WHO’s Global Initiatives for Rehabilitation and Health Equity

Rehabilitation is often treated as an afterthought in global health planning – something addressed after the “real” medical work is done. But the World Health Organization (WHO) has been working steadily to change that narrative. With nearly a third of the world’s population living with a health condition that could benefit from rehabilitation, WHO recognizes this not as a niche concern, but as a core public health priority. Its initiatives, policies, and research investments are reshaping how countries understand and deliver rehabilitation – especially for those who need it most.

The scale of the global rehabilitation gap 🔗

According to WHO, an estimated 2.4 billion people worldwide are currently living with a health condition that may benefit from rehabilitation. The need is predicted to increase as populations age and more people live with chronic disease and disability. Yet in some low- and middle-income countries, more than 50% of people do not receive the rehabilitation services they require.

This gap isn’t just a healthcare statistic – it represents millions of people who cannot fully participate in work, education, or daily life. A landmark study jointly developed by WHO and the Institute for Health Metrics and Evaluation (IHME) found that the global need for rehabilitation has increased 63% since 1990, rising from 1.48 billion to 2.41 billion people. The study challenged the longstanding perception of rehabilitation as an optional or specialist service, arguing it is a critical strategy for universal health coverage.

Global rehabilitation needs remain unmet due to multiple factors: lack of prioritization and funding at the national level, absence of services in rural areas, high out-of-pocket costs, shortage of trained professionals – with fewer than 10 skilled practitioners per 1 million population in many low- and middle-income settings – and insufficient research and data on rehabilitation.

WHO’s Rehabilitation 2030 initiative 🔗

The Rehabilitation 2030 initiative was launched in February 2017, introducing a “call for action” that rallied stakeholders toward concerted and coordinated global action to scale up rehabilitation. It marked a turning point – for the first time, WHO was placing rehabilitation at the center of the global health agenda rather than on its margins.

The initiative draws attention to the profound unmet need for rehabilitation worldwide and highlights the importance of strengthening health systems to provide it. It emphasizes that rehabilitation should be available to all people at every stage of life, integrated into all levels of health care, and treated as an essential service crucial for achieving universal health coverage.

The initiative commits to strengthening rehabilitation services globally by focusing on key actions such as improving governance and investment, expanding the rehabilitation workforce and services, and enhancing data collection. In July 2019, a second meeting was held to identify facilitators and barriers in advancing the global rehabilitation agenda, where “functioning” was promoted as a public health goal and proposed as the third health indicator, alongside mortality and morbidity.

The 10 priority action areas 🔗

To achieve its goals, Rehabilitation 2030 identified 10 priority areas for action, including creating strong leadership and political support at all levels of government; strengthening rehabilitation planning within emergency preparedness and response; improving integration of rehabilitation into the health sector; incorporating rehabilitation in universal health coverage; and building comprehensive service delivery models to progressively achieve equitable access to quality services, including assistive products, for all populations including those in rural and remote areas.

The World Health Assembly resolution of 2023 🔗

The momentum built by Rehabilitation 2030 culminated in a historic milestone. In May 2023, the Resolution on “Strengthening Rehabilitation in Health Systems” was adopted unanimously by the 194 Member States of the World Health Assembly – the highest health policy-setting body – marking the first time in 75 years that rehabilitation was on its agenda.

This resolution has been a historic milestone, marking the first time in 75 years that rehabilitation has been recognized as a core global public health priority. The resolution outlines priority actions for Member States, civil society, and the WHO Secretariat, aligning directly with the Rehabilitation 2030 action areas. By 2026, WHO’s Director-General is expected to present a baseline report on rehabilitation needs, with progress reports continuing through 2030.

As of now, WHO has supported approximately 78 countries across all world regions to strengthen their health systems and provide better rehabilitation services, and the number of countries requesting technical support is ever-increasing.

Advocacy and policy integration 🔗

Passing resolutions is one thing – embedding rehabilitation into national health systems and emergency frameworks is another. WHO’s advocacy efforts go well beyond declarations; they involve equipping governments with the tools, policies, and capacity to act.

Rehabilitation within universal health coverage 🔗

WHO views rehabilitation as an essential part of achieving both universal health coverage and Goal 3 of the Sustainable Development Goals – ensuring healthy lives and promoting well-being for all at all ages. To this end, WHO works to make rehabilitation part of health care at all levels through efforts to strengthen health systems as a whole.

Member States have underscored the need for rehabilitation to be available to the whole population and integrated into health planning and implementation. They stress that rehabilitation is an important enabler of quality of life and community participation, and that commitment to rehabilitation services must be built through integration within national health plans, inter-ministerial work, and meaningful participation of rehabilitation users.

Rehabilitation in health emergencies 🔗

One of the most critical – and most neglected – areas of WHO’s advocacy is rehabilitation in emergency contexts. Rehabilitation is a neglected but essential part of emergency response and long-term recovery. Emergencies disproportionately affect weaker health systems and the most vulnerable populations, but early and ongoing access to rehabilitation reduces complications, optimizes functioning, and reduces disability in those affected, supporting individuals, families, and communities in their recovery.

