World Bank

Borrowing country governments align infrastructure, education, and social protection projects with the World Bank's Disability Inclusion and Accountability Framework before loans close, incorporating accessibility requirements that national regulations would not otherwise mandate.

ENABLE Model location

• Builder-side Interventions → Set Requirements that Include Accessibility
• Builder-side Interventions → Design Accessible Experiences
• Builder-side Interventions → Iterate to Address Shortcomings
• Builder-side Interventions → Provision Resources for Accessibility
• Builder-side Interventions → Provide Support Channels

What it is

The World Bank Group, through its two primary lending arms, the International Bank for Reconstruction and Development (IBRD) and the International Development Association (IDA), provisions development finance to more than 100 countries, ranging from school construction and urban transport to social protection systems and health infrastructure. Since 2018, borrowing countries have been required to satisfy the Bank's Environmental and Social Framework (ESF) before loans close. The ESF mandates that borrowers assess risks to persons with disabilities, apply universal design principles in new construction, and conduct meaningful consultations with disability communities before project appraisal.¹ In the same year, Charlotte McClain-Nhlapo, who has served as the Bank's Global Disability Advisor since 2014, anchored a set of ten institutional commitments at the first Global Disability Summit, including a target that 75 percent of World Bank-financed social protection projects would be disability-inclusive by 2025.²

The Disability Inclusion and Accountability Framework, first published in 2018 and updated in 2022, provides operational guidance to project teams, task managers, and national counterparts on how to embed disability considerations across education, transport, health, post-disaster reconstruction, digital development, and employment.³ The IDA, which lends on concessional terms to the poorest countries, designated disability inclusion as a cross-cutting theme in its IDA19 replenishment, directing investment toward disaggregated data collection, differentiated sectoral interventions, and accessible physical infrastructure.⁴ These requirements enter the project cycle at requirement-setting and are intended to carry forward through design and post-completion review.

By 2026, the Bank's disability page highlighted support reaching 44 IDA countries, more than 100,000 persons with disabilities identified through Nepal's reconstruction work, and more than 1 million students reached through disability-inclusive education work in Burkina Faso, Cambodia, and Rwanda.⁴ Those headline results document institutional reach, but disability-rights monitors at the Bank Information Center argue that Bank project documents still promise accessibility more reliably than many teams deliver it in implementation.⁵ The ESF disability requirements apply only to Investment Project Financing that began on or after October 1, 2018, so a large legacy portfolio remains outside the framework, and even covered projects depend on task managers and borrower agencies whose disability competency varies sharply.¹

Why it matters

World Bank lending spent seven decades treating disability as outside development finance. The Bank's founding in 1944 at Bretton Woods organized development finance around infrastructure, macroeconomic stabilization, and growth, categories whose designers and beneficiaries were defined against a normatively able-bodied, wage-earning subject. Schools built without ramps, hospitals built without accessible examination tables, transport systems built without accessible boarding infrastructure, and rural roads built without curb cuts all accumulated across hundreds of projects in dozens of countries. Through the structural adjustment era of the 1980s and 1990s, Bank and IMF lending conditions required borrowing governments to cut public sector spending, privatize health and education services, and introduce user fees, reforms that public health researchers including Rene Loewenson documented as driving down access to maternal and child health care and widening inequalities in the populations that generate and carry disability.⁶ The 2011 joint WHO/World Bank World Report on Disability documented the cumulative result. Over one billion people, or 15 percent of the global population, live with disability, 80 percent of them in developing countries, and disabled people in those countries face higher rates of poverty, lower educational attainment, and worse health outcomes than non-disabled peers.⁷ Disabled Persons Organizations and international human rights bodies pushed the Bank into disability inclusion after decades of advocacy named development lending as a driver of inaccessible infrastructure, and the International Disability Alliance co-hosted the 2018 Global Disability Summit where the Bank announced its ten commitments.

