A/HRC/40/32 31. Although comprehensive data on unmet needs for assistive devices do not exist, there is evidence that many people with disabilities across the world, even in high-income countries, do not have access to basic assistive products.16 To ensure the affordability of assistive products, States should include assistive devices in the coverage of national health insurance and/or social protection schemes, and consider other cost-reducing measures such as waiving import duties and taxes on assistive products manufactured abroad, supporting local producers through grants, loans and tax credits, or improving procurement-managed expenditure (A/71/314, para. 47). 32. Assistive products must suit the environment and the user. The availability of follow-up care and affordable local maintenance is important for ensuring safe and efficient use (ibid., para. 46). Trained personnel are essential for the proper prescription, fitting, user training, follow-up and maintenance of assistive products.17 4. Peer support 33. In article 26 (1), reference is made to peer support as one of the potential elements of the provision of rehabilitation services. Peer support can be defined as the social, emotional or practical support that people with lived experience of disability are able to give to one another. States must recognize the voluntary nature of the activity and fully respect the freedom of association and expression of peer support groups, while taking positive measures to support and promote peer-led rehabilitation services.18 Peer support in the form of self-help groups has proven an effective strategy for providing certain forms of rehabilitation in low-income countries as part of community-based inclusive development.19 34. The benefits of peer support are widely recognized. Experience shows that peer support can be successfully integrated in comprehensive rehabilitation programmes in a number of ways. It can be an independent means of providing certain types of interventions, support or help with certain elements of rehabilitation provision, such as awareness-raising. Peers can also work alongside professionals, including in health settings, assisting in the communication between the client and the rehabilitation personnel and helping overcome barriers such as learned helplessness, anxiety and mistrust. 20 B. Ensuring a human rights-based approach to rehabilitation 1. Free and informed consent 35. All rehabilitation services and programmes must be voluntary and based on free and informed consent. 21 This requires that the individuals be provided with adequate information about the suggested intervention(s) in a manner that is accessible and understandable to them and they are enabled to exercise free choice in the matter. Information provided by rehabilitation personnel must include a full and impartial explanation of the reason for the suggested intervention, its expected outcomes including potential benefits and risks, the methods to be used (including the likely duration and frequency of sessions), the consequences of not undergoing the intervention, and the available alternative interventions. Consent is not a once-and-for-all activity, but it should be regularly reviewed to ensure the individual’s wish to continue, particularly when circumstances change. A person has the right to withdraw from receiving the service at any time, as well as to re-engage the process. 16 17 18 19 20 21 WHO, “Priority assistive products list”, May 2016, p. 3. WHO, “Priority assistive products list”, p. 3. See also WHO, Rehabilitation in Health Systems, p. 26. For instance, by providing public funding to organizations of persons with disabilities, including child- and youth-led organizations, or by providing training. WHO, Community-based Rehabilitation: CBR Guidelines – Empowerment Component (Geneva, 2010), pp. 37–47. WHO, Community-based Rehabilitation: CBR Guidelines – Health Component (Geneva, 2010), p. 55. Committee on the Rights of Persons with Disabilities, general comment No. 5, para. 90. 9