldwide discrimination and abuse of people with 

disabilities is obtained and made available to policymakers and the public. The State 

Department DRL, which produces annual Country Reports on Human Rights Practices, 

has already demonstrated a willingness and an ability to provide this documentation in an 

effective manner. Congress should provide DRL with the additional funds needed to 

further improve its coverage of people with disabilities in the Country Reports. The 

Department of State should be required by law to report on human rights violations 

against people with disabilities wherever they occur. Where reliable information about 

human rights conditions of people with disabilities is not available, DRL staff should 

(1) investigate some of the more common human rights violations against people with 

disabilities and/or (2) provide grants to independent nongovernmental disability 

organizations and mainstream human rights organizations to provide necessary 

documentation (grants may be coordinated with the proposed USAID Fund for Inclusion, 

described below). 

7Ä
Ensure inclusion of people with disabilities in all U.S. programs abroad by providing 

a broad legal mandate to require every U.S. agency operating abroad to operate in a 

manner that is accessible and inclusive of people with disabilities. This mandate 

should apply to all aspects of U.S. foreign assistance, including economic development, 

disaster relief, and human rights programs. All new investments in physical infrastructure 

using U.S. government funds, including U.S. military construction programs, should be 

accessible to people with disabilities. Legislation should require all U.S. agencies 

operating abroad to develop plans to ensure that the concerns of people with disabilities 

are among their priorities. Specific action steps for the inclusion of people with disabilities 

should be included in the strategic plans of all USAID divisions (including, but not limited 

to, such programs as democracy and governance, cultural exchange, health, economic 

development, disaster relief, and rebuilding post-conflict societies). 

Create an office on Disability in Development (DID) at USAID, similar to the USAID 

office of Women in Development (WID), responsible for promoting the inclusion of 

people with disabilities in all USAID programs. As with WID, Congress should set aside 

funds for the operation of the DID office. Unlike WID, however, the DID office should 

be incorporated into one of the main substantive divisions or ìpillarsî of USAID to 

ensure the office is not isolated and that disability programs are effectively mainstreamed 

into a broad array of existing programs. The DID office will provide technical assistance 

to other USAID offices to assist them in developing appropriate accommodations and 

outreach programs to ensure the inclusion of people with disabilities in all existing areas 

of USAID programming. The DID office will ensure that annual and long-term strategic 

plans at all USAID offices include provisions requiring that concrete steps be taken to 

ensure the inclusion of people with disabilities. The DID office will administer a 

Disability Rights Fellowship that will place technical experts on disability issues in U.S. 

Missions abroad. Congress should set aside sufficient funds to permit DID to assist all 

U.S. Missions and to place a Disability Rights Fellow in the majority of USAID Missions 

8Ä
abroad. The Disability Rights Fellows should be composed of a strong contingent of 

people who have personal experience with disability and disability advocacy as well as 

the necessary technical expertise. 

Establish a Fund for Inclusion, Leadership, and Human Rights of People with 

Disabilities (referred to as the Fund for Inclusion). The Fund for Inclusion will be a 

grants program designed to promote the participation of people with disabilities in all 

aspects of U.S. foreign assistance programs. The Fund for Inclusion will 

Support the creation, development, and viability of nongovernmentalÄ

organizations (NGOs) made up of people with disabilities around the world; Ä

Promote educational exchanges, technical assistance, and collaboration amongÄ

U.S. disability rights groups, foreign governments, human rights organizations,Ä

and disability leaders abroad;Ä

Assist governments in drafting enforceable disability rights legislation and assistÄ

NGOs in proposing and promoting such legislation; andÄ

Establish independent human rights oversight, advocacy, and enforcementÄ

programs for people with disabilities.Ä

The Fund for Inclusion shall be used to support the work of U.S.-based disabilityÄ

organizations to provide technical assistance abroad or to serve as cooperatingÄ

partners in the development of disability programs by USAID. Congress shouldÄ

allocate substantial resources to this program at least as large as other specializedÄ

programs for other vulnerable populations. Ä

New initiatives in post-conflict societies should make people with disabilities a 

priority–USAID and U.S. military programs in post-conflict societies should recognize 

that (1) war and conflict lead to high levels of disability, (2) the health and safety of 

people with disabilities are particularly at risk in post-conflict societies, and (3) it is most 

cost-efficient to plan for the inclusion of people with disabilities when new investments 

9Ä
are being made in the built environment. Thus, inclusion of people with disabilities 

should be a priority in the immediate aftermath of major conflicts and disasters. 

Inclusion should be a required part of the Millennium Challenge Account–The 

proposed Millennium Challenge Account, which would establish a development program 

parallel to USAID, should be required to include people with disabilities from the outset. 

Request the GAO to document access to people with disabilities in current U.S. 

governmentñfunded programs. GAO will complete the task it set for itself in 1991 to conduct a 

thorough examination of the procedures and directives that guide the Department of State in the 

construction and renovation of facilities abroad to ensure accessibility to people with disabilities. 

Support the drafting of a UN Disability Rights Treaty–In addition to amending the Foreign 

Assistance Act, NCD calls on Congress and the Bush Administration to demonstrate their 

commitment to the international human rights of people with disabilities by supporting the 

drafting of a new UN Convention on the Rights of People with Disabilities in the spirit of the 

ADA and other civil rights laws that will bring about the full inclusion of people with disabilities 

in society. 

U.S. agencies operating abroad should establish guidelines for the implementation of the 

Rehabilitation Act in their programs abroad. The Department of State and other U.S. agencies 

should initiate a planning process to ensure the inclusion of people with disabilities into all their 

programs abroad. NCD supports the principle, recognized in the current USAID Disability 

Policy, that people with disabilities should be included in all existing foreign assistance 

programs. NCD requests that USAID make this policy an agency commitment that is binding in 

all programs run by U.S. Missions abroad and a mandatory part of all USAID grants and 

contracts. USAID should establish a program for fully implementing this commitment and 

should incorporate this program into its main strategic plans. Other U.S. government agencies 

operating abroad should establish similar policies. 

10Ä
PART II.

Right to Inclusion in Foreign Policy and Assistance Programs 

1. Background: Discrimination and Development 

People with disabilities are subject to economic and social marginalization, segregation, 

discrimination, and a broad range of other civil and human rights violations around the world.3 

Three UN Special Rapporteurs have found that individuals with disabilities experience 

discrimination in employment, housing, health services, public accommodations, education, 

transportation, communication, recreation, voting, and opportunities for political participation on 

every continent.

4

 With 600 million people with disabilities in the world, of whom 80 percent are 

in developing countries,5 the scope of this problem is enormous.6 UN Special Rapporteur 

Leandro Despouy found in 1991 that ìmillions of children and adults [with disabilities] 

throughout the world are segregated and deprived of virtually all their rights and lead a wretched, 

marginal life.î7 This yearís State Department Country Reports on Human Rights Practices refers 

to only a small number of the worldís human rights violations against people with disabilities, 

but they are valuable examples of the deprivations that could be addressed through political 

pressure or targeted foreign assistance.8 NGOs have documented severe human rights abuses 

against people with disabilitiesóincluding arbitrary detention in institutions, where people are 

subject to inhuman and degrading treatment, and life-threatening conditions.9 

People with disabilities are among the poorest of the poor in most developing nations. A recent 

study done by the World Bank found that people with disabilities have less access to education 

and lower income levels than the rest of the population and are thus more likely to live below 

poverty levels than the rest of the population in most countries.10 A report by the British 

Department for International Development cites statistics that ìmortality for children with 

disabilities may be as high as 80 percent even in countries where under-five mortality as a whole 

has decreased below 20 percent. In certain cases there seems to be a ëweeding outí of children 

with disabilities, the ëmissing childrení.î11 

11Ä
The problem of AIDS in developing nations is closely linked with issues of disabilities. People 

living with AIDS may acquire a broad range of physical or mental disabilities. Failure to 

accommodate the disabilities associated with AIDS may exclude individuals from the economic 

and social support systems they need to care for themselves. Failure to provide education in 

AIDS prevention in a manner that is accessible to people who are blind, deaf, or mentally 

disabled leaves this population particularly at risk of AIDS. 

The lack of protection against discrimination and exclusion of people with disabilities leads to 

economic hardship and a loss of productive capacity in every society.

12 Even in societies with 

no active exclusion of people with disabilities, the experience of human rights violations, 

economic hardship, stigma, and the lack of opportunities for leadership limits the access of 

people with disabilities to participation in public life. Without representation of the skills, 

experiences, and voices of people with disabilities, representative democracy in any society will 

not be fully effective. 

The 1993 World Development Report of the World Bank has documented the enormous cost to 

society of excluding people with disabilities from economic opportunities.13 Foreign assistance 

programs of other major donor nations are increasingly cognizant of the fact that discrimination 

against people with disabilities impedes economic development. As described by the British 

Department for International Development in its study Disability, Poverty, and Development, 

Disability does not just affect the individual, but impacts on the whole community. 

The cost of excluding people with disabilities from taking an active part in the 

community life is high and has to be born[e] by society, particularly those who take 

on the burden of care. This exclusion often leads to losses in productivity and human 

potential. The UN estimates that 25 percent of the entire population is adversely 

affected in one way or another as a result of disabilities.14 

The British study describes a ìvicious cycleî of disability and poverty. For example, ì[p]eople 

with disabilities who are denied education are then unable to find employment, driving them 

more deeply into poverty.î Thus, the British foreign assistance program recognizes that 

specialized programs to attack barriers to participation by people with disabilities are needed: 

[G]eneral improvements in living conditions will not be enough. Specific steps are 

still required, not only for prevention, but also to ensure that people with disabilities 

12Ä
are able to participate fully in the development process, obtain a fair share in the 

benefits, and claim their rights as full and equal members of society.

15 

The British foreign assistance programs specifically target the problem of discrimination as the 

root cause of many of the costs associated with disability: 

There is increasing recognition that the term disability does not simply express a 

medical condition but a complex system of social restrictions emanating from 

discrimination. Empowerment, participation and equal control become the means of 

overcoming disability, rather than medical care alone.

16 

The Norwegian government has adopted a similar approach that supports active participation by 

people with disabilities and human rights protections as a way to promote both economic and 

social development.17 

The World Bank has also adopted a new program to incorporate disability into its activities.18 

The cofounder of the World Institute on Disability and a former Assistant Secretary of Education 

is the newly appointed World Bank Disability Advisor. The World Bank program is premised on 

the idea that economic development and the inclusion of people with disabilities are closely 

linked.19 The World Bank disability program anticipates that disability issues will become 

increasingly important in the years to come. The proportion of persons with disabilities is 

growing because of increased aging of the world population and because of the worldwide 

problem of AIDS/HIV. The World Bank policy also recognizes the special vulnerability of 

people with disabilities in war-torn countries and post-conflict societies. The World Bank policy 

on disability recognizes that increasing the participation and opportunities for persons with 

disabilities results in economic and social benefits for the whole society.

20 

While the United States does not have a formal disability and foreign policy program, it is one of 

the worldís leaders in developing civil rights protections for people with disabilities at home. 

In domestic U.S. law, there has been a 30-year public commitment to banning discrimination and 

promoting full participation of people with disabilities in public life. The Rehabilitation Act of 

197321 protects people with disabilities against discrimination by the U.S. government, and it 

bars federal funds from programs that are not fully accessible to people with disabilities. When 

President Bush signed the ADA22 in 1990, the United States extended its commitment to 

13Ä
protection against discrimination to private individuals and entities. The ADA is a powerful 

statement of the U.S. commitment to full inclusion, equality of opportunity, independent living, 

and economic self-sufficiency for people with disabilities. As described by NCD, 

The unparalleled legal protection given Americans through the Rehabilitation Act, 

ADA, and other disability rights laws won the admiration of people with disabilities, 

human rights activists, and people of goodwill around the world. These laws 

underscore the authority of the United States to speak not only as a rich and powerful 

nation but also as a good and moral one. By demonstrating its strong commitment to 

the equality of all people, including those with disabilities, the United States 

strengthened its global position. Disability policy fits naturally with foreign policy.

23 

Overview 

In 1996, NCD issued a report, Foreign Policy and Disability, to examine the role of people with 

disabilities within U.S. foreign policies and programs abroad. Based on a review of federal laws 

and regulations as well as U.S. foreign policies and practices (including a questionnaire 

completed by selected U.S. embassies abroad), the 1996 NCD Report found a broad failure to 

include people with disabilities in foreign policy. 

This report is a follow-up to the 1996 report. This paper documents the lack of progress in 

developing new policies since 1996 to ensure the inclusion of people with disabilities within U.S. 

foreign programs. This paper offers legislative and policy recommendations to ensure a legally 

enforceable right of access to people with disabilitiesóas participants in policymaking and as 

subjects or beneficiaries of policies and programs. Unlike the 1996 NCD Foreign Policy and 

Disability report, this paper is not an empirical analysis of the operation of programs in the field. 

Such an analysis is needed, and NCD recommends that Congress request the General Accounting 

Office (GAO) to conduct a thorough examination of the extent to which people with disabilities 

have access to U.S. programs abroad. This paper does draw on the field experiences and policy 

recommendations of a working group of disability rights, womenís rights, and international 

human rights experts convened by NCD in 2000 and 2002. 

Part II of this paper provides background on the reasons people with disabilities should be 

included in U.S. foreign policy. It examines efforts over the past decade to accomplish this goal 

of inclusion, including NCDís 1996 recommendations. 

14Ä
Part III of this paper examines current laws that may be used to ensure the inclusion of people 

with disabilities in foreign policies and programs, including provisions of the Foreign Assistance 

Act, which currently require a linkage between human rights and foreign policy. Part II also 

examines other legislation, such as laws requiring the inclusion of women in development, that 

can be used as models and adapted to promote the inclusion of people with disabilities in foreign 

assistance programs. 

Part IV examines U.S. civil rights protections and evaluates the extent to which programs funded 

by the U.S. government are now legally required to protect against discrimination and ensure 

equal access to people with disabilities. The 1996 NCD Foreign Policy and Disability report 

found that U.S. programs abroad did not conform to the letter or spirit of U.S. disability rights 

law. The 1996 Report assumed, however, that U.S. disability rights laws were not binding on 

U.S. programs abroad. Recent developments in case law suggest that current disability 

discrimination law is applicable to U.S. foreign programs operating abroad. These new cases 

provide a basis for the extraterritorial application of both the Rehabilitation Act of 1973 and the 

ADA. Congress has already amended Title I of the ADA to apply to employees of American 

companies overseas. Congress should now instruct the State Department and USAID, as well as 

other federal agencies, that the Rehabilitation Act and Titles II and III of the ADA also apply 

overseas, require that U.S. offices and U.S.-funded buildings abroad be physically accessible, and 

ensure that U.S. citizens with disabilities are protected against discrimination in U.S. government 

programs and activities overseas. 

Part V provides detailed recommendations for legislative and policy changes needed to ensure 

the inclusion of people with disabilities in U.S. foreign policy and programs abroad. 

Part VI concludes with a look ahead to the development of a UN Convention on the Rights of 

People with Disabilities. 

NCD recognizes that the reform of foreign assistance programs to ensure full inclusion of people 

with disabilities is an enormous challenge and that foreign assistance agencies are already 

overwhelmed by demands that require them to stretch very limited resources. The inclusion of 

people with disabilities will be possible only if this process is not set up as one more ìspecial 

15Ä
interestî group that drains resources from the common goal of development. With appropriate 

planning and project designóand the incorporation of lessons learned from successful programs 

implemented in the United States and around the worldódevelopment for all people will be 

more effective if people with disabilities are included. 

