A/HRC/34/58 4. Disadvantaged groups 46. Persons with disabilities belonging to groups that have been historically discriminated against or disadvantaged (such as indigenous peoples, ethnic minorities and persons living with HIV/AIDS) are disproportionately affected in accessing support arrangements and services. This also applies to migrants, persons living in conflict situations, internally displaced persons, refugees, asylum seekers, stateless persons and prisoners with disabilities, as humanitarian responses tend to overlook their support needs. Moreover, there is a strong link between belonging to a racial and cultural minority and experiencing coercion and institutionalization.15 Policies and programmes to ensure access to support must seek to overcome the impact of the multiple and aggravated forms of discrimination faced by persons with disabilities belonging to these groups in accessing support. 47. Policies and programmes to ensure access to support should respond to the heterogeneous needs of the diverse disability community, which includes deaf, deafblind and autistic persons, persons with psychosocial and intellectual disabilities and persons with albinism. For example, in Kazakhstan new regulations provide that all blind and deafblind persons are entitled to personal assistance. Nonetheless, while impairmentspecific considerations may be necessary to provide targeted support services for specific groups, States should carefully assess whether the adoption of specific measures that benefit certain groups may exclude others. D. Unpacking the obligation to provide access to support 48. Following the standards developed by the Committee on Economic, Social and Cultural Rights, 16 the Special Rapporteur has identified four interrelated and essential elements of the obligation to provide support to persons with disabilities. These elements can vary in accordance with different conditions and types of support arrangements. 1. Availability 49. Appropriate support services and arrangements must be available to all persons with disabilities in sufficient quantity within countries. States should consider establishing a system, under domestic law, to ensure access to a wide range of support measures. This system can be composed of a single scheme or a variety of schemes, both formal and informal. States have a duty to ensure that support is available for persons with disabilities, regardless of whether it is actually provided by public service providers, civil society, families, communities, or a combination of public and private actors. While the support provided by family, friends and the broader community is extremely important and should be encouraged and enabled, it is not always a reliable or sustainable solution in the longer term (see A/HRC/28/37, paras. 35-36). 50. Support systems should ensure the availability of an adequate number of functioning programmes and services to provide the fullest possible range of support to the diverse population of persons with disabilities, including communication support, support in decision-making, mobility support, personal assistance, living arrangements services and community services. Ensuring the availability of a reliable, skilled and trained workforce, 15 16 12 Ruchika Gajwani and others, “Ethnicity and detention: are black and minority ethnic (BME) groups disproportionately detained under the Mental Health Act 2007?”, Social Psychiatry and Psychiatric Epidemiology, vol. 51, No. 5 (May 2016), pp. 703-711. General comments No. 13 (1999) on the right to education, No. 14 (2000) on the right to the highest attainable standard of health and No. 19 (2007) on the right to social security.