WHO & ISPRM

The ISPRM-WHO-Liaison Committee (ISPRM-WHO-LC)

 

Chair:Christoph Gutenbrunner,MD, PhD, Professor

Secretary: Boya Nugraha, MSc

 

Scope of the ISPRM-WHO-Liaison Committee

Since 1999 ISPRM has become an official relation with the WHO and collaborated with the DAR team. This includes the participation of ISPRM in WHO meetings and collaboration in the network of WHO partners. As a Non-Governmental Organisation (NGO), ISPRM has to contribute substantially to WHO activities according to agreed and accepted working plans (see below). This mainly relates to disability and rehabilitation as well as the contribution to the development of classifications.

 

Committee structure

The ISPRM-WHO-Liaison Committee is chaired by Christoph Gutenbrunner (Hannover, Germany) who at the same time is the ISPRM´s-Liaison officer to WHO and the main focal point for WHO. Boya Nugraha (Hannover, Germany) is secretary of the committee and focal point to WHO, and Gerold Stucki (Lucerne, Switzerland) advisor to the committee chair.

In order to be able to fulfil its tasks and to ensure a continuous input on the highest possible level, the ISPRM-WHO-LC has four subcommittees working on specific topics of the collaboration plan (Figure 1).

These are

    •  The “Implementation of the UN-Convention of the Rights of Persons with Disabilities, the World Report on Disability and the WHO’s SCI-specific report-Subcommittee” (WRD-Implementation Subcommittee)(Chair: Alessandro Giustini, Italy; Co-chairs: Per von Groote, Switzerland; Bryan O’Young, USA)
    • The “Implementation of the International Classification of Functioning, Disability and Health-Subcommittee” (ICF-Implementation Subcommittee)(Chair: Friedbert Kohler, Australia; Co-chair: Marcelo Riberto, Brasil)
    • The “Community Based Rehabilitation-Subcommittee” (CBR-Subcommittee)(Chair: Luz Helena Lugo, Columbia; Co-chair: Peni Kusamastuti, Indonesia; Secretary: Luz Maria Escobar, Columbia)
    • The “Strengthening Medical Rehabilitation-Subcommittee” (SMR-Subcommittee)(Chair: Christoph Gutenbrunner, Germany; Co-chair: Anthony Ward, UK; Secretary: Matthias Bethge, Germany)

The Rehabilitation Disaster Relief Subcommittee was part of the ISPRM-WHO-LC. This subcommittee has worked as a full committee since June 2013. However, in order to ensure continuous input to the collaboration plan it will be represented in the ISPRM-WHO-LC policy advisory group.

 

What are the contents of collaboration?

The contribution of ISPRM is defined in collaboration plans that are reviewed and updated regularly. The collaboration plan of ISPRM with the WHO for the period of 2011 to 2013 includes nine main areas:

  1. Contribution to WHO invited meetings
  2. Involvement of WHO representatives at the bi-annual congress of the ISPRM
  3. Strengthening Medical Rehabilitation and information to ISPRM members about WHO
  4. Development, Dissemination and Implementation of a World Report of Disability
  5. Implementation of the ICF at the clinical level and in population-based epidemiology
  6. Community-based rehabilitation guideline
  7. ISPRM will participate through its Liaison Officers in the WHO Meeting of Partners to explore ways to implement the principles of the Convention on the Rights of Persons with Disabilities
  8. ISPRM will contribute to the development, dissemination and implementation of an International Perspective on Spinal Cord Injury
  9. PRM Contribution to Rehabilitation Disaster Relief.

A new collaboration for the period from 2014 to 2017 is under preparation

 

What has been achieved in the last two years?

An important landmark both for the activities of WHO in the field of disability and rehabilitation and for the ISPRM-WHO-LC was the launch of the World Report on Disability (WHO & World Bank 2011) in June 2011. It summarizes the available data on the prevalence on disability worldwide and analyses the life situation of persons with disabilities. Additionally it contributes to the conceptual discussions about disability that is described as an interaction between a person with a health condition and his or her environment. Thus one of the main recommendations of the report is to remove barriers that hinder participation and inclusion. Concerning rehabilitation, the report clearly states that rehabilitation is neither purely social nor purely medical. It is a comprehensive strategy with the goal to “enable persons with health conditions experiencing or likely to experience disability to achieve and maintain optimal functioning in interaction with the environment” (Gutenbrunner et al. 2011; Meyer at al. 2011). The report also highlights the role of PRM as the medical specialty in rehabilitation. The WRD includes a number of important recommendations for a disability policy and the main areas from rehabilitation and assistive technology to health care, education and labor.

ISPRM’s immediate response to the WRD was strategic workshops in Puerto Rico in June 2011 and in Sao Paulo in January 2012 where the contribution of ISPRM to dissemination, analysis and implementation of the World report have been conceptualised. Regarding dissemination, a report was published in the official journal of ISPRM and many sessions in international regional and national conferences were organised. Regarding the analysis, basic principles have been developed and by using cases and data that were collected from countries in all ISPRM world areas and subareas. The results of these works will be published in a special issue of the American Journal of Physical Medicine and Rehabilitation by the end of 2013.

Members of ISPRM gave significant contribution to another WHO report that deals with the situation of persons with spinal cord injury (SCI). The respective WHO-report will be launched by WHO in December 2013.

Within the context of the conceptual discussions around the WRD and following the work that has been done in the Professional Practice Committee of the UEMS-PRM section, conceptual descriptions of rehabilitation as a health strategy and of PRM were developed within the Strengthening Medical Rehabilitation-subcommittee. These conceptual descriptions are based on the comprehensive model of functioning and see rehabilitation as a comprehensive health strategy. Additionally, they show that PRM is the medical specialty that fulfils the needs of medical assessment and intervention for persons who experience disability in light of their health condition. After internal discussion and modifications in November 2012 both conceptual descriptions were adopted by ISPRM and can be used as official ISPRM documents (Gutenbrunner et al. 2011; Meyer et al. 2011). For the next steps, the feasibility of the descriptions and their relevance for PRM practice need to be shown in used cases.