NCD also recognizes that inclusive development will require that accommodations be made in a 

broad range of programs, including programs to support economic growth, democratization, 

human rights, health, education, and other areas of development. The population of people with 

disabilities is enormously diverse in any country, and the reforms that would be needed to bring 

about their full participation in society are tremendously varied. Following are only a few of the 

most common challenges: buildings, streets, transportation, medical services, schools, and other 

public accommodations must be physically accessible; communication systems must be adapted 

for people who are deaf; public information must be accessible to people who are blind; 

educational programs must be appropriate for children with developmental disabilities; mental 

health services should not segregate people from society in closed facilities; counseling services, 

womenís shelters, and rights protection programs must be established to reflect the fact that 

women and girls with disabilities are subject to double discrimination in society and require 

protections against physical and sexual abuse in the family and in the very social programs 

created by society to serve them; workplaces should be adapted to provide qualified individuals 

with disabilities with the opportunity to earn a living and establish their economic independence; 

and all people with disabilities should have the right to vote and the opportunity to participate in 

cultural, social, and political life. The civil rights protections needed to ensure access for a 

qualified individual with a disability in an employment setting are enormously different from the 

human rights needs of a child with a disability living in poverty who is denied access to medical 

care. International development programs must respond to each of these varied challenges. 

The U.S. disability movement has experience in crafting effective responses to these challenges in 

the United States and abroad. To date, this experience is a largely untapped resource available to 

the international development community. People with disabilities in the United States are eager 

to lend their expertise in developing accessible and appropriate programs that meet the needs of 

people with disabilitiesóand that promote the most effective development for all people. 

16Ä
2. History of Efforts to Ensure Inclusion 

NCD issues this paper after more than a decade of educational and collaborative efforts to bring 

about changes in U.S. government policies abroad. In the early 1980s, for example, the World 

Institute on Disability and the Disability Rights Education and Defense Fund (DREDF) brought 

to the attention of the U.S. Department of State and USAID the fact that few people with 

disabilities had access to U.S. governmentñfunded programs abroad. One recommendation was 

that Congress establish a legal commitment to include people with disabilities in international 

development programs modeled on the Percy Amendment of the 1970s. The Percy Amendment 

guaranteed the creation of programs for the inclusion of women in development. 

Despite these efforts, U.S. agencies operating abroad have shown little commitment to 

addressing disability issues. The U.S. State Department is particularly weak in the enforcement 

of disability rights for its employees even within the United States. NCD has recently conducted 

a study of compliance with Section 504 of the Rehabilitation Act by five U.S. federal agencies 

with regard to the programs it funds in the United States (the study found that the Department of 

State provided $139 million to 313 recipients in fiscal year 2000). This study, Rehabilitating 

Section 504, released February 12, 2003, found that the U.S. Department of State ranked the 

lowest among federal agency practices reviewed. The study found that 

The Department of State has reported no federally assisted civil rights enforcement 

over the 10 years covered by this paper. It effectively has no Section 504 

enforcement program. The agency reports that it has had no formal Section 504 

complaints filed against recipients during the period covered by this report. The lack 

of complaints likely reflects the agencyís lack of public education and outreach about 

the rights of people with disabilities under Section 504 rather than a lack of 

discrimination against people with disabilities.24 

The lack of domestic efforts to educate its personnel about disability rights issues and to enforce 

disability rights law is consistent with the findings of two studies conducted in 1991 and 1996 

concerning the operation of State Department programs abroad. 

17Ä
i. The 1991 GAO Report–Foreign Assistance: Assistance to Disabled Persons in 

Developing Countries 

In 1991, the GAO conducted an investigation of U.S. foreign assistance programs in developing 

countries.25 The GAO report found that while many foreign assistance programs did affect the 

lives of people with disabilities, inclusion of people with disabilities in such programs was 

ìsporadic.î26 GAO found that the major U.S. foreign assistance agency, USAID, ìdoes not 

generally attempt to target the disabled in its regular bilateral assistance programsÖ.î27 In the 

absence of planning or directives from its central office in Washington, DC, USAID officials 

observed that USAID Missions abroad could take the initiative to include people with 

disabilities, since USAID Missions have broad discretion as to how to program approximately 75 

percent of U.S. foreign assistance funds.28 As of 1991, however, the GAO report documented the 

lack of such programs at the Mission level. The GAO report found that ìother than small, 

random efforts, the missions had not provided any assistance to the disabled during the past three 

years and that missions have no assistance projects planned for the future.î29 To address this 

problem, USAID officials recommended programs for ìheightening awareness of disability 

issuesî among USAID Mission staff and foreign government counterparts,30 including a number 

of proactive measures, such as providing support for NGOs to ìestablish sub-offices in 

developing countries to assist in the development of disability organizations.î31 GAO 

recommended further study of the problem of physical access and other accommodations for 

people with disabilities at U.S. Missions abroad.

32 

ii. The 1996 NCD Report: Foreign Policy and Disability 

Five years after GAOís report, the NCD issued a report entitled Foreign Policy and Disability. 

The 1996 NCD Report determined the extent to which U.S. foreign policy and foreign assistance 

programs conformed to the principles of nondiscrimination, independence, and full participation 

as represented in U.S. disability rights law. The 1996 NCD Report reviewed the activities of the 

Department of State, USAID, and the U.S. Information Agency (USIA) and found that ìthe 

United States does not have a comprehensive foreign policy on disability.î33 As the report found, 

18Ä
Those responsible for creating and implementing U.S. overseas policies and 

programs generally are unaware of disability issues, cannot articulate our national 

policies with respect to people with disabilities, do not incorporate the interests of 

people with disabilities into U.S. foreign policy objectives, and do not see the 

importance of U.S. disability advances and achievements for people with disabilities 

in other countries.34 

Accordingly, the 1996 report concluded that ìneither the spirit nor the letter of U.S. disability 

rights laws is incorporated into the activities of the principal foreign policy agencies. People 

with disabilities are rarely targeted in U.S. foreign assistance programs, and few programs 

address disability.î35 

The 1996 NCD Report examined two types of access to U.S. foreign policy and assistance 

programs: (1) access by U.S. personnel or contractors, including employment and physical access 

to U.S. embassies and other offices abroad, and (2) access in recipient countries to the benefits of 

U.S.-funded assistance, including participation in international organizations (such as the UN) 

that receive U.S. funds. The 1996 NCD Report found a broad failure to incorporate disability 

rights principles in both aspects of U.S. foreign policy and practice. With regard to access by 

U.S. personnel, many U.S. employees with disabilities have been excluded from serving abroad 

because embassies are inaccessible or because of the lack of enforcement of anti-discrimination 

laws and policies for foreign service workers. 

With regard to access to the benefits of U.S. foreign service programs, the U.S. government has 

long heldóand maintains to this dayóthat U.S. disability rights law does not apply to its 

programs abroad and that the U.S. government is under no legal obligation to ensure that people 

with disabilities have access to benefits of foreign assistance programs.36 

As a result of these findings, the 1996 NCD Report proposed a number of legal and policy 

initiatives, including the following recommendations: 

Create a comprehensive foreign policy on disability to advocate for people with 

disabilities through activities on international levels; 

Extend U.S. disability law by legislation or executive order to include unambiguously the 

international operations of the U.S. government; 

19Ä
Employ domestic standards of nondiscrimination in U.S.-sponsoredÄ

international activities;Ä

Train U.S. foreign affairs agencies and their contractors to plan for programmaticÄ

accessibility; andÄ

Establish the principle that no U.S. international activity should have a lower standard ofÄ

inclusion than its domestic correlate.Ä

iii. USAID Disability Policy 

In response to the 1996 NCD Report Foreign Policy and Disability, USAID adopted a Disability 

Policy in consultation with U.S. disability rights organizations. The Disability Policy states a 

commitment to ìpromote the inclusion of people with disabilities both within USAID programs 

and in host countries where USAID has programs.î 37 USAID summarizes its approach as one to 

ìavoid discrimination against people with disabilities in programs which USAID funds and to 

stimulate an engagement of host country counterparts, governments, implementing organizations 

and other donorsÖ.î38 

The USAID Disability Policy falls short of addressing NCDís 1996 recommendations in a 

number of key areas. It creates no measurable goals or timelines, nor does it require the creation 

of any disability-specific programs by USAIDís central office or U.S. Missions abroad. The 

Policy recommends ìengagementî with disability organizations in host countries, but it does not 

suggest any framework for consultation. There is no requirement that U.S. Missions consult with 

disability organizations in the United States or abroad to develop or implement programs or to 

ensure access to existing programs. 

The mechanism for implementation of the USAID Disability Policy is a Disability Plan of 

Action, in which USAID promises to raise disability issues within interagency and interdonor 

meetings. The Plan of Action creates an Agency Team for Disability Program that is intended to 

meet quarterly and ìfoster awareness...regarding the importance of including persons with 

disabilities in USAID.î39 The Agency Team will issue periodic reports on the implementation of 

the USAID Disability Policy. 

20Ä
Instead of any centralized requirements, the USAID Disability Policy states that each U.S. 

Mission should create its own plan for outreach to people with disabilities. It promises that 

ìUSAID employees and contractors will be trained in issues of relevance to people with 

disabilities so that, as appropriate, USAID programs reflect those issues.î40 

Pursuant to the Disability Plan of Action, USAID published annual reports in 1998 and 2000. 

These reports show very little progress toward real inclusion of people with disabilities in 

USAID programs and activities. The first annual report found that the great majority of Missions 

had never created any Disability Plan.

41 The report called for an immediate remedy to this 

problem and stated that by the end of the second year each USAID Mission will have a specific 

disability plan, and that 80 percent of the Missions will have at least one contact NGO in the 

disability community in that country.

42 In 2002,43 the self-assessment report found that ìwhile 

several USAID organizations have included people with disabilities in their development 

programs with great success, others still deny any potential linkage between disability and 

development issues.î The second USAID self-assessment reached the following conclusion: 

Specific disability programming has taken hold only in response to congressional 

mandates: i.e., the Patrick J. Leahy War Victims Fund. ëSporadicí examples of 

inclusion are available, and may be increasing slightly. However, egregious 

exclusion can also be discoveredÖ. Efforts at promoting the USAID Disability 

Policy have been disjointed and minimally effective.Ö Opportunities for personal 

contact with PWDs, while fruitful, have not been deemed a priority. And, a reward 

structure does not exist to promote adherence to this policy.

44 

The 2002 USAID report recommended that, due to the enormous pressure of conflicting 

priorities, specific funding should be set aside for disability issues. The report also recommended 

that a specific ìhomeî be established for the implementation of the disability policy; otherwise, it 

will never become an agencywide effort and will continue to be the campaign of a small group.45 

The third report on the Implementation of the USAID Disability Policy (2003) finds significant 

improvements in the inclusion of people with disabilities in USAID programs. But there are 

still major shortcomings. Of 48 USAID Missions that responded to the survey, only 11 reported 

having a Mission-specific disability plan. The survey found, however, that ìthere is not a direct 

correlation between plans and projects.î A full 35 USAID Missions report having at least one 

21Ä
project that included people with disabilities. Despite the gains cited in the 2003 USAID report, 

it concludes that ì[a]lmost all of USAID programs have the potential to prevent disability or to 

enhance the lives of people with disabilities. Except where there is specific legislation, 

however, relatively few programs give systematic thought to including PWDs in their design 

and implementation.î 

The 2003 USAID report provides a valuable insight into the resistance on the part of some staff 

at USAID to include people with disabilities in their work. ì[W]ithin the official development 

arena, disability is still largely considered a ëspecial interestí that requires a separate effort.î 

USAID staff have similarly explained at NCD meetings that the agency has so many 

Congressional mandates to serve the needs of special interest groups that funds are limited to 

meet their core goal of promoting economic development. The 2003 USAID report responds to 

this perception, stating that ì[d]isability is much more than a ëspecial interestí in the developing 

world.î The 2003 USAID report cites the United Nations World Program of Action Concerning 

People with Disabilities, which points out that ì[a]s many as 80 percent of all disabled persons 

live in isolated rural areas in the developing countries. In some countries, the proportion of the 

disabled population is estimated to be as high as 20 percent. Thus, if families and relatives are 

included, 50 percent of the population could be adversely affected by disability.î The 2003 

USAID report provides a valuable endorsement to the principle that overcoming barriers to the 

inclusion of people with disabilities must be core to USAIDís mission. 

The 2003 USAID report recommends training on disability at all USAID Missions. With USAID 

funding, Mobility International USA has drafted a training manual to sensitize international 

development workers to disability issues and to provide them with guidance on developing 

accessible programs. 

iv. Recent NCD Efforts and New Policies on Foreign Affairs and Disability 

Since its 1996 Foreign Policy and Disability report, NCD has continuously reached out to U.S. 

foreign policy and foreign assistance personnel to promote collaboration and to offer technical 

assistance to promote inclusion in foreign assistance efforts. Furthermore, over the past three 

years, NCD has convened two meetings, in 2000 and 2002, to gather information from 

22Ä
international disability experts on the topic of foreign assistance and disability. Participants at 

these meetings described a number of consistent barriers to access for people with disabilities: 

International facilities remain inaccessible–U.S. government employees, contractors, and 

representatives of NGOs are limited in their access to U.S. government offices throughout the 

world because buildings are physically inaccessible. UN offices, international policy conferences, 

and programs funded by U.S. government funds remain similarly inaccessible. After years of 

pressure by disability activists, the U.S. Department of State has recently promised to make 

improvements. In a September 2002 speech to the International Career Advancement Program, 

the Director General of the Foreign Service and the Director of Human Resources promised to 

make U.S. embassies abroad more accessible to people with disabilities. While this promise is 

extremely valuable, the Department of State still does not recognize that it is obliged to provide 

such access as a matter of law. 

Lack of disability-specific mandates undercuts participation by international disability 

organizations–In the absence of disability-specific mandates, most large USAID requests for 

proposals (RFPs), requests for applications (RFAs), technical cooperation contracts, cooperative 

agreements, or other programs lack any mention or consideration of disability as a priority. The 

structure of USAID RFPs and RFAs favors large international development organizations that 

can respond to the broad expertise in the areas sought by USAID, such as in health, education, 

civil society, rule of law, small-enterprise development, or womenís issues. While a number of 

disability rights organizations have developed an excellent international track record within the 

disability area, they are at a disadvantage in applying for these larger contracts or cooperative 

agreementsóeven in the rare cases when disability is one of many parts of a larger program. In 

theory, disability organizations can form partnerships with large mainstream development 

organizations. In practice, however, without any requirement that disability issues be included in 

RFPs and RFAs, mainstream development organizations have no incentive for including 

disability groups in leading roles. The development of large USAID proposals is prohibitively 

expensive for most disability organizations that lack other funding sources for international 

activities. Given these barriers to entry into international affairs by disability groups, mainstream 

23Ä
international development and civil society organizations do not benefit from the tremendous 

expertise of U.S. disability rights organizations. 

Disability activists have established one new program to promote the inclusion of people with 

disabilities, particularly women with disabilities, in overseas development programs.46 Mobility 

International USA (MIUSA) has worked with InterAction, a coalition of more than 165 U.S.-

based international development, relief, refugee, advocacy, and environmental agencies, to create 

a system of voluntary standards for the inclusion of women with disabilities in development 

programs. While InterAction members are NGOs, 56 percent of these organizations receive 

funding from USAID. InterAction has recently adopted the disability standards, and their impact 

has not yet been fully tested. While MIUSA is optimistic about the promise for increasing the 

inclusion of people with disabilities in overseas development programs, these are voluntary 

standards that do not mandate a change in practices or create any new disability-specific 

programs. Rather, the standards address organization policy, management practice and human 

resources, the inclusion of people with disabilities in programs, accessibility of material 

assistance to people with disabilities, and child sponsorship.47 

MIUSA has recently published a valuable companion to the new InterAction standards entitled 

ìGender and Disability: A Survey of InterAction Member Agencies.î Of the 165 members of InterAction, 104 organizations participated in MIUSAís survey. The survey found that almost one-third 

of respondents operate disability-specific programs. Despite this, ìfew women and men with 

disabilities are employed by respondent organizations or are served in field programs aimed at 

general populations.î48 The survey finds that ì[a]lthough people with disabilities are the poorest, 

least enfranchised, and most discriminated-against group in almost every society, many respondent 

organizations tend to overlook them as a group despite the fact that they are present among the 

general populations they serve. This omission is paradoxical in light of the humanitarian goals of 

most respondent organizations.î49 MIUSA describes the findings of the survey as a ìclarion call for 

InterAction members to begin implementingî the new disability standards.50 

Field offices are unaware of USAID disability policy and concerns of people with 

disabilities–As reported to GAO in 1991, USAID Missions abroad have the discretion to use 

24Ä
funds to support disability projects. As directed in the USAID Disability Policy, each U.S. 

