LET us look at cross-cutting disability issues by focusing on disability and HIV/AIDS. We all know that disability and HIV/AIDS are permanent conditions people have.
It is because of this condition they are called after each condition such as disabled people and people living with HIV/AIDS commonly referred to as PLWHA.
The question that the world needs to answer is; are people living with HIV/AIDS disabled because of having that permanent condition?
Since there is no cure for now, but life prolonging drugs or maybe we wait until we are told that scientists have failed to find the cure and declared condition permanent.
For us to appreciate this thought, let us look at the definition of disability according to United Nations convention on the rights of the Disabled.
Disability is the consequence of an impairment that may be physical, cognitive, mental, sensory, emotional, developmental, or some combination of these. A disability may be present from birth, or occur during a person’s lifetime.
We must mention here that a disability is an umbrella term, covering impairments, activity limitations, and participation restrictions.
An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.
Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.
The United Nation convention on rights of the disabled new definition has stated  that an individual may also qualify as disabled if he/she has had an impairment in the past or is seen as disabled based on a personal or group standard or norm.
Such impairments may include physical, sensory, and cognitive or developmental disabilities. Mental disorders (also known as psychiatric or psychosocial disability) and various types of chronic disease may also qualify as disabilities.
However some advocates object to describing certain conditions such as deafness and autism as “disabilities”, arguing that it is more appropriate to consider them developmental differences that have been unfairly stigmatised by society.
In this article we will discuss more on medical conditions more especially Chronic or disambiguation.
A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects.
The term chronic is usually applied when the course of the disease lasts for more than three months. Common chronic diseases include arthritis, asthma, cancer, COPD, diabetes and HIV/AIDS.
In medicine, the opposite of chronic is acute. A chronic course is further distinguished from a recurrent course; recurrent diseases relapse repeatedly, with periods of remission in between which affect a person ability to function normally.
It is a fact that there is a close link between HIV/AIDS and disability which is permanency in terms of condition which one must accept and live with so society must understand that people living with HIV/AIDS today live with that condition until death just like persons with disabilities.
If we take condition as a point of identification we can safely say may be they are also disabled because people living with HIV/ AIDS are at high risk of becoming disabled permanently or episodic basis as a result of being HIV/AIDS positive.
However, our society negative attitude against people living with HIV/AIDS may be change of this declaration is made because relatives spent a lot of money in trying to find a cure for the loved one but if the World Health Organization (WHO) publicly declare that the condition for people living with HIV/AIDS is permanent like any other conditions attitudes will change and stigma reduced.
People living with HIV/AIDS end up using crutches or wheel chairs as the disease prolong the fact that many of us we have seen within our families or communities so calling them disabled would not change anything but open the closed door and remove force hopes created by society that one day the condition will change for better
This “cross cutting of disability” principle implies the responsibility to integrate disability issues in the main stream of health policies and practice of all Government ministries rather than handling disability as a matter of social welfare sector or charity but as a developmental agenda with focus on promoting inclusive approach.
The main objective of crosscutting disability gender and HIV/AIDS should be toward addressing identified health information challenges and ensuring that each ministry has a disability component within the budget.
Crosscutting must have a comprehensive approach to provision of health information to persons with disabilities without discrimination.
As I said earlier that this must be based on United Nations convention on the rights of the disabled and places rights and equal opportunities of persons with disabilities as one of the Cross-Cutting strategies.
That measure or action will easily effectively implement crosscutting disability strategy for integrating health and gender issues on disability programmes, gender and social equality, rights of persons with disabilities must be integrated in all development action and be on the centre stage of Government planning.
There is a need to engage all NGOs in addressing crosscutting disability and gender if the discriminatory approach to information provision to persons with disabilities can be addressed and training leaders of disabled peoples Organisation’s on matters of advocacy and creating a strong voice with a strong message on disability crosscutting and HIV/AIDS.
Conducting advocacy programmes within communities and in all sectors with aim to accommodate person with disabilities in line with the provision of CRPD within society and complement universal and equal provisions with targeted, additional support and services to equalize access and opportunities for quality health delivery.
Relevance of disability as it related to HIV/AIDS is still not understood well everywhere because society feel persons with disabilities do not require information on HIV/AIDS and access to health related information and services.