Another main activity of ISPRM is the development of concept for a response of Physical and Rehabilitation Medicine to natural disasters. The Rehabilitation Disaster Relief Committee developed a conceptual framework for such activities based on scientific work and experiences from the Sichuan and Haiti earthquakes as well as from other natural disasters e.g. in Japan, Indonesia, and Italy. Besides the provision of concepts, recent activities are the development of a database, educational programs and funding activities for concrete actions. The results and projects of this committee have been published and presented and discussed in many international and regional congresses.

With regard to the implementation of the ICF the respective subcommittee took the initiative to define or describe the functional properties of the main health conditions or diagnosis in rehabilitation. This was discussed in workshops in Sao Paulo in January 2012 and in Beijing in June 2013. Another important project of the ICF-Implementation subcommittee is the development of assessment tools to measure disability and functioning in international comparative studies. These instruments will be mainly based on the ICF core sets. The projects of this committee will be reported in News & Views soon.

Most of the topics of the ISPRM-WHO collaboration plan have been included in the mutual recognition agreements of ISPRM with regional PRM societies.

 

What are recent activities?

During the first half of the year 2013 one of the most important activities within WHO was the discussion of the Executive Board about a report of the secretariat on disability  and the discussion and adoption of a resolution about disability of the 66th World Health Assembly (May 2013). This resolution is of great significance to PRM as it (among others):

  • “(…) ENDORSES the recommendations of the World report on disability”;
  • “URGES Member States (…) to promote habilitation and rehabilitation across the life course and for a wide range of health conditions through: early intervention; integrated and early intervention; integrated and decentralized rehabilitation services (…); improved provision of wheelchairs, (…) and other assistive technologies; (…) to enable people with disabilities to achieve their potential and have the same opportunities to participate    fully in society”;
  • “REQUESTS the Director-General (…) to prepare, in consultation with other organizations of the United Nations system and Member States and within existing resources, a comprehensive WHO action plan with measurable outcomes, based on the evidence in the World report on disability, in line with the Convention on the Rights of Persons with Disabilities and the report of the High-level Meeting of the United Nations General Assembly on Disability “The way forward: a disability-inclusive development agenda towards 2015 and beyond” for consideration, through the Executive Board, by the Sixty-seventh World Health Assembly”.

In the discussion in the Executive Board of WHO and in the World Health Assembly, ISPRM gave statements to support the report of the secretariat and to highlight the conceptual description of rehabilitation as a health strategy and to urge more scientific research. In the technical briefing for the UN high level meeting, ISPRM additionally stressed the importance of education and training of all health and other professionals in disability issues.

As another important WHO activity, its Family of Classifications group (WHO-FIC) has been working on the 11th revision of the International Classification of Diseases (ICD-11) that – for the first time – will include functional properties of the diseases, and the International Classification of Health Interventions (ICHI).

The main projects of the ISPRM-WHO-LC in 2013 are

  • to analyse the WRD and to publish a special issue of the American Journal for Physical Medicine and Rehabilitation
  • to give input to the Executive Board of WHO and to the WHA (especially to the agenda topic on disability)
  • to disseminate and analyse the resolution on disability of the 66th WHA
  • to give input to the action plan of WHO related to the WHA resolution on disability and to the UN High-level Meeting on disability and development
  • to disseminate and analyse the IPSCI-report as soon as it will be launched by WHO
  • to describe and analyse the functional properties of the most frequent diseases in rehabilitation and to develop assessment tools for functioning and disability
  • to conceptually describe rehabilitation services and to develop a concept for a classification of rehabilitation service organisation
  • to develop models how to integrate specialised medical rehabilitation into community based rehabilitation concepts and to ensure access to such services
  • to contribute to the development of health related classifications, in particular to ICD-11 and ICHI
  • to contribute to WHO strategies to intervene after natural disasters and to prevent that persons with disabilities will be affected more intensively by such incidents

Additionally, the collaboration with other professional organisations in official relation with WHO have been intensified, in particular with Rehabilitation International (RI), the International Society for Prosthetics and Orthotics (ISPO), the World Federation of Occupational Therapists (WFOT), the World Federation of Physiotherapists (WFPT), and the International Society for Spinal Cord Injury (ISCI). This will ensure more coordinated activities and more efficient strategies to implement relevant contents.

Click here to read the presentation of the WHO LC at the ISPRM Congress held in Cancun, Mexico, June 2014.

Documents 

  1. Statement at the 66th World Health Assembly in Geneva, May 2013 (Gutenbrunner, 2013)
  2. Statement at the Meeting of WHO Europe in Izmir, September 2013 (Nugraha, 2013)
  3. Towards a conceptual description of rehabilitation as a health strategy (Meyer et al. 2011)
  4. Towards a conceptual description of Physical and Rehabilitation Medicine (Gutenbrunner et al. 2011)
  5. ISPRM Discussion paper: Proposing a conceptual description of health-related rehabilitation services (Meyer et al. 2013)
  6. Medical Rehabilitation after Natural Disasters: Why, When, and How? (Rathore et al 2012)
  7. The NHV rehabilitation services program improves long-term physical functioning in survivors of the 2008 Sichuan earthquake: a longitudinal quasi experiment (Zhang et al. 2013)
  8. Evaluation of functional outcomes of physical rehabilitation and medical complications in spinal cord injury victims of the Sichuan earthquake (Li et al. 2012)