Mission is supposed to determine how to create outreach programs for people with disabilities 

suited to local circumstances. Representatives of international disability organizations at the 2000 

and 2002 NCD meetings reported a general lack of awareness of the USAID Disability Policy by 

agency officials abroad. While a few disability organizations have received contracts through 

U.S. Missions abroad, this situation remains the exception. 

Local disability groups lack support to compete for grants–The USAID Disability Policy 

calls for local outreach to disability organizations abroad. In practice, this may be impossible in 

countries where disability organizations are not well developed or do not exist. Mental Disability 

Rights International reports, for example, that in many countries there are no organizations made 

up of people with psychiatric or developmental disabilities. Umbrella groups made up of people 

with disabilities do not always include members with mental as well as physical disabilitiesóor 

they might actively exclude certain disability groups.51 USAID officials often state that civil 

society support programs are open to all local nongovernmental groups and that disability groups 

abroad can compete for funding with other local NGOs. It is difficult for many disability groups 

to compete, however, against other more established civil society organizations. People with 

disabilities and the organizations representing themóstruggling with current and historical 

discrimination, exclusion from educational programs, and economic marginalizationóoften lack 

the necessary resources or experience to apply for competitive programs. Legal or social barriers 

may make it literally impossible for people with disabilities to apply for grants.52 

It has been difficult to identify and engage staff members from USAID or the Department of 

State, and some gains have been reversed by the lack of coordination within 

agencies–Officials were designated by the Department of State and USAID on a short-term 

basis to coordinate with NCD on the implementation of the new Disability Policy. When these 

officials were transferred, no one was assigned to pick up their responsibilities. As a result, 

different parts of the State Department do not collaborate on this issue. At a 2000 NCD 

conference on disability and foreign affairs, numerous disability experts working abroad reported 

frustration with the lack of support or interest by Department of State and USAID officials. A 

high-level USAID official attending the meeting suggested an educational and outreach effort by 

25Ä
the disability community to educate and sensitize U.S. foreign service and development 

employees to disability issues. In response to this request, NCD conducted a series of roundtable 

discussions in 2000 and 2001 with USAID and State Department staff to develop plans for 

technical assistance and cooperation between the disability community and those people 

responsible for overseas program planning and execution. One State Department staff member 

with a personal interest in disability participated, but there was no official engagement of the State 

Department in the project. Apart from the USAID staff member assigned to liaise with NCD on 

this, USAID participants were generally not supportive, even indicating during the meeting that 

the USAID Disability Policy was never intended to become agency policy, only a ìresourceî for 

staff with an interest in disability issues. The liaison who had been supportive left USAID the 

week after the first roundtable, and no further events were scheduled due to lack of interest. 

Lack of coherent strategy for inclusion undermines U.S. leadershipóAt NCDís December 

2002 meeting, international disability experts pointed out that the lack of a coherent international 

strategy for the inclusion of people with disabilities has already begun to erode U.S. leadership in 

the international disability field. As described above, the World Bank, the United Kingdom, and 

the Scandinavian countries have developed major new policy initiatives to promote the inclusion 

of people with disabilities in their foreign assistance programs, and they have dedicated new 

funds for these programs.53 

The NCD 2000 meeting recommended that NCD learn from the experience of womenís rights 

activists and seek an amendment to the Foreign Assistance Act, similar to the Percy Amendment, 

which was adopted in 1973 to promote the inclusion of women in all development programs. In 

December 2002, NCD invited representatives of womenís organizations to meet with disability 

experts to provide additional advice as to how to learn from the experience of the inclusion of 

women in development. Participants at the meeting agreed that legislation to bring about access 

to people with disabilities in both foreign policy and foreign assistance should draw from a 

variety of legislative models developed by the human rights and womenís rights communities. 

Seven years after NCDís report Foreign Assistance and Disability and 12 years after GAOís 

report Foreign Assistance: Assistance to Disabled Persons in Developing Countries, NCD has 

26Ä
concluded, consistent with USAIDís own reports, that a legislative mandate is needed to ensure 

that U.S. foreign policy and assistance efforts are responsive to the concerns of people with 

disabilities. After years of collaborative efforts with U.S. officials to bring about the inclusion of 

people with disabilities in U.S. foreign policy and assistance programs, NCD now recognizes that 

it is necessary to enact legislation to ensure inclusion as a matter of law. 

The following part reviews these legislative models to determine their potential usefulness in 

drafting legislative proposals to promote the inclusion of people with disabilities. 

27Ä
28Ä
PART III. 

Current Foreign Assistance Legislation Regarding Human Rights 

The international community has long recognized the importance of human rights. While 

international law has traditionally been built on the core principle of state sovereignty, the United 

Nations Charter established that matters of human rights are of common concern and are a proper 

subject of international action. The basic scope and principles of modern international human 

rights law were established by the Universal Declaration of Human Rights (UDHR), adopted 

unanimously by the UN General Assembly in 1948 and now commonly accepted as part of 

customary international law. Since 1948, the UN has adopted a broad array of international 

human rights covenants, including specialized conventions to protect vulnerable groups such as 

women, children, and migrant workers. Regional bodies such as the Council of Europe, the 

African Union, and the Organization of American States (OAS) have also established regional 

human rights regimes, including mechanisms for promoting the domestic enforcement of human 

rights. By ratifying human rights conventions, governments agree to abide by international 

human rights standards and to subject their own practices to international scrutiny. Many human 

rights conventions explicitly commit governments to collaborate on the advancement of human 

rights. The obligations established by international human rights law entail a corresponding duty 

of governments to take action against violations of internationally recognized human rights at 

home or abroad.54 

One important development in the international human rights field for people with disabilities 

has been the adoption of the Standard Rules on the Equalization of Opportunities for Persons 

with Disabilities

55 by the UN General Assembly in December 1993. The UN Standard Rules 

establish that people with disabilities have a right to participate in public policymaking and 

program development on matters that concern them. The Standard Rules are nonbinding, but they 

ìimply a strong moral and political commitment on behalf of States to take action for the 

equalization of opportunities for persons with disabilitiesÖ. The Rules offer an instrument for 

policymaking and action to persons with disabilities and their organizations. They provide a basis 

29Ä
for technical and economic cooperation among States, the United Nations, and other international 

organizations.î56 The Standard Rules establish guidelines for the inclusion of people with 

disabilities in policymaking, human rights protection, medical care, support services, education, 

employment, income maintenance and social security, family life and personal integrity, culture, 

recreation and sports, and religion. Rule 21 of the Standard Rules states that ìboth industrialized 

and developing [nations] have the responsibility to cooperate in and take measures for the 

improvement of the living conditions of persons with disabilities in developing countries.î The 

Standard Rules have been explicitly used by other donor governments as a new framework for 

reforming international development and cooperation programs to ensure the inclusion of people 

with disabilities.57 However, while an important development, the Standard Rules are but one 

step in the right directionóagain, the Rules are nonbinding and lack timelines and other 

enforcement mechanisms. 

While the United States has yet to craft an international disability policy, Congress has long 

established that human rights principles should guide our foreign policy and assistance programs. 

As mandated by Section 502B of the Foreign Assistance Act of 1974, ìa principal goal of the 

foreign policy of the United States shall be to promote the increased observance of 

internationally recognized human rights by all countries.î58 

Through a series of amendments to the Foreign Assistance Act, Congress has sought to enforce 

human rights protections by conditioning a foreign governmentís eligibility for U.S. military 

assistance 59 or economic aid60 on its human rights record, or by withholding the use of 

multilateral funds to governments with unsatisfactory human rights records.61 In addition to 

creating sanctions for countries that do not enforce human rights, Congress has established a 

broad array of targeted foreign assistance programs to promote the efforts of governments to 

enforce human rights. These programs include assisting governments in implementing the rule of 

law, ìcivil societyî programs to assist NGOs in advocating for human rights, and targeted 

assistance to assist particularly vulnerable populations. 

As the rights of people with disabilities are increasingly recognized as international human rights, 

the U.S. government should include the concerns of people with disabilities explicitly in its 

30Ä
foreign policies not just as a matter of good policyóbut as a matter of currently binding law. 

Disability organizations can learn from the lessons of international human rights organizations to 

leverage existing protections. Any new legislative initiative should build on links that have 

already been established, and new protections for people with disabilities should be 

mainstreamed into current foreign assistance legislation. 

The human rights and foreign assistance legislation can be roughly divided into two categories: 

general legislation and rights-specific legislation (targeted to promote the enforcement of a 

particular kind of right or targeted to protect the rights of a specific population).62 General 

protections apply to people with disabilities as they do to all other individuals. As such, they 

represent an untapped resource to promote international disability rights. In addition to general 

protections, there are a number of kinds of rights-specific legislation. Some of this legislation now 

protects sub-groups of people with disabilities, such as war victims. New rights-specific 

legislation needs to be crafted to promote the protection of the rights of all people with disabilities. 

This part deals with general legislation and the next one reviews rights-specific legislation. 

1. General Legislation 

i. Security Assistance 

The first main article concerning human rights and foreign assistance is Section 502b of the 1961 

Foreign Assistance Act,63 which starts off with this proclamation: 

(a) (1) The United States shall, in accordance with its international obligations as set 

forth in the Charter of the United Nations and in keeping with the constitutional 

heritage and traditions of the United States, promote and encourage increased respect 

for human rights and fundamental freedoms throughout the world without distinction 

as to race, sex, language, or religion. Accordingly, a principal goal of the foreign 

policy of the United States shall be to promote the increased observance of 

internationally recognized human rights by all countries. 

The statute continues and specifies as follows: 

(2) Öno security assistance may be provided to any country the government of which 

engages in a consistent pattern of gross violations of internationally recognized 

human rightsÖunless the President certifies in writing [to Congress] that 

31Ä
extraordinary circumstances exist warranting provision of such assistance and 

issuance of such licenses. 

The President is instructed to ìformulate and conduct international security assistance programsî 

in a manner that ìwill promote and advance human rightsî (Section (3)).

64 The allocation of 

funds given under this article or under the Arms Export Control Act65 needs to take into account 

significant improvement of the human rights record of the foreign country. 

The definition of ìgross violations of internationally recognized Human Rightsî is as follows: 

(d) (1) the term ìgross violations of internationally recognized human rightsî 

includes torture or cruel, inhuman, or degrading treatment or punishment, prolonged 

detention without charges and trial, causing the disappearance of persons by the 

abduction and clandestine detention of those persons, and other flagrant denial of the 

right to life, liberty, or the security of person.66 

In practice, human rights conditionality under Section 502(b) of the Foreign Assistance Act is 

rarely invokedóyet the threat of its use has provided powerful political leverage to influence 

governments. Indeed, this provision can be applied to gross violations of human rights abuses 

against people with disabilities. Section 502(b) should be amended to include disability along 

with race, sex, language, and religion as appropriate for protection under the principles of human 

rights and fundamental freedoms. 

The European Court of Human Rights67 and the Inter-American Commission on Human Rights68 

both have found individual human rights violations against individuals with disabilities that 

constitute ìinhuman and degrading treatmentî under international human rights law. Where 

abuses against people with disabilities are permitted by governments to continue on a large 

scaleósuch as the detention of individuals in institutions where they are exposed to dangerous 

communicable diseases or left to freeze or die of starvationóabuses could certainly rise to the 

level of the ìgross violationsî of rights contemplated by Congress.69 

The requirement that a specific kind of human rights abuse could trigger sanctions under the 

Foreign Assistance Act would not be unique to people with disabilities. Congress has indicated 

that a foreign governmentís denial of freedom of religion to its own citizens could justify 

sanctions.70 This was added by the International Religious Freedom Act of 1998,71 which 

32Ä
includes ìparticularly severe violations of religious freedomî72 as one of the human rights 

violations that can justify sanctions under Sections 116 and 502(b) of the Foreign Assistance Act 

of 1961. 

ii. Development Assistance 

Section 116 of the Foreign Assistance Act of 196173 establishes a linkage between development 

assistance and human rights practices. It provides that assistance can be given to a country with a 

grossly repressive government only if the assistance ìdirectly benefitsî the needy people in such 

a country.

74 Given the linkage between the creation of opportunities for community integration 

and general economic and social development, it would be hard to justify a suspension of foreign 

assistance because of disability rights violations that are common in the world today. Where 

foreign governments are clearly unresponsive to the most extreme abuses against people with 

disabilities, however, Section 116 provides economic leverage that must be available to people 

with disabilitiesóas it is to all other vulnerable peoples. 

iii. Country Reports on Human Rights Practices 

The evaluation of any countryís human rights record requires an objective foundation of 

documentation regarding its record of enforcing human rights. The most important source of 

information for U.S. government policy is the U.S. Department of Stateís Country Reports on 

Human Rights Practices. Section 116, Subsection (d) creates a duty for the State Department to 

report annually on the human rights practices of all the countries that are members of the UN, 

whether or not they receive foreign assistance.75 The report must include information on the 

governmentís conduct in many human rights issues: freedom from torture and other cruel or 

inhuman punishment, detention without charge, disappearances, denial of right to life or liberty, 

religious freedom, human rights of children, trafficking of women, and treatment of refugees.76 

In 1993, an amendment to the Foreign Appropriations Act was proposed to require the State 

Department to include in its Country Reports ìan examination of the discrimination against 

people with disabilities, including whether the government has enacted legislation or otherwise 

mandated provision of accessibility to public buildings.î This proposal has not become law. In 

recent years, however, the U.S. State Department has begun to include regular reporting on the 

33Ä
rights of people with disabilities abroad. While this is a valuable development, reporting is often 

cursory. While issues of physical access are often covered, a broad array of other important 

disability rights issues are usually left outóincluding the most extreme forms of human rights 

violations that take place in institutions. As described above,77 there is now a growing body of 

evidence that people with disabilities are deprived of their liberty in life-threatening conditions in 

psychiatric institutions, mental retardation facilities, orphanages, jails, and prisons around the 

world, and they are often subjected to inhuman treatment or punishment. 

Officials at the Office of Democracy, Human Rights, and Labor (DRL) in the State Department 

who write the Country Reports have explained that they obtain most of their information from 

NGOs that document abuses. One of the main reasons the State Department does not include 

evidence of human rights abuses against people with disabilities in most countries, DRL officials 

explain, is that they are not aware of any disability rights groups documenting these abuses. In 

part, this is a failure of outreach, as there are some disability rights organizations in most 

countries. In part, it is a reflection of the same limitations that undermine the effectiveness of the 

current USAID Disability Policy: such limited funds are available for disability rights 

organizations that basic information about documentation of human rights conditions is lacking. 

NCD recommends that Congress remedy this problem by setting aside funds to support the 

development, training, and operation of disability rights organizations around the world. 

A specific Congressional mandate in the Foreign Assistance Act itself that reinforces the State 

Departmentís role in documenting human rights abuses against people with disabilities in the 

Country Reports would be helpful. Congress should state in detail the kinds of abuses that should 

be documented. Congress should require that State Department human rights officers consult 

with local disability rights groups. Where local human rights or disability rights groups have not 

documented abuses against people with disabilities, human rights officers preparing the Country 

Reports should conduct site visits to places where they may encounter human rights abuses 

against children or adults with disabilities, such as orphanages, segregated schools, psychiatric 

facilities, or other closed institutions. 