In most countries, the situation of persons with disabilities is further compounded by societal barriers that hinder their full and effective participation in society, including access to education. Despite the growing relationship between HIV/AIDS and disability, persons with disabilities have not received sufficient attention within national responses to HIV and AIDS.
Furthermore, existing HIV prevention, treatment, care and support programmes generally fail to meet their specific needs.
There is not much demand for disability crosscutting  approach by partners despite demand by DPOs in Zambia  that  Disability seems still to remain a”NGO business” – not a main stream business by developmental partners.
One difficult challenge is that crosscutting disability approach needs “ownership” and a responsible agent.  ”Everybody’s business is often nobody’s business.” On the global scene there is a need for an infrastructure for crosscutting approach.
This calls for investing in core funding for agents that facilitate the national  ”public goods”, i.e. appropriate national approach  that would be needed for mainstreaming disability issues in development and poverty reduction.
Public goods are by definition things that benefit all regardless whether one contributes for them or not but because they are respected and are part of that society.
Poverty reduction is one of the global public goods and it should be national good for persons with disabilities to be included in every strategy aimed at addressing matters affecting them.
If we do not manage reduce HIV/AIDS pandemic everybody will be affected but mainstreaming disability in development for poverty reduction would yield double benefits in reducing deprivation and exclusion.
The growing relationship between HIV/AIDS and disability is an emerging issue and cause for concern as persons with disabilities are at higher risk of exposure to HIV.
Additionally, there is a growing understanding that persons living with HIV or AIDS are also at risk of becoming disabled on a permanent or episodic basis as a result of their condition.
Like any other person, persons with disabilities require information on HIV/AIDS and access to programmes, services, and resources.
In most countries, the situation of persons with disabilities is further compounded by societal barriers that hinder their full and effective participation in society, including access to education. Despite the growing relationship between HIV/AIDS and disability, persons with disabilities have not received sufficient attention within national responses to HIV and AIDS.
Furthermore, existing HIV prevention, treatment, care and support programmes generally fail to meet their specific needs.
Persons with disabilities are often excluded from HIV education, prevention and support services because of assumptions that they are not sexually active or do not engage in other risk behaviours such as drug use.
Sexual and reproductive health service providers may lack knowledge about disability issues, or have misinformed or stigmatising attitudes towards person with disabilities.
Services offered at clinics, hospitals and in other locations may be physically inaccessible, lack sign language facilities or fail to provide information in alternative formats such as Braille, audio or plain language.
In places where there is limited access to medication, persons with disabilities may be considered a low priority for treatment.
Women and girls with disabilities are especially vulnerable to sexual assault or abuse.  Persons with intellectual impairments and those in specialised institutions are also at particularly high risk.
Around the world, children with disabilities are a large proportion of the children and persons with disabilities not enrolled in school, which results in their exclusion from vital sexual and reproductive health education that is often provided in school settings.
Low literacy levels and a lack of HIV prevention information in accessible formats, such as  Braille make it all the more difficult for persons with disabilities to acquire the knowledge they need to protect themselves from being infected.
Persons with disabilities are seldom recognized as a group to be included in the national response to HIV/AIDS.
Integrating their specific needs is a crucial component to mitigate the worsening condition of persons with disabilities.
The failure to understand and provide essential information to persons with disabilities concerning HIV/AIDS, results in their increasing marginalisation.
Work on HIV/AIDS issues at all levels, local, national, regional and global levels, should consider the rights and needs of persons with disabilities through the design of legislation, funding structures, policies, and programmes. HIV/AIDS professionals and advocates can help create a dialogue with and within the disability community to foster more open discussion of HIV/AIDS issues.
The Convention on the Rights of Persons with Disabilities provides a global policy framework to promote the equal rights to health for persons with disabilities, including sexual and reproductive health, on par with those without disabilities and enable policies to implement AIDS programming for persons with disabilities and programmes to fight against stigma, discrimination and other barriers faced by persons living with HIV/AIDS, Some countries have adopted anti-discrimination laws and other measures that explicitly cover discrimination on the basis of HIV/AIDS.
The author is Regional Disability policy Analyst for SADC and Inclusive Development Advisor for Centre for Disability Development Research, Law and Policy, Johannesburg
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