The social structure that sustains the gap between the Bank's disability policy and its project portfolio involves multiple layers of institutional decoupling. At the institutional level, the Bank employs one Global Disability Advisor to support operational teams across a lending portfolio of hundreds of active projects annually, a staffing ratio that makes substantive project-level engagement selective rather than universal.² Task managers who lack disability competency can still write Project Appraisal Documents that satisfy ESF paperwork requirements without translating them into procurement language, consultation design, or supervision routines, a gap that disability-rights monitors describe as the persistent distance between inclusive project language and inaccessible implementation.⁵ Borrowing governments whose ministries of finance and planning do not include disability expertise in procurement and infrastructure units replicate that gap at the national level. Persons with disabilities in project-affected areas who cannot reach consultation events held in inaccessible venues, communicated in inaccessible formats, or conducted without sign language interpretation are excluded from the processes nominally designed to include them, a form of enduring inaccessibility baked into the project cycle itself.

Marta Russell, in her 2001 essay "Disablement, Oppression, and the Political Economy," argued that disabled people function within capitalist economies as a surplus population whose exclusion from labor markets serves capital accumulation by depressing wage floors and sustaining a reserve labor pool.⁸ Applied to international development lending, Russell's framework identifies the economic logic that makes disability inclusion costly to enforce. Infrastructure built to universal design standards costs incrementally more at design and construction stages, but the costs of excluding disabled people from employment, education, and services fall on households and communities rather than on borrowers or lenders. World Bank loan terms reflect project-delivery costs, not the downstream costs of inaccessibility. When a school built without accessible toilets produces twenty years of lower enrollment and attainment for children with physical disabilities, that cost does not appear in the project's completion report. The Bank's 2018 commitment structure named this problem without resolving it. Aspirational targets set in 2018 for achievement by 2025 created accountability pressure but not the pricing signal that would make disability inclusion a condition of favorable loan terms rather than a compliance checkbox.

Nirmala Erevelles, in Disability and Difference in Global Contexts (2011), examined a World Bank-sponsored self-help group project in south India and found that the project's normative subject, the entrepreneurial, economically productive participant, excluded disabled people whose impairments did not fit the productivity metric the Bank's design assumed.⁹ Erevelles argues that international development institutions, including the World Bank, organize development around a subject defined by capitalist productivity norms in ways that reproduce the marginalization of people whose bodies or minds do not conform to those norms. Helen Meekosha, in "Decolonising Disability: Thinking and Acting Globally" (Disability and Society, 2011), extends that critique by naming how global North institutions universalize a disability framework built on Northern experience while the Global South carries the impairment-producing weight of colonial extraction, war, environmental dumping, and sweatshop labor.¹⁰ Tsitsi Chataika, writing from Zimbabwe, argues that African disability scholarship has to be written from the ground of African lives rather than imported through donor programs, and that externally driven disability inclusion can reinscribe the North-South hierarchy it claims to disrupt.¹¹ The Bank's disability inclusion commitments since 2018 operate within that same tension. They require that disability be considered in project design while continuing to organize projects around economic productivity and infrastructure delivery metrics, and they route consultation through the International Disability Alliance and national OPDs without funding those organizations at a scale that would make them structural partners in governance rather than inputs to a Bank-led process.¹² Disabled Persons Organizations in countries receiving Bank lending, including in Latin America and sub-Saharan Africa, have called for the Bank to fund disability-led organizations, include DPO members in project governance, and adopt accountability mechanisms that give affected communities recourse when disability commitments in Project Appraisal Documents go unimplemented. The 2022 Global Disability Summit showed progress in rhetoric but did not produce binding enforcement mechanisms.

The WHO/World Bank World Report on Disability documents a biosocial cycle that development lending, when it fails disability inclusion, directly reinforces. Malnutrition, preventable disease, inadequate prenatal care, and unsafe working conditions, all conditions associated with poverty in low-income countries, produce disability at higher rates than in wealthy countries. Disability then concentrates poverty further through reduced employment access, higher out-of-pocket healthcare costs, exclusion from social protection programs, and restricted mobility in inaccessible physical environments.⁷ A 2018 study of extra costs of disability found that disabled people and their households face systematic additional expenditures, the "conversion handicap" Amartya Sen identified, that standard poverty measurement tools undercount by failing to adjust for disability-related costs.¹³ When the Bank finances infrastructure projects that do not apply universal design, it builds the physical environment that will concentrate the next generation's disability-poverty cycle. School buildings without ramps exclude children with mobility disabilities from education; inaccessible transport systems exclude disabled workers from employment; health facilities without accessible examination equipment produce worse diagnostic outcomes for disabled patients. Each inaccessible facility adds to the cumulative built environment that the 2011 report documented as a primary driver of disability-related poverty.