34Ä
2. Rights-Specific Legislation 

In addition to provisions in the Foreign Assistance Act and related laws, ìrights-specificî 

legislation provides a number of elements that can be used as models in the development of 

disability rights legislation. By seeking disability-specific legislation and specialized programs, 

people with disabilities are not seeking a privileged position within the current rights protection 

framework. This review demonstrates the U.S. governmentís commitment to specific protections 

and specialized forms of assistance to aid discrete groups of people. The existence of other 

rights-specific legislation is evidence of the need to craft specialized enforcement mechanisms 

and incentives to ensure that particularly vulnerable groups are protected. The following are 

examples of rights-specific legislation that may provide a model for much-needed disability 

rights legislation: 

i. Torture Victims Protection Act 

Section 132 of the Foreign Assistance Act78 authorizes the President to provide assistance for the 

rehabilitation of torture victims. This assistance can be in the form of grants to treatment centers, 

specific projects, or other activities designed to treat victims of torture.

79 The aid can be used for 

direct services to victims or for research and training to health care providers, enabling them to 

provide appropriate care for torture victims.80 This section is different from Section 502(b) in 

several ways: (1) instead of sanctions, this law provides positive measures to remedy abuses; 

(2) it is aimed at remedying the effect of a specific human rights violation rather than preventing 

future abuses; and (3) it is not directed to the government of a foreign country but to specific 

organizations that provide treatment or rehabilitation. Each of these elements could be valuable 

contributions to a disability rights legislation that seeks to provide assistance to individuals with 

disabilities who have been subjected to serious abuses. 

Practitioners report that one of the most effective elements of the Torture Victims Protection Act 

is that it creates a pool of funding to which U.S. Missions abroad can apply. This provides 

incentive for U.S. Missions to create relevant programs, and it rewards Missions that do so by 

allowing them to expand the resources available to them. As described below, NCD recommends 

35Ä
that Congress establish a somewhat similar approach when creating a ìFund for Inclusionî of 

people with disabilities. The Fund could be used as an incentive for Missions abroad to create 

disability programs. Provisions must be established, however, for the fact that Missions abroad 

may not take advantage of this incentive. People with disabilities represent a much larger 

proportion of the world population (10 percent) than torture victims, and they live in every 

country of the world. Thus, special provisions must be established to ensure that people with 

disabilities have access to support even in countries where the Mission has not been proactive. 

ii. War Victims Fund 

The War Victims Fund was established in 1989 through the initiative of Senator Patrick Leahy. 

Initially, the fund was focused on providing prosthetics and orthotics to victims of conflict. It has 

become a significant contributor to people with disabilities, with $45 million spent in 14 

countries during its first eight years. The fund has been particularly successful because it 

promotes the use of local resources and employs local techniciansóincluding people with 

disabilitiesóto provide prosthetics and orthotics quickly and inexpensively. Since the middle of 

the 1990s, the fund has expanded its work by providing a broad array of rehabilitation services.81 

The War Victims Fund demonstrates that U.S. foreign assistance programs can respond to the 

needs of specific groups, such as people with disabilities, when a specific Congressional mandate 

is created. The program is limited in scope, however, and does not respond to the concerns of the 

vast majority of people with disabilities. The program has been criticized because it is not 

mainstreamed into other USAID activities. In fact, the fund operates separately from USAID 

Missions. In some countries where the fund operates, the Mission reported that its officials were 

not aware that there was any USAID activity with regard to persons with disabilities.82 

iii. Trafficking Victims Protection Act 

The Trafficking Victims Protection Act (TVPA) of 200083 is the most recent addition to assistance 

conditionality with respect to human rights, and it provides an example of several linkages 

between human rights violations associated with trafficking victims and foreign assistance. 

36Ä
The TVPA establishes minimum standards for evaluating foreign governmentsí efforts and 

conduct toward elimination of trafficking of people.84 According to the standards, the 

governments of such countries should prohibit all forms of trafficking in persons and punish acts 

of trafficking, including setting severe punishments for traffickers. Countries must demonstrate 

that they are making serious and sustained efforts to eliminate trafficking.

85 

Section 109 of the TVPA86 authorizes the President to provide assistance to foreign countries for 

programs, projects, or activities designed to improve the policies and conduct of the receiving 

country in order to eliminate trafficking. The goal of the assistance is clearly defined: to make the 

country meet the minimum standards for the elimination of trafficking as defined in Section 7102 

of the TVPA. The legislation also specifies some of the means the country should employ to 

combat trafficking.

87 

Perhaps the most important element of the TVPA as a model for disability rights legislation is the 

inclusion of funding for specific programs to end the practice of trafficking and to minimize the 

underlying factors that lead to this practice. The TVPA provides funds through loans or training 

to individuals subject to trafficking. The TVPA provides support for programs to promote 

womenís participation in economic decisionmaking; programs to keep children, especially girls, 

in elementary and secondary schools; programs to educate persons who have been victims of 

trafficking; and public education about trafficking programs and promotion of womenís role in 

society.

88 Section 7105 authorizes programs to assist trafficking victims in foreign countries.89 

The law creates a duty to report on each countryís conduct regarding trafficking of women, as 

well as its policies and efforts to combat this phenomenon. Part of the report on each country 

proposed to receive security assistance under Section 502(b) or development assistance under 

Section 116 of the Foreign Assistance Act must include a detailed account of that countryís 

policy and conduct toward trafficking of women.90 Again, this detailed reporting model could be 

used as part of a new disability rights legislationóand reports could be mainstreamed into the 

current Department of State Country Reports. 

The section that generated the most debate in Congress91 and won the most attention in other 

countries is Section 110.92 Section 110 sets up sanctionsóin the form of denials of foreign 

37Ä
assistance and exchange programs and attempts to curtail loans from international monetary 

bodies, such as the IMFóagainst countries whose governments do not comply with the 

minimum standards for the elimination of trafficking or are not making significant efforts at 

compliance.

93 Similar kinds of sanctions should be a tool available to protect people with 

disabilities who are actively exploited. 

iv. Women in Development 

The challenges to promote the inclusion of women in development bear many similarities to the 

challenges faced by people with disabilities. People with disabilities do not make up as large a 

percentage of the population as women, but they are a much larger group than the other small, 

discrete populations protected by other rights-specific legislation. The interplay between 

discrimination, economic marginalization, and stereotypes that hold back women and people 

with disabilities means that remedies for this problem must be multifaceted and must be 

integrated into a wide variety of other programs. The thirty-year experience of the women in 

development movement provides invaluable lessons for the disability community. 

In 1973, Congress passed the Percy Amendment to the Foreign Assistance Act, which requires a 

portion of U.S. foreign assistance for international development to be allocated to the integration 

of women into the economy of the recipient country.

94 The rationale, as stated in a USAID policy 

paper from the 1990s,95 is to integrate women into the national economies, ìthus improving their 

status and assisting the total development effort.î In 1974, the Women in Development (WID) 

office was created within USAID, and was charged with overseeing implementation of the Percy 

Amendment. U.S. representatives to different monetary bodies, such as the World Bank and the 

International Monetary Fund, were instructed to encourage the integration of women into the 

national economies of member and recipient countries and into professional and decisionmaking 

positions in such organizations.96 

Both economic and social arguments were used to support the original Percy Amendment. In the 

early 1970s, the growing international womenís movement was committed to demonstrating that 

womenís contributions to society and to development went all too often unrecognized and that 

current development strategies deny women the benefits of being involved in the development 

38Ä
process.97 This view was reflected in the international development strategy for the Second 

United Nations Development Decade (1970ñ1980).98 Later, in the 29th Session of the UN, the 

General Assembly adopted the Charter of Economic Rights and Duties of States. The charter 

viewed the integration of women in development as an important component, stressing the need 

for womenís equality with men in the home and in family life so that women could take a greater 

part in the life of the community, and aimed to achieve effective home and work possibilities for 

both sexes.99 

The UN called on bilateral and multilateral development agencies to reevaluate their programs 

according to the various declarations, charters, and plans of actions adopted by the UN, and to 

channel their resources to ensure greater participation and benefit of women in the development 

programs.100 Thus, when the WID office was set up, its mission was to ìhelp ensure that women 

participate fully and benefit equally from U.S. development assistance programs.î101 The main 

concern was not womenís rights but rather achieving better development through the inclusion 

of women.102 

In 1978, Congress added another amendment to the WID legislation authorizing up to $10 

million for economic assistance to be ìused primarily to support activities which will increase the 

economic productivity and income earning capacity of women.î103 Congress added the section 

later known as (b)(2), which states ì[n]othing in this section shall be construed to authorize the 

establishment of a separate development assistance program for women.î104 The House Report 

explains that the goal of this amendment was to promote the participation and integration of 

women as equal partners in the development process. The committee did not want to create a 

separate program for women that would become marginalized, but rather wanted to integrate the 

participation of women in the development programs in each of the current programs. 

The original conception of WID has been criticized for its lack of attention to gender roles and 

womenís rights and equality.

105 Others have observed that the international womenís movement 

was able to develop and build upon many of the gains that resulted from the original WID 

approach.106 Without question, the WID approach has shifted over the past decade from promoting 

women as a resource, to women as a group entitled to the protection of their human rights. 

39Ä
As the disability community seeks support for a new Disability in Development (DID) office, it 

can build on the experiences of the international womenís movement. There are a variety of 

economic and social arguments for the inclusion of people with disabilities in development 

programs. In some contexts, these certainly will be persuasive. Economic arguments support a 

broad-based approach to disability in development that promotes the participation of people with 

disabilities in education, employment, and private enterprise. Many international development 

experts not familiar with developments in the disability rights movement may expect a DID 

office to be justified purely in economic terms. Proponents of a new DID program should not feel 

obliged to revive the old arguments for the Percy Amendment, however. U.S. disability rights 

legislation establishes that protection against discrimination and full inclusion in society have 

been established as a matter of right. Recent experience with WID demonstrates that a rightsbased approach to participation in development can be effective. 

A new DID program should model itself on WIDís broad mandate that includes economic, 

human rights, and civil society components. WID has four strategic objectives: (1) enhancing 

the economic status of women; (2) expanding educational opportunities for girls and women; 

(3) improving womenís legal rights and increasing their participation in civil society; and 

(4) integrating gender considerations throughout USAID programs.107 

It is important to note that implementation of the Percy Amendment has gone through many steps 

and that changes in the development field have been slow.108 A new DID program should not rely 

on a Percy type amendment alone but should attempt to create additional mechanisms to avoid 

the pitfalls of the early WID experience. 

Two USAID studies of the WID office in 1982 and 1987 109 demonstrate difficulties that 

legislation to promote the inclusion of people with disabilities should avoid. Both studies 

document the difficulty of implementing gender policies by the preexisting aid bureaucracies. 

These studies emphasized the importance of programs sensitizing USAID staff to promote the 

inclusion of new concepts into their work. The 1982 paper also points to the limited mandate of 

the WID office, which enabled it to voice its concerns about new projects and policies but not to 

have genuine influence. 

40Ä
One analysis published in 1990 found that WID had made little impact since its budget was so 

low and it did not have the ability to influence other mainstream USAID programs.110 This 

analysis cites the following figures from the mid-1980s: no more than 4 percent of development 

funding went to WID; one-tenth or less of the agricultural projects specified a womenís 

component; fewer than one-fifth of all international trainees were female. 

Over the years, USAID has made a number of efforts to overcome the early limitations of WID. 

In 1996, USAID put together a Gender Plan of Action (GPA) designed to ensure that gender 

considerations were institutionalized throughout its agenciesí development programs and 

projects.111 The GPA creates mandatory staff training on gender and new guidelines for USAID 

grantees and contractors that require grant applicants to demonstrate their abilities to address 

gender issues. The GPA also requires that each Mission review and revise its ìmission ordersî to 

ensure that gender issues are considered at all appropriate points in the process of planning, 

achieving, and evaluating program results.112 These elements of the GPA are consistent with the 

recommendations of the 1996 NCD Report Foreign Policy and Disability. Full inclusion of 

people with disabilities in foreign assistance programs would be greatly aided by such staff 

training and the establishment of guidelines for contractors and grantees to ensure access to 

people with disabilities in all programs. A regular review of Mission activities to ensure 

inclusion of people with disabilities would be equally important. 

In recent years, with the increase of international attention on womenís rights, the issue of women 

in development received more attention both from NGOs working on womenís rights and from 

the international community. There was an upgrade in the WID program: the head of the program 

was raised to a higher executive level and a gender officer was appointed to each regional 

program.113 Another key lesson for a Disability in Development program: its director at USAID 

must be at a sufficiently high level to bring about changes in policy throughout the agency. 

Despite these developments, the financial commitment to WID at USAID is still small. 

According to Womenís Edge, a coalition of individuals and organizations concerned with 

promoting the economic status of women around the world, of the $2.7 billion the United States 

spent on international development in 2000, only $10 million directly supported WID. In 2002 

41Ä
the figure was $14 million. The small size of the WID office itself is an argument that could 

favor individuals with disabilities. A coordinating Disability in Development program would 

similarly cost a small amount to establish (in relation to the full USAID budget and the large 

proportion of individuals with disabilities). 

WID is supplemented by a Small Grants Program that supports the development of new NGOs 

representing women working on different thematic issues.114 A similar small grants program for 

disability rights groups will be critical to promoting participation by people with disabilities in 

development. Womenís organizations around the world are far more advanced than disability 

groups. Rather than thematic support, disability groups are in need of funding for basic 

organizational infrastructure, including membership outreach and development.115 

v. Democracy, Governance, and Civil Society 

USAID has established ìDemocracy and Governanceî as one of its current priorities. In addition 

to assisting governments in establishing the mechanisms they require for the operation of 

effective democracy, the Democracy and Governance Programs include a major component of 

support for the activities of NGOs, commonly referred to as ìcivil society.î A current USAID 

priority is to support the participation of NGOs that promote civil society in the public policy 

arena.116 A new disability program could be established to ensure inclusion of people with 

disabilities within civil society programs.117 

Arguments for a new civil society initiative are consistent with current USAID goals and 

principles established by Congress in the Foreign Assistance Act. Disability groups, like other 

advocacy NGOs, promote citizen participation, free flow of information, and a democratic 

political cultureóall objectives of ìDemocracy and Governance.î USAID itself wrote in one 

report118 that ìsupport of [NGOs that represent people with disabilities] fits easily within the 

USAID goal of strengthening civil societyî and that ìas a rule people with disabilities are the last 

to receive education and other services in developing countries.î 

While current civil society programs are theoretically open to people with disabilities, this is an 

area where a targeted outreach program is essential to ensure accessibility. Given the long history 

42Ä
of discrimination and exclusion of people with disabilities, as well as active discrimination in 

most of the world today, people with disabilities and organizations representing them are, at best, 

at a competitive disadvantage in applying for the very programs intended to help start new civil 

society organizations. 

For all practical purposes, civil society programs are not currently accessible to many people with 

disabilities in developing countries. To take one example, individuals detained in psychiatric or 

other institutions are literally cut off from information or opportunities to advance their own 

interests. In some countries, according to Mental Disability Rights International, people with 

mental disabilities who live in the community can be declared ìmentally incompetentî for a 

lifetime without any form of due process or any opportunity to challenge the deprivation of their 

legal rights. Such individuals with disabilities cannot take a book out of a public libraryómuch 

less register a legal organization and apply for internationally supported civil society grants. 

Representative democracies cannot operate effectively if large portions of the population are not 

in a position to participate in public life. In order to develop effective programs to respond to the 

needs of individuals with disabilities, governments and international development organizations 

must be in a position to draw on the experiences and expertise of people with disabilities. As a 

practical matter, any new program to ìmainstreamî people with disabilities into other 

development programs may need to begin with an investment in the education, training, and 

leadership of individuals with disabilities. It may also be necessary to directly attack the 

discrimination, segregated social structures, and other human rights abuses that create barriers to 

participation by people with disabilities. 

