GENEVA – 12 NOVEMBER 2015 – HIV-related stigma and discrimination in health care are prevalent and undermine access to services and the quality of health care delivery for people living with HIV and other key populations, thus undermining efforts towards achieving the highest attainable standard of health. Building on the UNAIDS 2016-2021 Strategy and the upcoming Global Strategy on Human Resources for Health: Workforce 2030, UNAIDS in collaboration with the Global Health Workforce Alliance (GHWA) have concluded a two day meeting (10 – 11 November 2015,) which mobilized key constituencies to discuss the way forward towards the elimination of discrimination in healthcare settings, using the lessons learnt from the HIV response as an entry point.
There are many manifestations of discrimination in health care, including denial of health care and unjust barriers in service provision; inferior quality of care; disrespect, abuse, and other forms of mistreatment; third party authorization requirements for accessing services; mandatory testing and treatment; and compulsory detention because of HIV or other health status. People are being discriminated on a daily basis because of their race, sexual orientation, their gender identity and expression.
The 2030 Agenda for Sustainable Development calls to break the silos in advancing development goals and urges an integrated perspective to ensure that the root causes of inequalities are identified and addressed. The attainment of health-related sustainable development goals (SDGs), including the target of ending the epidemics of HIV, TB, and malaria, is underpinned by the imperative to address discrimination and inequalities.
An extensive, global consultation on HRH has just been completed and the results are currently being translated into an updated draft of WHO’s Global Strategy on Human Resources for Health: Workforce 2030. Like the UNAIDS 90/90/90 Strategy, Workforce 2030 identifies health-workforce related efforts required to realize the ambitious agenda set by the SDGs, particularly as relating to UHC and equity. It calls for a paradigm shift in how we plan, educate, deploy, and reward health workers. This in turn has important linkages to arriving at the goal of zero discrimination in healthcare settings; including how best to integrate human rights and ethics training/supervision to ensure the sustained change in behavior.
The meeting promoted a strategic, outcome-focused dialogue among government representatives, health care professional associations and providers, UN partners, development agencies, community and civil society representatives, and other actors, concluded with a clear call for more coordinated actions and for a set of commitments on behalf of most participants. UNAIDS and GHWA will use the next 100 days until the Zero Discrimination Day (March 21) to consult and develop an action plan to steer the work towards ending discrimination in healthcare settings. Some of the priorities for this action include high level political advocacy in positioning zero discrimination on global agenda, strengthening accountability mechanisms; sharing existing evidence and best practices and building an evidence base for scale-up as well as ensuring the implementation and operationalization of actions at regional, national, subnational and facility levels.
Quotes from the meeting:
The UNAIDS Strategy makes a clear call to eliminate discrimination in health care settings that is an important barrier to achieving the end of AIDS. At this meeting, hand in hand with governments and civil society actors, community representatives, and health workers professional associations, we have committed scale-up actions to eliminate discrimination in health care and to advance human rights and better health for all. – Luiz Loures, UNAIDS Deputy Executive Director
Getting to the goal of zero discrimination in healthcare settings is linked to the development of institutions and systems able to provide just, people-centred, health services. At its core this requires access to appropriately trained, well supported health workers with a minimum core set of competencies. Getting to the goal of zero discrimination in healthcare settings is linked to the development of institutions and systems able to provide just, people-centred, health services. At its core this requires access to appropriately trained, well supported health workers with a minimum core set of competencies. – Jim Campbell, Executive Director Global Health Workforce Alliance / Director, Health Workforce Department, WHO
Respecting the rights of and ensuring social justice for people living with HIV and those most vulnerable is our individual and collective obligation and not an option. For us to achieve an AIDS free generation, we must stop discrimination against PLHIV and address the stigma associated with AIDS. 90-90-90 targets and fast track will not be achieved otherwise. – H.E. Dr. Somia Idris Osman Mohammed, Member of Parliament, State Minister of Health of Sudan
Health is our right, and yet health care settings are places where our rights are frequently violated, because of stigma, poor knowledge, ineffective systems that perpetuate discrimination. Transgender community faces multiple facets of discrimination because of who we are, how we express ourselves, whom we love or our health status. The meaningful collaboration amongst communities, healthcare providers and stakeholders is urgently required and communities need to be at the helm and heart of efforts to eliminate discrimination in health care in order for them to succeed. I can’t tell you how happy we are that finally our concerns are addressed in the framework of human rights. We are looking forward to the commitment of healthcare providers, governments, UN agencies and all stakeholders to the implement the action plans on eliminating stigma and discrimination in healthcare settings at all levels. – Natt Kraipett, Network Coordinator, Asia and Pacific Transgender Network,