The World Bank's Disability Inclusion and Accountability Framework moved disability from a margin note to a named requirement in the Bank's Environmental and Social Framework, which means borrowing governments now face a formal obligation to consider disability in projects that did not exist before 2018. McClain-Nhlapo's decade-long tenure as Global Disability Advisor gave that shift an institutional anchor, and the Bank's own 2026 results page now advertises disability-inclusive reach across 44 IDA countries and more than 1 million students.⁴ World Bank managers and borrowing governments still control whether that requirement changes a project after approval. People harmed by IBRD- and IDA-financed projects can file through the World Bank Accountability Mechanism's Inspection Panel and Dispute Resolution Service, a builder-side support channel inside the Bank that is complaint-driven, usually requires prior engagement with Bank management, and activates only after affected people learn the project exists and organize themselves well enough to challenge it.¹⁴ Task managers still work under delivery deadlines and cost pressure, and that pressure lands long before a community can assemble a complaint file. Until disability inclusion carries the same day-to-day consequences inside supervision, procurement, and disbursement that financial and environmental noncompliance already carries, World Bank projects will keep reproducing exclusion even when the paperwork names inclusion.

Real-world examples

In the news

Disability Discrimination at the World Bank: Is it Immunity or Impunity? (April 2021)
-- Inter Press Service

• While the World Bank raised $82 billion for international disability inclusion programs, a Disability Support Group of Bank staff alleged that the institution denied worker's compensation to disabled employees, eliminated jobs while staff were on disability leave, and used diplomatic immunity to avoid accountability under US disability law. Bank leaders could publicly fund disability inclusion while disabled employees still alleged discrimination inside the institution, the same split between policy announcement and institutional behavior that the Bank's own portfolio review identified at the project level.

In the news

Why is the 2022 Global Disability Summit important for the World Bank? (2022)
-- Bank Information Center

• The Bank Information Center's assessment argued that the World Bank's 2018 Global Disability Summit commitments raised disability's profile at the Bank but left disability-inclusive projects a small fraction of the active portfolio. BIC called for "strong ambitious commitments" at the 2022 summit and for the Bank to make disability inclusion a condition of requirement-setting with enforceable consequences rather than aspirational targets. The assessment framed iteration as slow when voluntary commitments replace structural incentives.

• In Nepal, the World Bank supported post-earthquake reconstruction that used disaggregated data to identify over 100,000 persons with disabilities in affected areas, enabling targeted support in housing, health, and livelihood recovery.⁴
• In Senegal, the Dakar Bus Rapid Transit project, financed with World Bank support, incorporated ramp access, accessible boarding infrastructure, and pedestrian walkways as design requirements before construction began, showing what design-stage disability inclusion looks like when enforced.⁴
• In Guyana, the Education Sector Improvement Project addressed disability through teacher training on inclusive education, accessible learning materials, and curriculum reform, illustrating how disability inclusion can be embedded across multiple dimensions of a single project.⁴

What care sounds like (builder-side interventions)

Care at requirement-setting and design means Bank task managers and borrowing country teams embedding disability inclusion before appraisal:

• "Every physical facility in this project applies universal design from the concept note stage. We are not retrofitting accessibility after construction."
• "We have scheduled pre-appraisal consultations with Disabled Persons Organizations in the project area, in accessible formats, before the Stakeholder Engagement Plan is finalized."
• "The social assessment for this project includes disaggregated data on disability prevalence and specific analysis of how the project affects people with different types of disability."
• "Post-completion review for this project includes accessibility audits of constructed facilities. Findings go to the task team and the borrower with remediation timelines."
• "We are building disability inclusion into the loan covenant, not just the Project Appraisal Document, so that the borrower government faces the same accountability for disability outcomes as for financial reporting."

What neglect sounds like (builder-side interventions)

• "Disability inclusion is mentioned in the ESF checklist. We flagged it as not applicable for this infrastructure project."
• "We held a stakeholder consultation. We can't control who showed up."
• "The borrower government is responsible for disability compliance under national law. Our framework doesn't require us to enforce above national standards."
• "Adding accessibility features would increase project costs and delay implementation. We're working within a fixed budget."
• "We don't have disability data disaggregated for this region. We'll use national averages."
• "The task team reviewed the disability requirement and determined the project doesn't affect vulnerable populations."