The development of the full recommendations outlined in this report may be incremental. NCD 

recommends that one of the first steps in support of people with disabilities in development 

should be an initiative to support new disability organizations, leadership opportunities for 

individuals with disabilities, and human rights protections for people with disabilities as a whole. 

A civil society initiative for people with disabilities could provide the engine for participation by 

people with disabilities that could drive the long-term development of a much larger movement 

in both human rights and economic development. 

43Ä
One of the main recommendations of NCD is that Congress should set aside funding in the 

Foreign Assistance Act for the creation of a Fund for Inclusion, Leadership, and Human Rights 

of People with Disabilities (to be known as the Fund for Inclusion). This proposed program is 

described in the recommendations section of this paper. 

44Ä
PART IV. 

Current Civil Rights Protections 

This section of the paper examines the requirements of U.S. disability rights laws and evaluates 

the extent to which they require programs funded by the U.S. government as well as private 

entities to protect against discrimination and ensure equal access to people with disabilities. 

In Foreign Policy and Disability, NCD found that U.S. programs abroad did not conform to the 

letter or spirit of U.S. disability rights laws. This study assumed that U.S. disability rights laws 

are not binding on U.S. programs abroad. Upon further examination, as well as a review of recent 

case law, it appears that American disability rights laws do indeed apply to U.S. foreign 

programs operating abroad and to Americans traveling and working overseas. Recent case law 

indicates that courts may be willing to extend the protections of American disability 

discrimination laws to persons and conduct overseas, even in the absence of specific legislative 

language, and even in the face of the long-held presumption against the extraterritorial 

application of American laws. Further, to the extent that there is any ambiguity about the 

extraterritorial application of American disability discrimination laws beyond U.S. borders, NCD 

recommends that Congress instruct all relevant federal agencies, including the U.S. State 

Department and USAID, that American disability discrimination laws apply to U.S. workers, 

embassies, and programs operated by or with the U.S. government overseas. 

1. Extraterritorial Application of the Disability Discrimination Laws 

i. Background 

The United States Congress has the authority to enact laws beyond its territorial boundaries, if it 

so chooses.119 Indeed, the Supreme Court has recognized this authority by upholding federal 

statutes applied to persons or activities outside of the United States, even against constitutional 

challenges.120 However, for nearly two hundred years courts have relied upon the presumption 

against extraterritoriality to prohibit the application of U.S. laws overseas. The original 

justification for the presumption was based on principles of sovereignty. Federal laws are 

45Ä
generally presumed to apply only to conduct or people within the United States, absent an 

affirmative congressional indication to the contrary, especially if the application of such laws 

would conflict with the laws of another country.

121 

The Supreme Court reaffirmed the presumption against extraterritoriality most recently in the 

context of civil rights laws in Equal Employment Opportunity Commission v. Arabian American 

Oil Co. (hereinafter Aramco).122 Aramco involved the application of Title VII to a foreign-born 

American worker employed overseas by an American corporation who alleged discrimination 

based on religion and national origin. Here, the Court refused to provide a remedy for the 

plaintiff, concluding that federal statutes are not to be construed to apply to conduct abroad 

ìunless a contrary intent appears.î123 

But the presumption against the extraterritorial application of federal law has been called into 

question. Especially since the Courtís decision in Aramco, Congress and scholars, as well as 

lower federal courts and the Supreme Court itself, in subsequent and conflicting decisions,124 

have challenged the continued legitimacy of the presumption against extraterritoriality in light of 

the developing global economy.

125 In fact, as courts have begun to look behind the words of 

federal statutes to determine their legislative intent, courts have found reasons either to ignore the 

presumption against extraterritoriality altogether or to articulate reasons for its inapplicability in 

certain cases.126 

Congress already has acknowledged the applicability of civil rights laws to conduct overseas. 

Within months after the Supreme Courtís decision in Aramco, Congress enacted amendments to 

the Civil Rights Act in 1991 specifically to overturn the Aramco decision 127 and to extend 

coverage of Title I of the ADA and Title VII of the Civil Rights Act of 1964 to conduct 

overseas.128 Upon enacting the 1991 Civil Rights Act (CRA) Amendments, Congress stated that 

its purpose was ìto respond to recent decisions of the Supreme Court by expanding the scope of 

relevant civil rights statutes in order to provide adequate protection to victims of 

discrimination.î129 The effect of the CRA Amendments, therefore, is to expand our nationís civil 

rights protections to all Americans working for U.S. or U.S.-controlled corporations regardless of 

the country in which they are employed. 

46Ä
ii. Civil Rights Protections for Americans with Disabilities Traveling and 

Working Abroad 

With respect to protections for people with disabilities, in particular, the 1991 CRA Amendments 

protect Americans with disabilities who work for private employers, covered by Title I of the 

ADA. These Americans with disabilities working overseas are now entitled to all the 

accommodations, rights, and remedies provided to Americans working within the United States. 

The Federal Government, however, is not covered by the ADA. Instead, the Rehabilitation Act 

applies to the Federal Government and entities that are funded by the Federal Government. 

Section 504 of the Rehabilitation Act provides protections to individuals employed by programs 

that receive federal financial assistance. An individual is protected from disability discrimination 

under Section 504 of the Rehabilitation Act if the person is an ìotherwise qualified individual[s] 

with a disability in the United States.î One could assume that the phrase ìin the United Statesî 

expresses Congressí intent to limit its application to actions that arise within the borders of the 

United States only. But upon review of recent court decisions, it appears that Section 504 also 

applies to conduct outside of the United States. For example, at least two courts have recently 

upheld the extraterritorial application of discrimination laws, even in light of the statutory phrase 

ìin the United States.î130 In one case, the court rejected a defendant collegeís argument that 

Section 504 does not protect a student who sought accommodations in an overseas study 

program operated by the college. The court observed that if the law were not applied 

extraterritorially, ìstudents on overseas programs would become the proverbial ëfloating 

sanctuaries from authorityí not unlike stateless vessels on the high seas.î And even a stateless 

vessel, the court continued, ìmay be subject to United States jurisdiction where defendants are all 

citizens or resident aliens of the United States.î131 

In a second case involving discrimination based on gender, a federal court observed that the 

phrase, a ìqualified individual in the United States,î applies to individuals who qualify for the 

lawís protection in the United States, but does not limit the lawís coverage only to programs 

within the United States. Rather, according to this court, the prohibition of discrimination applies 

to ìall federally funded programs, not only those in the United States.î132 

47Ä
Similarly, Section 503 of the Rehabilitation Act, which prohibits discrimination by contractors 

with the Federal Government, may apply extraterritorially, even in the absence of a specific 

legislative provision. Although to date no court has addressed this issue, in the absence of 

legislative language limiting the geographical area of such contracts, the United States may still 

be obligated to comply with the nondiscrimination mandate of Section 503 in programs overseas, 

except insofar as such compliance would conflict with another countryís laws. 

Section 501 of the Rehabilitation Act, which prohibits discrimination against federal employees, 

may also apply to programs abroad. Section 501 contains no prohibition on its application to 

federal employees who are stationed abroad. Indeed, in the context of discrimination claims by 

federal employees, courts have held that federal employees working abroad are entitled to 

protection under American civil rights laws, including the Rehabilitation Act.133 

iii. Federal Buildings and Programs Abroad 

The 1996 NCD Report indicated that federal buildings, including embassies, remain 

inaccessible.134 The 1996 Report also observed that ì... many of the officials interviewed 

contended that U.S. accessibility standards do not apply overseas, but federal accessibility 

regulations do not reflect this opinion. In fact, accessibility standards and federal disability 

compliance regulations make no exemption for overseas U.S. operations, and there has been no 

definitive jurisdictional test of disability rights statutes in court.î135 

All federal buildings must be made accessible under the Architectural Barriers Act of 1968.136 

This law requires that buildings designed, constructed, or financed by the Federal Government 

must ensure physical accessibility. The law contains no requirement that such buildings must be 

located within the United States. Therefore it is disturbing that government agencies have read 

into the law such a geographical limitation and that the Federal Government has not recognized 

its own responsibility to comply with this accessibility mandate. 

In addition to the Architectural Barriers Act, the Rehabilitation Act as well as Title I of the ADA 

may also require that a federal building overseas be made accessible if such accessibility would 

be an accommodation for a worker protected under the Rehabilitation Act or Title I. Although 

48Ä
Title I does not apply to the Federal Government, a private employer who provides services to 

the Federal Government overseas would be required to provide accommodations, including an 

accessible workplace, to its workers under Title I. 

Further, not only does federal law require the U.S. government and private employers to 

accommodate American workers with disabilities overseas, but a federal court recently extended 

the ADAís accessibility mandate. Although the ADA includes no specific provision extending 

the reach of the ADA to places of public accommodations overseas, a recent decision lends 

support for the potential application of Title III of the ADA to non-American actors. In Stevens v. 

Premier Cruises Inc.,137 the United States Court of Appeals for the Eleventh Circuit held that the 

presumption against extraterritoriality did not preclude application of the accessibility mandate of 

Title III of the ADA to a foreign cruise ship which was required to provide accommodations to a 

patron who uses a wheelchair.138 

In sum, in light of courtsí recent willingness to apply American laws to conduct and persons 

overseas, the Federal Government is out of step with current legal developments when it acts as if 

American disability discrimination laws do not apply to its programs or employees overseas. To 

make clear that the presumption against the extraterritorial application of American disability 

discrimination laws does not preclude the Federal Government from complying with its own laws 

here and abroad, Congress should instruct all applicable federal agencies, including the U.S. State 

Department and USAID, that the Rehabilitation Act, as well as the ADA, prohibits discrimination 

against workers and in programs operated or funded by the Federal Government overseas. 

49Ä
50Ä
PART V. 

Recommendations 

NCD recommends that Congress adopt legislation to ensure full inclusion of people with 

disabilities in foreign policy and foreign assistance programs. 

1. GAO Should Conduct a Study of Current Practices 

The 1991 GAO report on disability and foreign assistance provided a valuable description of the 

barriers to access by people with disabilities in U.S. agency activities abroad. The 1996 NCD 

Report relied heavily on these findings, which led to the establishment of a USAID Disability 

Policy. While no formal policy directives have been established by other U.S. government 

agencies operating abroad, these agencies have had ample opportunity to improve practices. A 

new GAO investigation would provide an opportunity to determine the extent to which U.S. 

agencies operating abroad have (1) developed new planning or programs to ensure the inclusion 

of people with disabilities as recipients of U.S. foreign assistance and (2) overcome the specific 

barriers to access by people with disabilities identified in the GAO study, the 1996 NCD Report, 

and this report. 

NCD recommends that GAOís new investigation be expanded to examine whether there are 

barriers to people with disabilities in policymaking, program development, and implementation 

of U.S. programs abroad. The 1991 GAO Report recommended a follow-up report on the 

procedures and directives that guide the Department of State in the construction and renovation 

of facilities abroad to ensure accessibility to people with disabilities.139 Apparently, this report 

has never been done. In addition to examining physical access to U.S. buildings abroad, NCD 

now recommends that GAO conduct a broad investigation of access for people with disabilities 

to full participation in U.S. policymaking and programs abroad. 

In addition to U.S. programs, the GAO report examined access to people with disabilities within 

the United Nations system in programs directly or indirectly funded by the United States. The 

Untied Nations is now engaged in a process of drafting a new UN Convention on the Rights of 

51Ä
People with Disabilities, and it is a particularly appropriate time to determine whether the UNís 

own offices and other facilities, technical agencies, and programs abroad are accessible to people 

with disabilities. 

2. Amend the Foreign Assistance Act 

Congress should amend the Foreign Assistance Act to ensure the full inclusion of people with 

disabilities in U.S. policies and foreign assistance programs. Congress should identify its 

commitment to protecting the rights of people with disabilities by establishing targeted 

protections within the human rights mandates of the respective foreign assistance programs and 

laws. NCD recommends the following specific amendments to the Foreign Assistance Act: 

Create a disability advisor at the U.S. Department of State to serve as a leader in the 

development of U.S. international disability policy, to ensure that respect for disability 

rights is included as a priority in U.S. bilateral and multilateral policies and programs 

(including United Nations programs and activities), to advise and assist the State 

Department Office of Democracy, Human Rights and Labor (DRL) in preparing a section 

on disability rights in the Country Reports on Human Rights Practices, to ensure the 

inclusion of people with disabilities in policymaking, program development, and 

implementation within the United States and abroad, and to coordinate the work of the 

Department of State with the Inter-Agency Task Force on Foreign Policy and Disability. 

Require documentation of disability rights in State Department Country 

Reports–State Department Country Reports on Human Rights Practices should be 

required to include specific information on the rights of people with disabilities, such as 

information about improper detention in institutions and conditions of confinement in 

psychiatric or mental retardation facilities, orphanages, and other institutions where 

human rights abuses may be particularly egregious. DRL should be required to establish 

guidelines for staff abroad to assist them in identifying human rights abuses against 

people with disabilities. These guidelines should require that U.S. human rights officers 

abroad make contact with nongovernmental disability rights organizations abroad 

representing the major groups of people with physical, mental, and sensory disabilities. In 

52Ä
countries in which such groups cannot be identified or operate without adequate public 

support, DRL should ensure that assistance is provided to create or support human rights 

groups run by people with disabilities through the Fund for Inclusion (described below). 

In countries in which effective documentation by domestic disability rights groups has not 

yet been established, DRLís guidelines should suggest that human rights officers conduct 

site visits to institutions where people with disabilities are detained. Congress should set 

aside funds for DRL to make this possible. 

Ensure inclusion in foreign assistance programs–Create a broad mandate 

toìmainstreamî people with disabilities into all aspects of U.S. foreign assistance and 

human rights programs. In addition to guaranteeing that all programs be accessible to 

people with disabilities, legislation should require planning to ensure that the concerns of 

people with disabilities are among the priorities of U.S. foreign assistance programs. This 

will require amending 22 U.S.C. 2151(n)(d) to include a new paragraph (10) addressing 

the rights of people with disabilities to be free from human rights abuses and 

discrimination; and by amending 22 U.S.C. 2304 (1)(1) to include the word ìdisabilityî 

following race, sex, language, and religion. 

Create an Office on Disability in Development (DID) at USAID, similar to the USAID 

office on Women in Development, responsible for promoting the inclusion of people with 

disabilities in all USAID programs. The DID office will provide technical assistance to 

other USAID offices to assist them in developing appropriate accommodations and 

outreach programs to ensure the inclusion of people with disabilities in all existing areas 

of USAID programming. In addition, the DID office will provide workshops for USAID 

staff to provide the knowledge of disability issues necessary for active collaboration in 

these efforts on the part of USAID staff and will collect data on people with disabilities 

who are included in programs supported by USAID funds. The DID office will establish a 

long-term Strategic Plan for Inclusion to reform agency programs and will develop an 

annual Disability Plan of Action to begin immediate implementation of the Strategic Plan 

for Inclusion. The DID office will establish minimum standards for the inclusion of 

53Ä
people with disabilities in all current USAID Requests for Proposals, Requests for 

Applications, cooperative agreements, grants, and contracts. 

The DID office will administer a Disability Rights Fellowship that will place technical experts in 

disability issues in U.S. Missions abroad that apply for this assistance to meet the requirement of 

creating a Disability Plan of Action for the Mission. Congress should set aside sufficient funds to 

permit the placement of a Disability Rights Fellow in a majority of USAID Missions abroad. 

To avoid the problems of isolation experienced by the WID office over the years, and to promote 

the mainstreaming of disabilities into substantive programs of USAID, NCD recommends that 

the DID office be integrated into one of the largest substantive divisions or ìpillarsî of USAID, 

such as the Democracy, Conflict, and Humanitarian Assistance Division, as this is where civil 

society issues are addressed. The DID office should be guided by a civil rights approach that 

seeks to bring about the full inclusion of people with disabilities into all USAID programs. 