Research shows that only one of 19 low- and middle-income countries studied had integrated rehabilitation into health emergency preparedness. The lack of rehabilitation preparedness has repeatedly been a key barrier to an early effective response in emergencies. To address this, WHO is developing advocacy and policy resources to support the integration of rehabilitation into health emergency risk management, building national and regional technical capacity to provide rehabilitation leadership and coordination in emergency responses.

WHO’s policy brief on strengthening rehabilitation in health emergency preparedness, response, and resilience outlines the evidence for rehabilitation in emergencies and sets out specific steps that decision-makers can take to better integrate rehabilitation into health emergency preparedness and response.

The World Rehabilitation Alliance 🔗

To sustain global advocacy beyond institutional walls, WHO established a dedicated network. The World Rehabilitation Alliance (WRA) is a WHO-hosted global network of stakeholders whose mission is to support the implementation of the Rehabilitation 2030 Initiative through advocacy activities. The WRA focuses on promoting rehabilitation as an essential health service integral to Universal Health Coverage and to the realization of UN Sustainable Development Goal 3. Its work is organized into five workstreams: workforce, primary care, emergencies, external relations, and research.

Research and evidence enhancement 🔗

Advocacy without evidence is advocacy without teeth. WHO has placed significant emphasis on building the research base for rehabilitation – particularly in low- and middle-income countries, where data are scarce and policy decisions are too often made without it.

Why rehabilitation research matters 🔗

Although rehabilitation is by its nature integrative and an essential part of universal health coverage, in many countries it is still not a part of the continuum of care. It is rarely provided at all levels and continues to be viewed as a service exclusively for persons with disabilities, delivered in specialized facilities and outside of the mainstream health system.

Health policy and systems research for rehabilitation generates the evidence needed by policymakers to make appropriate decisions and to develop action plans that enhance the capacity of the health system to serve the population in need. Specifically, this evidence helps establish priorities for rehabilitation service delivery, evaluate outcomes of interventions, identify societal benefits, and strengthen health systems to increase access and quality.

WHO’s tools and data initiatives 🔗

Through Rehabilitation 2030, WHO emphasizes improving data collection and research on rehabilitation. It continues to support countries by providing technical support, developing guidance and practical tools, and building robust evidence for rehabilitation – focusing both on local and national health systems as well as emergency response settings.

More than 30 countries are implementing strategic plans for rehabilitation using WHO tools, collaborating with development partners, civil society, and service users. These countries are setting objectives to strengthen health systems for rehabilitation and executing actions to achieve them. For instance, Georgia has been working to integrate rehabilitation into its universal health coverage benefit packages – a direct outcome of evidence-driven policy work supported by WHO.

Addressing data gaps in low-income settings 🔗

Reliable data about unmet needs for rehabilitation and assistive technology remain scarce, but useful estimates can be drawn from information like global burden of disease profiles and age statistics. Much of the unmet need is concentrated among the poorest and most vulnerable populations in low- and middle-income countries and conflict-affected settings, which are often ill-equipped to cope with increasing demand for rehabilitation services.

The WRA’s dedicated research workstream is specifically tasked with advocating for the demand and use of health policy and systems research evidence, promoting high-quality research generation, and ensuring findings are published, disseminated, and translated into action at the country level. This pipeline – from data to decision – is central to WHO’s vision of making rehabilitation both evidence-based and universally accessible.

Why health equity is at the heart of WHO’s rehabilitation agenda 🔗

Across all of WHO’s rehabilitation work – from Rehabilitation 2030 to emergency preparedness to research – one theme runs consistently: health equity. The people who most need rehabilitation are often the least likely to receive it. They live in rural areas, earn low incomes, reside in conflict zones, or belong to marginalized communities. In many countries, less than half of people receive the rehabilitation care they require, and the problem is amplified for vulnerable and marginalized populations.

WHO’s rehabilitation guidelines are applicable across care settings and geographies. Like most complex health reform initiatives, they require change at multiple levels – from macro-level health governance to the delivery of services in individual communities. The challenge is not just building services but ensuring those services reach the people who fall furthest behind.

Rehabilitation isn’t a finishing touch on healthcare – it’s a foundation. It’s what allows a stroke survivor to speak again, a child with cerebral palsy to attend school, or an earthquake survivor to regain independence. WHO’s Rehabilitation 2030 initiative and the broader global effort it has inspired represent a recognition that no health system is truly universal if rehabilitation remains a privilege of geography or income.

What do you think? Given that over 2.4 billion people need rehabilitation yet services remain deeply unequal across countries, what do you think should be the top priority – expanding the rehabilitation workforce, improving financing, or strengthening research and data systems? And how responsible do you think wealthier nations are for supporting rehabilitation infrastructure in low-income countries?

References

1. https://www.who.int/news-room/fact-sheets/detail/rehabilitation
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC10699090/
3. https://www.who.int/initiatives/rehabilitation-2030