What compensation sounds like (navigator-side compensations)

Compensation describes the labor disabled people in borrowing countries carry when development projects exclude them:

• "The new school was built with Bank money and it has no ramp. I asked the district education office and they said the design was approved. My daughter still can't get in."
• "The Bank-financed transport system has accessible buses, but the stops have no curb cuts. I still can't get to the bus."
• "I went to the consultation meeting for the infrastructure project and it was in a building I couldn't enter. I sent written comments by email and never heard back."
• "The social protection registry says I'm enrolled, but the payment office is on the second floor of a building with no lift. I have to ask someone to help me collect my payment every month."
• "I know there are disability provisions in the loan agreement because an NGO told me. But when I assert my rights to the project office they say that's between the Bank and the government, not something I can act on directly."
• "The accessible format materials were promised in the project documents. They were never produced. I've given feedback three times and nothing changed."

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All observations occur within the context of World Bank Group development lending to low- and middle-income countries, with particular focus on IDA-eligible countries in sub-Saharan Africa, South Asia, and Latin America.

Footnotes

1. World Bank. "Environmental and Social Framework." worldbank.org. https://www.worldbank.org/en/projects-operations/environmental-and-social-framework ↩ ↩²

2. World Bank. "Charlotte V. McClain-Nhlapo Appointed New Disability Advisor for the World Bank Group." Press release, October 27, 2014. https://www.worldbank.org/en/news/press-release/2014/10/27/charlotte-v-mcclain-nhlapo-appointed-new-disability-advisor-for-the-world-bank-group ↩ ↩²

3. World Bank. "Disability Inclusion and Accountability Framework." Washington, DC, 2018 (updated 2022). https://documents.worldbank.org/en/publication/documents-reports/documentdetail/437451528442789278/disability-inclusion-and-accountability-framework ↩

4. World Bank. "Disability." worldbank.org. https://www.worldbank.org/en/topic/disability ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

5. Bank Information Center. "Why is the 2022 Global Disability Summit important for the World Bank?" bankinformationcenter.org. https://bankinformationcenter.org/en-us/update/the-world-banks-2018-global-disability-summit-commitments/ ↩ ↩²

6. Loewenson, Rene. "Structural Adjustment and Health Policy in Africa." International Journal of Health Services 23, no. 4 (1993): 717--730. https://journals.sagepub.com/doi/10.2190/WBQL-B4JP-K1PP-J7Y3 ↩

7. World Health Organization and World Bank. World Report on Disability. Geneva: WHO, 2011. https://www.who.int/publications/i/item/9789241564182 ↩ ↩²

8. Russell, Marta. "Disablement, Oppression, and the Political Economy." Journal of Disability Policy Studies 12, no. 2 (2001): 87--95. https://journals.sagepub.com/doi/10.1177/104420730101200205 ↩

9. Erevelles, Nirmala. Disability and Difference in Global Contexts: Enabling a Transformative Body Politic. New York: Palgrave Macmillan, 2011. ↩

10. Meekosha, Helen. "Decolonising Disability: Thinking and Acting Globally." Disability and Society 26, no. 6 (2011): 667--682. https://www.tandfonline.com/doi/abs/10.1080/09687599.2011.602860 ↩

11. Chataika, Tsitsi, and Dan Goodley, eds. The Routledge Handbook of Postcolonial Disability Studies. London: Routledge, 2024. https://www.routledge.com/The-Routledge-Handbook-of-Postcolonial-Disability-Studies/Chataika-Goodley/p/book/9781032316499 ↩

12. International Disability Alliance. "Global Disability Summit." Accessed April 18, 2026. https://www.internationaldisabilityalliance.org/content/global-disability-summit ↩

13. Mitra, Sophie et al. "Extra Costs of Living with a Disability: A Review and Agenda for Research." Disability and Health Journal 10, no. 4 (2017): 475--484. https://www.sciencedirect.com/science/article/pii/S193665741730078X ↩

14. World Bank Accountability Mechanism. "How to file a complaint." Accessed April 18, 2026. https://accountability.worldbank.org/en/file-complaint ↩