Create regional and Mission-level Disability Program Officers–Every regional 

program of USAID and every U.S. Mission abroad will be required to identify a 

Disability Program Officer. The Disability Program Officer will create a Mission 

Disability Plan of Action and will oversee its implementation in collaboration with 

Mission staff. 

Establish a Fund for Inclusion, Leadership, and Human Rights of People with 

Disabilities (referred to as the Fund for Inclusion)óThe Fund for Inclusion will permit 

USAID to provide grants and fellowships to promote the inclusion of people with 

disabilities in foreign assistance programs. Until such time as discriminatory practices are 

dismantled around the world, a targeted program to promote leadership and participation 

by people with disabilities will be essential. As a practical matter, governments and 

development organizations will not be able to effectively overcome barriers to full 

participation by people with disabilities until targeted programs are created. These targeted 

programs can provide education, training, and leadership experience that will help people 

with disabilities overcome discriminatory barriers throughout their own societies. NCD 

recommends that Congress allocate substantial support to the Fund for Inclusion that will 

54Ä
allow an appropriate response to the scope of the issue and capacity building, recognizing 

that people with disabilities make up at least 10 percent of the population of any country. 

Funding should be at least as large as Congress now allocates for more specialized 

programs that respond to the needs of particular vulnerable populations.140 

This fund will: 

Support the creation of new nongovernmental organizations and strengthen existing 

ones made up of people with disabilities around the world. The Fund for Inclusion should 

be used to support the work of U.S.-based disability organizations to provide technical 

assistance abroad and to serve as cooperating partners in the development of disability 

programs by USAID. People with disabilities who run organizations in the United States 

have a broad range of valuable skills that should be tapped for the development of 

participation by counterparts abroad. 

Notwithstanding the important participation by people with disabilities from the United States, at 

least half of the Fund for Inclusion shall go directly to organizations run by people with 

disabilities abroad in the form of small grants, training, fellowships, or technical assistance. The 

Fund for Inclusion will provide support to strengthen existing organizations, including crossdisability organizations, and promote their active participation in civil society and public 

policymaking. The Fund for Inclusion will target support for the development of organizations 

run by individuals with disabilities that currently have no organizations representing them or are 

under-represented in umbrella disability organizations as well as cross-disability organizations. In 

many developing countries, for example, there are no organizations run by people with 

psychiatric disabilities. 

Promote educational exchanges, technical assistance, and collaboration between 

U.S. disability rights groups, foreign governments, human rights organizations, and 

disability leaders abroad and build on successes that already exist in regional and 

interregional training programs occurring between disability policy organizations. 

55Ä
Provide technical assistance to governments and nongovernmental disability 

organizations in the methodology of disability rights legislation, implementation 

mechanisms, and legal advocacy. 

Assist governments in creating independent human rights oversight or ombudsman 

programs to monitor and protect the internationally recognized human rights of people 

with disabilities in institutions and in the community. Ombudsman or human rights 

oversight programs should be independent of government authorities service programs 

they monitor; these programs should report directly to independent advisory boards that 

include representation by leading local disability organizations; and these programs shall 

publish annual reports on the conditions of people with disabilities. 

The DID office will create guidelines for the operation of the Fund for Inclusion and will oversee 

its operation. Grants will be administered directly by U.S. Missions abroad. Individuals and 

disability groups may apply directly to the Fund for Inclusion from any country in which USAID 

has a Mission. 

New initiatives in post-conflict societies should include people with 

disabilities–USAID programs in post-conflict societies, and any legislation establishing 

new programs in post-conflict societies, should recognize that (1) war and conflict lead 

to high levels of disability, (2) the health and safety of people with disabilities are 

particularly at-risk in post-conflict societies, and (3) it is most cost efficient to plan for 

the inclusion of people with disabilities when new investments are being made in the 

built environment. Thus, inclusion of people with disabilities should be a priority in the 

immediate aftermath of major conflicts and disasters. 

Inclusion should be a required part of the Millennium Challenge Account–The 

proposed Millennium Challenge Account, which would establish a development program 

parallel to USAID, should be required to include people with disabilities from the outset. 

Since education is a proposed component of the Millennium Challenge Account, the 

requirement of inclusive and appropriate education of all people with disabilities should 

be a particularly important priority of this program. 

56Ä
3. Enforce the Application of the Rehabilitation Act of 1973 to U.S. Government 

Programs Overseas 

The Rehabilitation Act, including Sections 501, 503, and 504, should be applied specifically to 

all U.S. governmentñfunded programs abroad. 

57Ä
58Ä
PART VI.

Looking Ahead: The UN Disability Rights Convention

In the past two years, NCD has identified a major new policy priority in the area of foreign 

affairs: the support of a new United Nations Convention on the Rights of People with 

Disabilities. In December 2001, the United Nations General Assembly adopted resolution 56/88 

creating an Ad Hoc Committee to draft a convention. NCD has endorsed the idea of drafting a 

new convention, and has published a white paper entitled Understanding the Role of an 

International Convention on the Human Rights of People with Disabilities.

141 Among the many 

important reasons for supporting a new convention,142 a disability-specific human rights 

instrument will (1) guide the practice of the U.S. government and international agencies to 

ensure inclusion of people with disabilities in international affairs and (2) promote collaboration 

between disability rights leaders in the United States and abroad. 

U.S. government support for a strong UN Disability Rights Convention will be a test of the 

countryís commitment to include disability issues as a meaningful priority of U.S. foreign policy. 

The process by which the U.S. government develops and advances its position on the convention 

will demonstrate the U.S. commitment to full participation of people with disabilities on matters 

that affect them. Effective international collaboration in the drafting process will require 

consultation and full participation of disability leaders in the United States and abroad. Given the 

lack of funds for disability groups to participate in the drafting process, NCD recommends that 

the United States set aside funding from its current contributions to the United Nations to support 

the UN Voluntary Fund on Disability to facilitate consultation and dialogue with international 

experts, national institutions, and leaders of NGOs concerned with the rights of people with 

disabilities. By supporting a strong new UN Disability Rights Convention, by consulting with 

disability groups, and by setting aside funds necessary to ensure access to the consultative 

process by people with disabilities, the U.S. will establish its role as a leader in international 

disability rights consistent with its commitments to citizens with disabilities at home. 

59Ä
60Ä
PART VII. 

Appendix 

Mission of the National Council on Disability 

Overview and Purpose 

The National Council on Disability (NCD) is an independent federal agency with 15 members 

appointed by the President of the United States and confirmed by the U.S. Senate. The overall 

purpose of NCD is to promote policies, programs, practices and procedures that guarantee equal 

opportunity for all individuals with disabilities, regardless of the nature or significance of the 

disability, and to empower individuals with disabilities to achieve economic self-sufficiency, 

independent living and inclusion and integration into all aspects of society. 

Specific Duties 

The current statutory mandate of NCD includes the following: 

Reviewing and evaluating, on a continuing basis, policies, programs, practices and 

procedures concerning individuals with disabilities conducted or assisted by federal 

departments and agencies, including programs established or assisted under the 

Rehabilitation Act of 1973, as amended, or under the Developmental Disabilities 

Assistance and Bill of Rights Act, as well as all statutes and regulations pertaining to 

federal programs that assist such individuals with disabilities, in order to assess the 

effectiveness of such policies, programs, practices, procedures, statutes and regulations in 

meeting the needs of individuals with disabilities. 

Reviewing and evaluating, on a continuing basis, new and emerging disability policy 

issues affecting individuals with disabilities at the federal, state and local levels and in the 

private sector, including the need for and coordination of adult services, access to 

personal assistance services, school reform efforts and the impact of such efforts on 

61Ä
individuals with disabilities, access to health care, and policies that act as disincentives 

for individuals to seek and retain employment. 

Making recommendations to the President, Congress, the Secretary of Education, the 

director of the National Institute on Disability and Rehabilitation Research, and other 

officials of federal agencies about ways to better promote equal opportunity, economic 

self-sufficiency, independent living and inclusion and integration into all aspects of 

society for Americans with disabilities. 

Providing Congress, on a continuing basis, with advice, recommendations, legislative 

proposals and any additional information that NCD or Congress deems appropriate. 

Gathering information about the implementation, effectiveness and impact of the 

Americans with Disabilities Act of 1990 (42 USC 12101 et seq.). 

Advising the President, Congress, the commissioner of the Rehabilitation Services 

Administration, the assistant secretary for Special Education and Rehabilitative Services 

within the Department of Education, and the director of the National Institute on 

Disability and Rehabilitation Research on the development of the programs to be carried 

out under the Rehabilitation Act of 1973, as amended. 

Providing advice to the commissioner of the Rehabilitation Services Administration with 

respect to the policies and conduct of the administration. 

Making recommendations to the director of the National Institute on Disability and 

Rehabilitation Research on ways to improve research, service, administration and the 

collection, dissemination and implementation of research findings affecting persons 

with disabilities. 

Providing advice regarding priorities for the activities of the Interagency Disability 

Coordinating Council and reviewing the recommendations of this council for legislative 

and administrative changes to ensure that such recommendations are consistent with 

62Ä
NCD’s purpose of promoting the full integration, independence and productivity of 

individuals with disabilities. 

Preparing and submitting to the President and Congress an annual report titled National 

Disability Policy: A Progress Report. 

International 

In 1995, NCD was designated by the Department of State to be the U.S. government’s official 

contact point for disability issues. Specifically, NCD interacts with the special rapporteur of the 

United Nations Commission for Social Development on disability matters. 

Consumers Served and Current Activities 

Although many government agencies deal with issues and programs affecting people with 

disabilities, NCD is the only federal agency charged with addressing, analyzing and making 

recommendations on issues of public policy that affect people with disabilities regardless of age, 

disability type, perceived employment potential, economic need, specific functional ability, 

veteran status or other individual circumstance. NCD recognizes its unique opportunity to 

facilitate independent living, community integration and employment opportunities for people 

with disabilities by ensuring an informed and coordinated approach to addressing the concerns of 

people with disabilities and eliminating barriers to their active participation in community and 

family life. 

NCD plays a major role in developing disability policy in America. In fact, NCD originally 

proposed what eventually became the Americans with Disabilities Act. NCD’s present list of key 

issues includes improving personal assistance services, promoting health-care reform, including 

students with disabilities in high-quality programs in typical neighborhood schools, promoting 

equal employment and community housing opportunities, monitoring the implementation of 

ADA, improving assistive technology and ensuring that those persons with disabilities who are 

members of diverse cultures fully participate in society. 

63Ä
Statutory History 

NCD was initially established in 1978 as an advisory board within the Department of Education 

(P.L. 95-602). The Rehabilitation Act Amendments of 1984 (P.L. 98-221) transformed NCD into 

an independent agency. 

64Ä
PART VIII. 

Endnotes 

1

 22 U.S.C.A. ß 2304 (1979) (Supp. 2001). 

2

 The 2000 and 2001 State Department Country Reports on Hungary both included a reference to 

the fact that people with mental disabilities are detained in cages in Hungarian social care 

facilities. Bureau of Democracy, Human Rights and Labor, U.S. Depít of State, Country Reports 

On Human Rights Practices 2000, Hungary, available at http://www.state.gov/g/drl/rls/hrrpt/ 

2000/eur/774.htm (viewed on June 1, 2003) [hereinafter Country Reports]; Country Reports 

2001, Hungary, available at http://www.state.gov/g/drl/rls/hrrpt/2001/eur/8264.htm. Mental 

Disability Rights International (MDRI) had documented this problem in its 1997 report, Human 

Rights and Mental Health: Hungary, but Hungarian psychiatric authorities consistently defended 

the use of cages. Mental Disability Rights Int‘l, Human Rights And Mental Health: Hungary 

(Washington College of Law, American University 1997) available at http://www.mdri.org/ 

report percent20documents/Hungary.doc (viewed June 1, 2003). Two days after the release of the 

2000 State Department Report, officials at the Hungarian Ministry of Welfare contacted MDRI 

and disability activists in Hungary to begin a collaborative process of drafting new regulations 

that would ban the use of cages. Since then, the use of cages in Hungary has rapidly declined. 

The practice has not yet been outlawed. 

3

 While there is currently no international convention on the rights of people with disabilities, 

existing human rights law provides a broad range of protections for people with disabilities. 

Report of the United Nations Consultative Expert Group Meeting on International Norms and 

Standards Relating to Disability, Convened by the United Nations in Cooperation With Boalt 

Hall School of Law, University of California at Berkeley and the World Institute on Disability 

(Oakland, California USA) at Boalt Hall School of Law, University of California at Berkeley 

8-12 December 1998 (part 3ñlegal framework), available at http://www.un.org/esa/socdev/ 

enable/disberk0.htm (viewed on May 30, 2003) (this meeting set out to review and discuss issues 

and trends relating to the practical application of international norms and standards to promote 

the human rights of persons with disabilities in the international and domestic contexts). 

4

 As part of the Decade for Disabled Persons from 1983 to 1992, the UN Human Rights 

Commission appointed two special rapporteurs, Leandro Despouy and Erica-Irene Daes, who 

documented a worldwide pattern of abuse. Leandro Despouy, U.N. Ctr. for Human Rights & 

U.N. Sub-comm‘n on Prevention of Discrimination and Prot. of Minorities, Human Rights and 

Disabled Persons, U.N. Sales no. E92.xiv.4 (1993); United Nations Sub-comm‘n on Prevention 

of Discrimination and Prot. of Minorities, Principles, Guidelines and Guarantees for the Prot. of 

Persons Detained on Grounds of Mental Ill-Health or Suffering from Mental Disorder, United 

Nations, Economic and Social Council, Commission on Human Rights, Sub-Commission on 

Prevention of Discrimination and Protection of Minorities, Human Rights And Disability, U.N. 

65Ä
Doc. E/CN.4/Sub.2/1991/31 (prepared by Leandro Despouy) [hereinafter Despouy Report]. 

United Nations, Economic and Social Council, Commission on Human Rights, Sub-Commission 

on Prevention of Discrimination and Protection of Minorities, Principles, Guidelines, 

and Guarantees for the Protection of Persons Detained on Grounds of Mental Ill-Health or 

Suffering from Mental Disorder, U.N. Doc. E/CN.4/Sub.2/1983/17 (prepared by Erica-Irene 

Daes) [hereinafter Daes Report]. 

5 Second Annual Report on the Implementation of USAID Disability Policy, available at 

http://www.usaid.gov/about/disability/2ar_imp_policy.html#background (viewed June 1, 2003). 

6 Comprehensive and Integral International Convention to Promote and Protect the Rights and 

Dignity of Persons with Disabilities, 3rd Comm., 56th Sess., Agenda Item 119(b), U.N. Doc. 

A/C.3/56/L.67/Rev.1 (28 Nov. 2001). See United NationsñDepartment Of Economics And Social 

Affairs, Statistics Division, available at http://unstats.un.org/unsd/disability/default.asp (viewed 

on June 1, 2003) (listing percentages of persons with disability in different countries. Examples, 

in percent, are United States 1994 Survey - 15.0; Canada 1991 Survey -15.5; China 1987 Survey 

- 5.0; New Zealand 1996 Survey - 20.0; Germany 1992 Survey - 8.4; Sweden 1988 Survey -

12.1; United Kingdom 1991 Census - 12.2; Zambia 1990 Census - 0.9; Uganda 1991 Census -

1.2; Bangladesh 1982 Survey - 0.8; India 1981 Census - 0.2. It seems that the percentage of 

people with disabilities increases the more developed the country is and the more recent the 

survey is. This is probably due to higher levels of awareness about disabilities and what 

constitutes disability. For the questions used in the surveys, see http://unstats.un.org/unsd/ 

disability/allquest.htm (viewed on June 1, 2003). ìExisting disability data is woefully inadequate, 

with published estimates of national, regional, and global populations of people with disabilities 

being highly speculative.î The United States Agency for International Development (USAID) 

estimates the global population of people with disabilities to be 10 percent or more, and the 

Roeher Institute in Toronto, Canada, estimates the global population to be 10 to 13 percent.î See 

Robert L. Metts, Disability Issues, Trends and Recommendations for the World Bank, 

Discussion Paper No. 0007, 6 (February 2000); Marcia Rioux, Enabling the Well-Being of 

Persons With Disabilities 2 (Roeher Institute 1998), cited in National Council on Disability, 

Understanding the Role of an International Convention on the Human Rights of People with 

Disabilities 5 (June 12, 2002) [hereinafter UN Convention White Paper]. 

7 Despouy Report, supra note 4 at para. 3. 

8

 In Bulgaria, for example, the Country Reports note that people in psychiatric facilities are held 

in cages. See Country Reports 2002, Bulgaria, available at http://www.state.gov/g/drl/rls/ 

hrrpt/2002/18358.htm (viewed on June 1, 2003). In Kosovo, the Country Reports note that 

physical and sexual abuses have gone unchecked in psychiatric facilities. In Albania, 

ì[w]idespread poverty, unregulated working conditions, and poor medical care posed significant 

problems for many persons with disabilities.î Country Reports 2000, Albania, available at 

http://www.state.gov/g/drl/rls/hrrpt/2000/eur/668.htm (viewed on June 1, 2003). 

9

 See, e.g., Mental Disability Rights International, Not On The Agenda: Human Rights Of People 

With Mental Disabilities In Kosovo (2002), available at http://www.mdri.org/pdf/ 

66Ä
KosovoReport.pdf (viewed on June 1, 2003); Mental Disability Rights International, Human 

Rights & Mental Health: Mexico (2000), available at http://www.mdri.org/publications/ 

index.htm, (viewed on June 4, 2003); Mental Disability Rights International, Children in 

Russia‘s Institutions: Human Rights and Opportunities for Reform (1999), available at 

http://www.mdri.org/publications/Russia.html (viewed on June 4, 2003); Mental Disability 

Rights International, Human Rights & Mental Health: Hungary (1997), available at 

http://www.mdri.org/report percent20documents/Hungary.doc (viewed on June 4, 2003). Mental 

Disability Rights International, Human Rights & Mental Health: Uruguay (1995), available at 

http://www.mdri.org/publications/index.htm (viewed on June 1, 2003). See also Amnesty 

International Urgent Action on Bulgaria at http://www.amnesty.org. See also Los Derechos 

Humanos De Las Personas Con Discapacidad (compiled by Rodrigo Jimenez, 1996). 

10 Ann Elwan, Poverty and Disability: A Survey of the Literature Social Protection Discussion 

Paper No. 9932, The World Bank Group, available at http://wbln0018.worldbank.org/HDNet/ 

hddocs.nsf/2d5135ecbf351de6852566a90069b8b6/a16f1100a7ae28ff852567f600636b11?OpenD 

ocument (viewed on June 4, 2003). (Elwan Report). According to figures of the National 

Organization on Disability, the education levels of people with disabilities in the United States 

are also below those of nondisabled: 22 percent of Americans with disabilities fail to complete 

high school, compared to 9 percent of those without disabilities. See National Organization on 

Disability Web site, at http://www.nod.org/cont/dsp_cont_item_view.cfm?contentId=14 (viewed 

on June 4, 2003). 

11 Department for International Development, Disability, Poverty and Development 5 (2000), 

citing B. Hariss-White, Presentation to the Development Studies Association Annual 

Conference, University of Bath (September 13, 1999). 

12 See Elwan Report supra, note 10. The report found that ìthe links between poverty and 

disability go two waysónot only does disability add to the risk of poverty, but conditions of 

poverty add to the risk of disability.î 

13 The World Bank, World Development Report: Investing in Health (1993). 

14 Department for International Development, Disability, Poverty and Development 4 (2000), 

citing Leandro Despouey, Human Rights and Disabled Persons–United Nations Centre for 

Human Rights Study Series 6 (1993). 

15 Disability, Poverty, and Development, Id. at 1. 

16 Id. at 8. 

17 Norwegian Association of the Disabled, Aid to the Disabled in Developing Countries (1994). 

18 The World Bank Web site: www.worldbank.org (viewed on October 26, 2002). 

67Ä
19 A recent study done by the World Bank concludes that ìPeople with disabilities in the 

developing world are among the poorest of the poorÖ. With disabled people invisible in 

development initiatives, hundreds of thousands of people who see themselves as potential and 

willing contributors to family and national economic activity are instead relegated to the margins 

of society where they are perceived as an actual burden. The result can be devastating, both to the 

individual and to the economy.î Deborah Stienstra, Yutta Fricke, April DíAubin Baseline 

Assessment: Inclusion and Disability in World Bank Activities, Canadian Centre on Disability 

Studies, June 2002, available at http://wbln0018.worldbank.org/hdnet/hddocs.nsf/ 

View+to+Link+WebPages/ 841239FD3C23B7FD85256C07006824FE?OpenDocument (viewed 

on June 4, 2003). 

20 For more information on World Bank projects concerning disabled people see World Bank, 

Support for Project Design at http://wbln0018.worldbank.org/HDNet/hddocs.nsf/ 

2d5135ecbf351de6852566a90069b8b6/ 9ba0357c78adaadc8525683c00588c7c?OpenDocument 

(viewed on June 4, 2003). 

21 Rehabilitation Act of 1973, P.L. No. 93-112, 87 Stat. 355 (1973). 

22 Americans with Disabilities Act of 1990 (ADA), P.L. No. 101-336, 104 Stat. 327 (1990). 

23 National Council on Disability, Foreign Policy and Disability at 1 (1996), available at 

http://www.ncd.gov/newsroom/publications/foreign/html. 

24 National Council on Disability, Rehabilitating Section 504 at 76 (February 12, 2003), available 

at http://www.ncd.gov/newsroom/publications/section504.html (viewed on June 4, 2003). 

25 U.S. General Accounting Office, Foreign Assistance: Assistance to Disabled Persons in 

Developing Countries (February 1991), Report #NSIAD-91-82, at 2. The report also examined 

activities of the United Nations, other international organizations, and efforts by 

nongovernmental organizations. 

26 The exception to the rule identified by the GAO report was the Peace Corps. ìAmong US 

Agencies, only the Peace Corps has a specific mandate to assist disabled persons, and it has 

emphasized special education and rehabilitation in the programs it has provided. Assistance from 

other agencies has generally been sporadic rather than part of planned programs with specific 

objectives to target disabled people.î Id. at 3. 

27 Id. at 26. 

28 Id. at 48. 

29 Id. at 26. 

68Ä
30 Id. at 48. 

31 Id. 

32 Transmittal letter of the GAO Report from Harold Johnson, Director, Foreign Economic 

Assistance Issues, to the Honorable Claiborne Pell, Chairman, Committee on Foreign Relations, 

United States Senate, and the Honorable Jesse A. Helms, Ranking Minority Member, Committee 

on Foreign Relations, United States Senate, February 15, 1991. 

33 Id. at 23. 

34 Id. 

35 Id. 

36 The current USAID Policy Paper on Disability states that ì[t]he Americans with Disabilities 

Act of 1990 (ADA) is generally not applicable to USAIDís overseas programs. While the ADA 

applies to US citizens (including USAID employees) overseas, it does not apply to non-US 

citizens, who are the primary beneficiaries of USAID programs. The USAID Disability Policy is 

thus in part an effort to extend the spirit of the ADA in areas beyond the jurisdiction of U.S. 

law.î U.S. Agency for International Development, Policy Guidance: USAID Disability Policy 

Paper, September 12, 1997, at 3, available at http://www.usaid.gov/about/disability/ 

DISABPOL.FIN.html (viewed on June 4, 2003). 

37 Policy states the following: ìTo avoid discrimination against people with disabilities in 

programs which USAID funds and to stimulate an engagement of host country counterparts, 

governments, implementing organizations and other donors in promoting a climate of 

nondiscrimination against and equal opportunity for people with disabilities.î Id. 

38 Id. 

39 Id. at 9. 

40 Id., at Section D. 

41 US Agency for International Development, First Annual Report on Implementation of US AID 

Disability Policy, December 23, 1998, available at http://www.usaid.gov/about/disability/ 

disrept.htm#Status (viewed on June 4, 2003). 

42 Id. 

43 US Agency for International Development, The Second Annual Report on the Implementation 

of the USAID Disability Policy, February 15, 2000, available at http://www.usaid.gov/about/ 

disability/2ar_imp_policy.html#toc (viewed on June 4, 2003). 

69Ä
44 Emphasis added. 

45 Id. 

46 At the December 6, 2002, meeting, Tina Singleton of Mobility International USA (MIUSA) 

reported on one positive effort to promote the inclusion of women with disabilities in current 

USAID programs. 

47 Id. 

48 Mobility International USA, Gender and Disability: A Survey of Inter-Action Member 

Agencies (2003), at ix, available at http://www.miusa.org/development/resources/ 

genderdisabilityreport.PDF (viewed on June 4, 2003). 

49 Id. at xv. 

50 Id. at ix. 

51 In parts of the world, psychiatric disability is considered an ìillnessî rather than a disability, 

and people with psychiatric disabilities are not included in umbrella disability organizations. In 

much of the world, family members represent people with disabilitiesóto the exclusion of 

individuals with disabilities themselves. In Kosovo, MDRI documented international 

development programs theoretically directed to support the inclusion of people with disabilities 

that excluded individuals with mental disabilities. A national Disability Task Force established 

by the United Nations with international funds to promote the inclusion of people with 

disabilities in public policies did not include representation by people with mental disabilities 

because there were no mental disability advocacy organizations in Kosovo. Instead, UN officials 

invited the chief technician working at the psychiatric ward to represent people with mental 

disabilities. MDRI, Kosovo Report, supra note 9. 

52 MDRI reports that in some countries, a person with a mental disability can be declared 

ìmentally incompetentî for a lifetime without any form of judicial review. Such individuals may 

have their identity papers taken away from them, may be excluded from educational or 

vocational programs, and may be prohibited from making contracts. In some countries, large 

numbers of people with disabilities are segregated from society in institutions that control every 

aspect of their lives. Such individuals are cut off from the assistance of mainstream 

nongovernmental organizations and lack information about foreign assistance programs that may 

be open to them. 

53 See, e.g., The Inclusion of Disability in Norwegian Development Cooperation: Planning 

and Monitoring for the Inclusion of Disability Issues in Mainstream Development Activities 

(January 2002). 

70Ä
54 Stephen B. Cohen, Conditioning U.S. Security Assistance on Human Rights Practices, 76 

A.J.I.L. 246 (1982). 

55 Standard Rules on the Equalization of Opportunities for Persons with Disabilities, adopted by 

the General Assembly 85th plenary meeting, 20 December 1993. 

56 Id. at para 14. 

57 See Nordic Disabled Person Organisations, Inclusion of the Disability Dimension in Nordic 

Development Cooperation, 2000, available at http://www.disability.dk/images/docpics/ 

1006794750_Conference_report.doc (reporting and consolidating the Nordic countriesí joint 

disability and development policy) (viewed June 6, 2003). 

58 22 U.S.C.A. ß 2304 (1979) (Supp. 2001), as updated by Foreign Relations Authorization 

Act, Fiscal Year 2003, P. L. No. 107-228, 116 Stat. 1350 (2002); P.L. 108-23, approved 

May 19, 2003. 

59 Id. 

60 Id. 

61 22 U.S.C.A. ß 262d-1(1979) (Supp. 2001). 

62 Frank Newman & David Weissbrodt, International Human Rights: Law, Policy and Process, 

395 (1996). This textbook about international human rights contains a specific chapter titled 

ìHow Can the U.S. Government Influence Respect for Human Rights in Other Countries?î 

(Chapter 9), which surveys the policies of different U.S governments concerning foreign 

assistance and human rights and notes different lectures and articles of various Secretaries of 

State about this issue as well as legislation. 

63 22 U.S.C.A. ß 2304 (2001), as updated by Foreign Relations Authorization Act, Fiscal Year 

2003, P. L. No. 107-228, 116 Stat. 1350 (2002); P.L. 108-23, approved May 19, 2003. 

64 Congress, it appears, was concerned not only with justice but also with the appearance of it. 

Another section of this clause says that the assistance should be given in a manner which would 

ìavoid identification of the United States, through such programs, with governments which deny 

to their people internationally recognized human rights and fundamental freedoms, in violation of 

international law or in contravention of the policy of the United States as expressed in this 

section or otherwiseî (22 U.S.C.A. ß 2304). The President has authority to lift such sanctions 

when he finds that a significant improvement in the foreign countryís human rights record has 

occurred. 22 U.S.C.A. ß 2304 (e). The term ìsignificant improvementî of a countryís human 

rights record lacks a real definition, apart from specification that changes must ì[warrant] lifting 

the prohibition on furnishing such assistance in the national interest of the United States.î 

71Ä
65 22 U.S.C.A. ß 2751 (2001). 

66 22 U.S.C.A. ß 2304 (d) (1). 

67 Price v. United Kingdom, 53 Eur.Ct. H.R., (2001) (in which a woman in a wheelchair detained 

in jail overnight was denied accessible toilet facilities). This is obviously not the kind of ìflagrant 

denialî of human rights envisioned by the Foreign Assistance Act, but the case demonstrates that 

international human rights bodies have recognized that denial of accessibility can cause great 

suffering and this can rise to the level of suffering necessary to trigger the protections of the most 

strict provisions of international human rights conventions. See generally Eric Rosenthal & 

Clarence Sundram, The Role of International Human Rights in Mental Health Legislation, 21 

N.Y.L.Sch.J.Intíl & Comp. L. 469. 

68 The Case of Victor Rosario Congo, Inter-American Commission on Human Rights Report 

29/99, Case 11,427, Ecuador, adopted in Sess. 1424, OEA/Ser/L.V/II.) Doc. 26, March 9, 1999 

(a case from Ecuador in which a man with a psychiatric disability died in detention after he was 

denied appropriate medical treatment). 

69 MDRI has documented conditions in psychiatric facilities where conditions are so inhuman 

and dangerous that annual mortality rates are above 20 percent. MDRI has received reports of 

institutions for children with disabilities with mortality rates as high as 80 percent. In some 

institutions MDRI has investigated, there is no oversight or protection. People are left covered in 

their own feces, detained in cages, tied to beds for long periods of time, or subjected to sexual 

abuses. See MDRI reports, supra note 9. 

70 22 U.S.C.A. ß 2304 (a)(4). ìIn determining whether the Government of a country engages in a 

consistent pattern of gross violations of internationally recognized human rights, the President 

shall give particular consideration to whether the government (A) has engaged in or tolerated 

particularly severe violations of religious freedom, as defined in section 6402 of this title; or 

(B) has failed to undertake serious and sustained efforts to combat particularly severe violations 

of religious freedom when such efforts could have been reasonably undertaken.î 

71 Pub.L. 105-292, Oct. 27, 1998, 112 Stat. 2787 (22 U.S.C.A. ßß 6401, 6402). 

72 Subsection 11 to ß 6402 reads: ìThe term ëparticularly severe violations of religious freedomí 

means systematic, ongoing, egregious violations of religious freedom, including violations such 

asó(A) torture or cruel, inhuman, or degrading treatment or punishment; (B) prolonged 

detention without charges; (C) causing the disappearance of persons by the abduction or 

clandestine detention of those persons; or (D) other flagrant denial of the right to life, liberty, or 

the security of persons.î 22 U.S.C.A. ß 6402 (11). 

73 22 U.S.C.A. ß 2151n, as updated by the Foreign Relations Authorization Act, Fiscal Year 

2003, P. L. No. 107-228, 116 Stat. 1350 (2002); P.L. 108-23, approved May 19, 2003. 

72Ä
74 Donald M. Fraser, ìCongressís Role in the Making of International Human Rights Policy,î in 

Human Rights and American Foreign Policy 247, 247-54 (Donald P. Kommers & Gilburt D. 

Loescher, eds. 1979) in Frank Newman & David Weissbrodt at 393, supra note 62. 

75 Country Reports are submitted to the Congress by the Department of State in compliance with 

sections 116(d)(1) and 502B(b) of the Foreign Assistance Act of 1961 (FAA), as amended, and 

Section 505 (c) of the Trade Act of 1974, as amended. As stated in Section 116(d)(1) of the 

FAA: ìThe Secretary of State shall transmit to the Speaker of the House of Representatives and 

the Committee on Foreign Relations of the Senate, by January 31 of each year, a full and 

complete report regarding the status of internationally recognized human rights, within the 

meaning of subsection (A) in countries that received assistance under this part, and (B) in all 

other foreign countries which are members of the United Nations and which are not otherwise the 

subject of a human rights report under this Act.î 22 U.S.C.A. ß 2151n (d). Section (a) provides: 

No assistance may be provided under this part to the government of any country which engages 

in a consistent pattern of gross violations of internationally recognized human rights, including 

torture, or cruel, inhuman, or degrading treatment or punishment, prolonged detention without 

charges, causing the disappearance of persons by the abduction and clandestine detention of 

those persons, or other flagrant denial of the right to life, liberty, and the security of person, 

unless such assistance will directly benefit the needy people in such country. 

76 22 U.S.C.A. ß 2151n (d) and (f). 

77 See MDRI Reports supra note 9. 

78 22 U.S.C.A. ß 2152. 

79 22 U.S.C.A. ß 2152 (b). 

80 22 U.S.C.A. ß 2152 (c). 

81 First Annual Report on Implementation of USAID Disability Policy, supra note 41. 

82 Id. 

83 P.L. 106-386, Div. A, Oct. 28, 2000, 114 Stat. 1464. 

84 22 U.S.C.A. ß 7106. 

85 More details concerning the criteria for determination that the government is making ìserious 

and sustained effortsî to eliminate trafficking are set up in subsection (c). Id. 

86 22 U.S.C.A. ß 2152d. 

73Ä
87 22 U.S.C.A. ß 2152d (a) (1)ñ(4). These include drafting of legislation, law enforcement 

measures, and creation of facilities and programs to protect victims of trafficking and exchange 

programs for learning how to combat trafficking. 

88 22 U.S.C.A. ß 7104. 

89 22 U.S.C.A. ß 7105 as amended by Foreign Relations Authorization Act, Fiscal Year 2003, 

P.L. No. 107-228, 116 Stat. 1350 (2002) (these recent changes specifically target NGOs that 

provide services to trafficking victims as recipients of foreign assistance funds). And see 

USAID WID office report about its activities regarding trafficking: Trafficking in Persons: 

USAID‘s Response, available at http://www.usaid.gov/wid/pubs/trafficking_pub_final.pdf 

(viewed June 5, 2003). 

90 22 U.S.C.A. ß 2304 (h). 

91 Sabrina Feve & Christina Finzel, Recent Development: Trafficking of People, 38 Harv. J. on 

Legis. 279 (2001). 

92 22 U.S.C. A. ß 7107. 

93 The President can decide to continue the foreign assistance despite noncompliance with the 

minimum standards in two cases: (a) American national interest requires it or (b) continuation of 

assistance would promote the objective of the legislation. ß 7107 (d)(4) Subsection (5) further 

decrees that the President will use his discretion when there will be an adverse effect on women 

and children. 

94 22 U.S.C.A. ß 2151k. 

95 USAID, Policy Paper: Women In Development, Washington, D.C., October 1992 at 2, 

reprinted in Gloria Nikoi, Gender and Development, at 20 (1998). 

96 22 U.S.C. ß 2225. 

97 Celestine I. Nyamu, How Should Human Rights and Development Respond to Cultural 

Legitimization of Gender Hierarchy in Developing Countries, 41 Harv. Int‘l L.J. 381, 

384 (2000). 

98 United Nations: International Development StrategyœAction Programme of the General 

Assembly for the Second UN Development Decade, 5, reprinted in Nikoi, supra note 95, at 11. 

Following the statement of goals and objectives came this: ìAs the ultimate purpose of 

development is to provide increasing opportunities for a better life, it is essential to bring about a 

more equitable distribution of income and wealth for promoting both social justice and efficiency 

of productionÖ. Thus, qualitative and structural changes in the society must go hand in hand 

74Ä
with rapid economic growth; and existing disparitiesóregional, sectoral, and socialóshould be 

substantially reduced.î Id. at 12. 

99 United Nations: 3281 (XXIX) Charter of Economic Rights and Duties of States 52, reprinted in 

Nikoi, supra note 95, at 13. The Charter stated further: ìThe right of women to work, to receive 

equal pay for work of equal value, to be provided with equal conditions and opportunities for 

advancement in work, and all other womenís rights to full and satisfying economic activity are 

strongly re-affirmed.î Id. 

100 Nikoi, supra note 95, at 19. 

101 WID Web site, available at www.usaid.gov/wid (viewed on June 5, 2003). 

102 Katherine Spengler, Expansion of Third World Women‘s Empowerment: The Emergence of 

Sustainable Development and the Evolution of International Economic Strategy, 12 Colo. J. Int‘l 

Envl. L. & Pol‘y 303, 313ñ314 (2001). 

103 P.L. 95-424, 1978 HR 12222 ß108. 

104 Id. 

105 Nyamu, supra note 97 at 385-386. 

106 Spengler, supra note 102 at 315. 

107 supra note 101. 

108 At the December 6, 2002, NCD meeting, Elise Smith of Womenís Edge, a coalition of 

individuals and organizations concerned with promoting the economic status of women around 

the world, observed that the Percy Amendment opened the door to women in development 

programs, but that a number of subsequent initiatives were needed to bring about effective 

inclusion. See also Ossai Miazad, Legislative Focus: Gains Act, 9 Hum. Rts. Br. 37 (2002). 

109 Kathleen Staudt and Alice Stewart Carloni, Women in Development: AID‘s Experience, 

1973ñ1985, A-14, reprinted in Nikoi, supra note 95 at 20-21. 

110 Women, International Development, and Politics–The Bureaucratic Mire, updated and 

expanded ninth edition (Kathleen Staudt, ed., 1997). 

111 Miazad, supra note 108. 

112 USAID Office of Women In Development, Gender Plan of Action: Fact Sheet, March 1997, 

available at http://www.usaid.gov/wid/pubs/actionfs.htm (viewed on June 5, 2003). 

75Ä
113 Elise Smith, Womenís Edge, Coalition of Individuals and Organizations Concerned With 

Promoting the Economic Status of Women Around The World, National Council on Disability 

Strategy Session, Washington, D.C., December 6, 2002. 

114 Id. 

115 MDRI has developed detailed recommendations to funders for the development of 

nongovernmental advocacy groups. See MDRI, Kosovo Report, supra note 9, and MDRI, 

Children in Russia‘s Institutions, supra note 9. 

116 See ìCivil Societyî section in the Office of Democracy and Governance on USAID Web site, 

http://www.usaid.gov/democracy/office/civ.html (viewed on June 5, 2003). 

117 The term ìcivil societyî means the independent, nongovernmental, nonprofit realm of citizen 

activity. Within civil society are all those nonprofit organizations formed of the free association 

of people and to create social support or other community work, express views, debate issues, 

and advocate for public policies on matters that affect them. 

118 First Annual Report on Implementation of the USAID Disability Policy, supra note 41. 

119 Art. I, ß 8, cl. 3 of the Constitution gives Congress broad powers ìto regulate Commerce with 

foreign Nations.î See EEOC v. Arabian Am. Oil Co., 499 U.S. at 248 (1991) [hereinafter 

Aramco] (citing Foley Bros. v. Filardo, 336 U.S. 281, 284-85 (1949)). 

120 See Hartford Fire Ins. v. Cal., 509 U.S. 764 (1949); Ford v. United States, 273 U.S. 593 

(1927); American Banana Co. v. United Fruit Co. 213 U.S. 341, 356 (1909); Lauritzen v. Larsen, 

345 U.S. 571, 579 n.7 (1953); Steele v. Bulova Watch Co., 344 U.S. 280, 282-86 (1952) 

(rejecting constitutional challenge to application of Lanham Act to conduct occurring in Mexico). 

121 See Aramco, 499 U.S. at 248; Hartford Fire Ins., 509 U.S. at 764 (Scalia, J., dissenting). 

122Aramco, 499 U.S. 244, superseded by P.L. No. 102-166 (1991). 

123 Id. at 248 (discussing Foley Bros., 336 U.S. at 285, quoted in William S. Dodge, 

Understanding the Presumption Against Extraterritoriality, 16 Berkeley J. Int‘l L. 85, 92 (1998); 

Curtis A. Bradley, Territorial Intellectual Property Rights in an Age of Globalism, 37 VA. J. Int‘l 

L. 505, 507 (1997). 

124 See, e.g., Hartford Fire Ins. Co., 509 U.S. at 794-96 (applying Sherman Act to conduct abroad 

without referring to presumption against extraterritoriality). 

125 See, e.g., Jonathan Turley, —When in Rome“ Multinational Misconduct and the Presumption 

Against Extraterritoriality, 84 NW. U. L. Rev. 598, 663-64 (1990). 

76Ä
126 See, e.g., Envtl. Def. Fund v. Massey, 986 F.2d 528 (D.C. Cir. 1993). For a thorough 

discussion of the questionable relevance of the presumption against extraterritoriality to 

disability discrimination laws, see Arlene S. Kanter, Taking it on the Road: The Extraterritorial 

Reach of Disability Discrimination Laws to Students Studying Abroad, Stanford J. Leg. and Pol. 

2003 (forthcoming). 

127 Following the Courtís decision in Aramco, Representative Jefferson (D-LA) introduced H.R. 

1694, American Employees Equity Act of 1991, Representative Mfume (D-MD) introduced H.R. 

1741, Extraterritorial Employment Protection Amendments of 1991, and Senator Danforth (RMO) introduced S. 1407, Protection of Extraterritorial Employment, together with Senator 

Kennedyís (D-MA) bills comprising the Civil Rights Act. 

128 Congress amended the Civil Rights Act in 1991 to give extraterritorial protection to American 

citizens working overseas for American employers in Section 109. See P.L. No. 102-166, 105 

Stat. 1071 (codified as amended at 42 U.S.C. ß 1981 (1991)), 136 Cong. Rec. S15, 235 (daily ed. 

Oct. 25, 1991) (statement of Sen. Kennedy). Senator Grassley, a sponsor of the amendments, 

remarked that the 1984 amendments to the Age Discrimination in Employment Act ìclose a 

loophole created by several court decisions.î See 130 Cong Rec. S65, 46 (daily ed. May 24, 

1984) (statement of Sen. Charles Grassley). 42 U.S.C. 12111-117 (1990). 

129 Civil Rights Act of 1991, P.L. No. 102-166, ß 109, 105 Stat. 1071 (codified in sections of 42 

U.S.C.). For a comprehensive review of the enactment of the Civil Rights Act of 1991, and cases 

applying that law, see Maher, supra note 49. 

130 See Bird v. Lewis & Clark College, 104 F. Supp. 2d 1271 (D. Or. 2000) aff‘d 303 F.3d 1015 

(9th Cir. 2002), cert. denied, 123 S.Ct. 1583 (March 24, 2003) (trial court upheld extraterritorial 

application of the ADA and Section 504 but denied relief under these laws to student who uses a 

wheelchair and claimed the University had failed to accommodate her disability in its overseas 

program, although the Court of Appeals for the Ninth Circuit did not reach the issue of 

extraterritoriality). 2002 U.S. App. Lexis 10842. See also King v. Bd. of Control of E. Mich. 

Univ., 221 F.Supp.2d 783 (2002). 

131 Order Ruling on Extraterritoriality, 9 (D.Or. Oct. 13, 1999) (on file with author, citing United 

States v. Juda, 46 F. 3d- 961,067 (9th Cir. 1995). 

132 King, 221 F. Supp. 2d 783 (2002). 

133 See, e.g., Barth v. Gelb, in which the court held that the State Department's Foreign Service is 

subject to the requirements of the Rehabilitation Act, in a case involving an insulin-dependent 

Foreign Service specialist who had alleged he was denied a reasonable accommodation in the 

form of flexibility in assignments. Although the court found for the defendant, Voice of America, 

the court specifically recognized the applicability of the Rehab Act to foreign service workers. 

Barth v. Gelb 761 F. Supp. 830 (D.C. Cir. 1991). See also Local 1812 American Fed. of 

Government Employees v. US Department of State, 662 F. Supp. 50 (D.C. Cir. 1987) (court 

77Ä
recognized that the Foreign Service Act is made subject to the Rehab Act in 22 U.S.C. 

3905(e)(4)); Guerriero v. Schultz, 557 F. Supp. 511 (D.D.C. 1983) (foreign service worker 

covered by the Rehabilitation Act); Mendez v. Gearan, 956 F. Supp. 1520 N.D. Ca. 1997) (Peace 

Corps worker covered by Rehabilitation Act); Barrera v. Dalton, 1997 U.S. App. Lexis 17611 

(4th Cir. 1997) (Navy employee covered by Rehabilitation Act). 

134 NCD Report at 21. 

135 Id. at 23. 

136 42 U.S.C. 4151-4157. 

137 Stevens v. Premier Cruises Inc. 215 F.3d 1237 (11th Cir. 2000). 

138 The Department of Justice and the Department of Transportation have taken the position thatÄ

foreign flag cruise ships are subject to Title III of the ADA when they dock in U.S. ports byÄ

virtue of their contacts with the United States. See U.S. Dept of Justice Letter re: Foreign FlagÄ

Cruise Ships, 18 Nat‘l Disability L. Rep. (Lab. Rel. Press) ¶ 31 (July 13, 1999); Letter re: CruiseÄ

ships, 3 Nat‘l Disability L. Rep. (Lab. Rel. Press) 330 (Dec. 7, 1992). Ä

139 Transmittal letter accompanying the 1991 GAO Report, Foreign Assistance: Assistance to

Disabled Persons in Developing Countries, from Harold J. Johnson, Director, Foreign EconomicÄ

Assistance Issues of the GAO National Security and International Affairs Division, to theÄ

Honorable Claiborne Pell, Chairman, Committee on Foreign Relations, U.S. Senate and TheÄ

Honorable Jesse A. Helms, Ranking Minority Member, Committee on Foreign Relations, U.S.Ä

Senate, dated February 15, 1991.Ä

140 For example, in USAIDís FY 2002 budget there exists the following congressionalÄ

mandated programs:Ä

Blind Childrenñ1.3 millionÄ

ALL Vulnerable Childrenñ25 millionÄ

Children with HIVñ14.9 millionÄ

Victims of Tortureñ10 millionÄ

War Victims Fundñ12 millionÄ

Women in Developmentñ11 millionÄ

Trafficking of Womenñ6 millionÄ

141 UN Convention White Paper, supra note 6. 

142 The most important reasons for supporting a convention are (1) to improve protections under 

international law for the human rights of people with disabilities around the world; and (2) to 

create an international mechanism to monitor human rights enforcement for people with 

disabilities. Other reasons for supporting a convention are described fully in the UN Convention 

White Paper at 2, supra note 6. 

78Ä
79
80

National Council on Disability Media Mail 

1331 F Street, NW, Suite 850 US Postage Paid 

Washington, DC 20004 Permit No. G-279 

Official Business ADDRESS SERVICE REQUESTED 

Penalty for Private Use, $300 
Foreign Policy and Disability • September 9, 2003 • National Council on Disability